The team at Fortis Memorial Research Institute (FMRI), Gurugram, in a statement, termed it as a medically challenging and rare surgery.
As per the available medical literature and published papers, there are very few cases worldwide and first in India of successful pregnancy completion of a mother being simultaneously treated for Hodgkin’s Lymphoma. In most of such similar cases, either the foetus does not survive or the baby passes away after birth. The patient had completed three cycles of chemotherapy when she delivered her healthy baby, the hospital said.
The patient Sofia was presented at Fortis carrying 20 weeks of pregnancy with persistent high-grade fever.
Initially ,she was given tubercular medications but after some time, her condition deteriorated as her platelets started falling which required immediate platelet and blood transfusion. Post hospitalisation at FMRI, her platelets and hemoglobin levels kept falling further with as low as 6,000 platelets and hemoglobin levels of 6-7 gm/dl.
Considering she was 5 months pregnant, and in deteriorating health, doctors did a bone marrow biopsy, which turned out to be negative for any malignant cells.
She developed progressive breathlessness at rest and amniotic fluid of the baby decreased gradually to almost nil. Further scans showed multiple lymph nodes not only in the chest but in the abdomen as well.
After repeated biopsy reports confirmed Hodgkin’s Lymphoma, the patient was immediately introduced to chemotherapy.
“The most challenging part of this case was the baby’s survival with almost negligible amniotic fluid for many days while we were waiting for the final diagnosis of the disease. Due to low platelets, we could not think of any other procedure. Luckily, the moment chemotherapy was started, amniotic fluid improved, and the baby started growing,” said Dr Deepti Asthana, Senior Consultant, Gynaecology, in the statement.
“We were closely monitoring the health of the baby and post the initial sessions, the positive response of chemotherapy was seen in the form of better blood counts and relief from breathlessness,” she added.
After the completion of 34 weeks, there was blood flow compromise noted in the umbilical artery, hence the decision to deliver the baby was taken. She delivered a healthy 1.5 kg baby requiring no respiratory support and is doing well, the doctor said.
Hodgkin’s Lymphoma is a cancer of the lymphatic system, which is part of the immune system which helps fight infections and other diseases. In it, cells in the lymphatic system grow abnormally and may spread beyond it. When cells in the lymphatic system grow abnormally, that can lead to disruption in the functionality of the body along with the development of lymph nodes in different body parts.