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India: Woman unconscious for seven months gives birth in Delhi

The 23-year-old Delhi brain-injured patient was 40 days pregnant when she was first admitted

A 23-year-old woman lying unconscious for seven months in AIIMS trauma centre after sustaining multiple head surgeries in a road accident, delivered a healthy baby girl last week.

Neurosurgeon Dr Deepak Gupta said, "A 23-year-old young woman came to AIIMS trauma centre on April 1, 2022 at 4.30am after sustaining a severe head injury the previous night when she was travelling with her husband on a two-wheeler (in Bulandshahar, UP). Both husband and wife were not wearing helmets at the time of the accident. The husband did not sustain any head injury while the wife sustained a very severe head injury, she fell down as she was sitting sideways and was without a helmet."

"She was initially treated at Abdullah Hospital, Bulandshar and later referred to AIIMS trauma centre. She was married six weeks back and was 40 days pregnant at the time of the accident (pregnancy test was positive). She was unconscious on arrival and had evidence of severe brain injury with acute subdural hematoma inside her brain. She was immediately put on ventilator support and taken up for emergency surgery (decompressive craniectomy, where part of her skull bone was removed to decrease pressure inside her swollen, damaged brain). She underwent a total of five neurosurgical operations in the last seven months during hospitalization," he added.

At present, the woman is still unconscious and breathing on her own.

"Presently, she is still unconscious, breathing on her own, not on any ventilatory support, and opens her eyes spontaneously and occasionally nods to painful stimuli. She stands a 10-15 per cent chance of regaining consciousness in the next couple of years with continued rehabilitation support," said Dr Gupta.

After a lot of discussions, the family decided to continue the pregnancy, as the woman was pregnant at the time of admission.

"A lot of discussions were held in her first and second trimesters of pregnancy on whether we should terminate her pregnancy or continue the pregnancy as the mother was still unconscious. As no congenital anomalies were noted in the fetus with serial level two ultrasound examinations, the medical team suggested the option to continue the pregnancy to the family. The decision to terminate the pregnancy in view of the mother's condition was left to the family. The family decided to continue the pregnancy subsequently," said Dr Gupta.

"She was brought to AIIMS by her family when they noticed some activity suggestive of impending labour pains in her. She gave birth to a healthy girl child weighing 2.5 kg at AIIMS trauma centre on October 22 by normal route ( no cesarean section). The delivery was conducted by a team from the Department of Obstetrics and Gynecology at AIIMS, Delhi," he added.

Urging people to use helmets, the AIIMS neurologist said, "Helmets reduce the risk of death and head injury by 50-60 per cent. With helmets, in-hospital deaths are reduced by 16 per cent, cervical spine injuries are lesser and facial injuries are also lesser by 12-60 per cent."

He further said, "In India, of the 1,50,000 deaths each year from head injury, 25 per cent of deaths result from two-wheeler road traffic accidents. In a study that was earlier conducted at the trauma centre in AIIMS, two times higher deaths were noted in non-helmeted riders (women) compared to helmeted riders."

"It is to be noted that in road traffic accidents, head injuries can happen to anyone irrespective of age, sex, or religion. Most head injuries are preventable. The present case highlights the importance of wearing helmets for pillion rider women in India. All women irrespective of religion must wear helmets to prevent such accidents."

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