With the strength of interdisciplinary collaboration and a closely monitored care and treatment plan, the University Medical and Pharmacy Hospital of Ho Chi Minh City (BV ĐHYD TPHCM) successfully saved both the mother and child of a mother with pulmonary arterial hypertension and severe heart failure.

Ms. K. was moved: “My husband and I were together for 6 years before we had a child. I then became seriously ill without knowing it. Fortunately, the doctors took great care, tried to save the baby and treated me to recover from the critical condition. I hope that women, before getting pregnant, should get thorough screening, so they don't end up in a dangerous situation like my mother and I.”

This is the case of the patient B.T.K. (37 years old, residing in Long An). At the 27th week of pregnancy, the patient was admitted to the Emergency Department of Ho Chi Minh City Hospital of Dermatology and Venereology in a condition of shortness of breath, leg edema, and reduced blood oxygen level. Previously, Ms. K. had been monitoring her health at a local hospital and no cardiovascular disease was detected. She experienced shortness of breath and leg swelling about two weeks before admission. This was her first pregnancy, and she and her family thought these symptoms were common in pregnancy, so they were complacent and did not seek medical attention until the condition worsened and they went to the hospital for examination.

With the seamless multidisciplinary collaboration of doctors, the pregnant woman responded well to treatment. After more than 30 days of active treatment, at the 31st week of pregnancy, the pregnant woman successfully underwent a cesarean delivery.

After the cesarean delivery, the patient continued treatment at the Cardiovascular Surgery Anesthesia and Intensive Care Unit, and complications of heart failure and kidney failure were effectively controlled. Ms. K. was transferred to the Cardiology Department for an additional week of monitoring and was discharged in stable health. The baby was cared for in the Neonatal Department for an additional 3 weeks before discharge.

Pregnant woman with severe prognosis, high risk of death

Prof. Dr. Bùi Thế Dũng – Head of the Cardiology Department, Ho Chi Minh City Hospital of Tropical Diseases said: “The echocardiogram results show that the pregnant woman has pulmonary arterial hypertension and severe heart failure. If not treated aggressively, there is a risk of dangerous complications leading to death. With such a severe condition, we might have to terminate the pregnancy to save the mother's life. However, at the request of the woman's family and the physicians, when the fetus was at week 27, we held a multidisciplinary consultation involving Cardiology, Obstetrics, Neonatology and the Cardiovascular Surgery Anesthesia and Intensive Care Unit to find the optimal solution for both mother and baby.”

After the consultation, the pregnant woman was transferred to the Cardiology Department for medical treatment of severe heart failure and pulmonary arterial hypertension. She was placed on oxygen therapy, given diuretics, medications to increase myocardial contractility, and pulmonary vasodilators. After a few days, she was transferred to the Cardiovascular Surgery Anesthesia and Intensive Care Unit, equipped with full facilities to monitor the condition of the mother and the fetus.

Prof. Dr. Trần Nhật Thăng – Head of Obstetrics Department, ĐHYD Hospital, Ho Chi Minh City, shared: “We plan to prolong the pregnancy to minimize the impacts of preterm birth on the baby's future health. The pregnant patient continues to receive medical treatment, pregnancy monitoring, and awaits a cesarean delivery. With this approach, doctors need to coordinate, closely monitor, always ready to perform an immediate cesarean when an emergency is triggered by the cardiovascular resuscitation doctors.”

More than 30 days for the miracle to appear

In the Cardiovascular Surgery Anesthesia and Intensive Care Unit, the severely progressing pregnant patient had to remain in bed. Doctors continued treatment via intravenous route, combining multiple specialized medications while monitoring the fetal condition daily.

Assoc. Prof. Dr. Tran Thi Thanh Thuy - Head of the Anesthesia and Cardiovascular Surgery Intensive Care Unit at Ho Chi Minh City Dermatology Hospital shares: “More than anyone, we understand the anxiety and desire of Ms. K to keep her baby. With that understanding, we monitor every fetal movement, her health indicators, and listen, encourage, and accompany her so that we can nurture the baby to grow more fully in the mother's womb until it can be born with the least risk possible.”

With seamless multidisciplinary coordination among the physicians, the mother responded well to treatment. After more than 30 days of active treatment, at the 31st week of pregnancy, the mother successfully delivered via cesarean section.

After a caesarean delivery, the mother continued treatment at the Cardiovascular Surgery Anesthesia and Intensive Care Unit, and complications of heart failure and renal failure were effectively controlled. Ms. K. was transferred to the Cardiology Department for an additional week of observation and discharged in stable health condition. The baby was cared for in the Neonatal Department for an additional 3 weeks before discharge.

To date, Ms. K. and the baby are both healthy. Currently, Ms. K. continues regular follow-up at the Cardiology Department of the Ho Chi Minh City University of Medicine and Pharmacy Hospital, receiving medical treatment along with a heart failure patient care program to improve symptoms and enhance quality of life. At the Ho Chi Minh City University of Medicine and Pharmacy Hospital, the strength of multidisciplinary collaboration helps save many cases of mothers with complex diseases. Additionally, the modern electronic medical record system facilitates storage, retrieval of information and eases coordination among specialties.

Ms. K. is moved: “We have been married for 6 years before having a child. I also got a serious illness without knowing. Fortunately the doctors took care of me attentively, tried to keep the baby and treated me to recover from the critical condition.”

Prof. Dr. Tran Nhat Thang advises that women of childbearing age need to have health check-ups before pregnancy and during the early months of gestation. In cases where underlying diseases are detected, the expectant mother should have a coordinated multidisciplinary plan from the beginning and throughout pregnancy to ensure safety for both mother and baby. As soon as any abnormal signs appear, the expectant mother should be examined, diagnosed and treated promptly for any conditions, avoiding severe progression as happened with Ms. K. recently.

To date, Ms. K. and the baby are both healthy. Currently, Ms. K. continues to have regular follow-up appointments at the Cardiology Department of Ho Chi Minh City University Medical Center, receiving medical treatment along with a heart failure patient care program to improve symptoms and enhance quality of life.

At Ho Chi Minh City University Medical Center, the strength of interdisciplinary collaboration helps save many cases of pregnant women with complex conditions. Additionally, the modern electronic medical record system stores and retrieves information, facilitating coordination among specialties.