A Landmark in Fetal Medicine: Father Muller Medical College Hospital Achieves Successful In Utero Rescue in Non-Immune Hydrops Fetalis
Mangalore: Father Muller Medical College Hospital, Mangalore, has once again set a benchmark in high-risk obstetric care and advanced fetal therapy with the successful in utero treatment of a fetus diagnosed with Non-Immune Hydrops Fetalis (NIHF)—a condition historically associated with high perinatal mortality.
Left to right: Dr. Praveen Nayak K, Pediatrician and Neonatologist; Dr. Prathima Prabhu – OBGyn/High-Risk Pregnancy & Fetal Medicine Specialist; Dr. Muralidhar G.K. – Senior Consultant Radiologist, Fetal Medicine & Intervention; Dr. Mandeep Sagar & Dr. Lenon D’Souza – Interventional Radiologists
Seated: Mother and Child
NIHF is a life-threatening fetal condition characterized by abnormal fluid accumulation in at least two fetal compartments, including:
- Skin (edema)
- Pleural cavity (pleural effusion)
- Pericardial cavity (pericardial effusion)
- Abdominal cavity (ascites)
Unlike immune hydrops, which arises from red cell alloimmunization (e.g., Rh incompatibility), NIHF has multiple non-immune causes such as fetal anemia, infections, cardiac defects, or chromosomal abnormalities. Prompt diagnosis and timely management are critical to survival.
A 24-week pregnant woman was referred to the High-Risk Pregnancy and Fetal Medicine Unit at Father Muller Medical College Hospital due to reduced fetal movements. Ultrasound evaluation revealed severe fetal anemia and hydrops, including scalp and abdominal wall edema.
Recognizing the critical nature of the situation, the multidisciplinary team opted for an emergency intrauterine transfusion (IUT)—a complex yet potentially life-saving intervention.
Precision in Procedure
Due to the anterior fetal position and a posterior placenta, the usual approach via placental cord insertion was not feasible. The team innovatively chose a direct fetal route, performing the transfusion via the fetal portal vein under real-time ultrasound guidance—a technically advanced and delicate procedure.
To ensure safety, fetal paralysis was induced to prevent movement during the intervention.
The multidisciplinary team included:
- Dr. Prathima Prabhu – High-Risk Pregnancy & Fetal Medicine Specialist
- Dr. Muralidhar G.K. – Senior Consultant, Fetal Medicine & Intervention
- Dr. Lenon D’Souza & Dr. Mandeep Sagar – Interventional Radiologists
Antenatal Journey and Positive Outcome
Post-transfusion, the pregnancy was closely monitored. Under the expert antenatal care led by Dr. Prathima Prabhu, the mother carried the pregnancy to term. She underwent a smooth vaginal delivery, giving birth to a healthy newborn.
Neonatal care was meticulously overseen by Dr. Praveen Nayak K, Consultant Pediatrician and Neonatologist, ensuring a stable and healthy postnatal course.
This case serves as a powerful example of how fetal anemia-induced NIHF, once considered a grim diagnosis, can have a favorable outcome through precise, timely, and expert intervention.
The success of this case reflects the unwavering commitment, skill, and collaborative excellence of the maternal-fetal care teams at Father Muller Medical College Hospital.
“This exceptional achievement demonstrates the dedication and expertise of our clinical teams. It reflects our mission to bring cutting-edge care to those most in need.”
— Rev. Fr. Faustine Lucas Lobo, Director, FMCI
“Our teams continue to push boundaries in maternal and fetal care. This case is a shining example of teamwork, precision, and compassion.”
— Fr. George Jeevan Sequeira, Administrator, FMMCH
“Academic excellence, research, and patient-centered care are the pillars of our institution. This case exemplifies all three.”
— Dr. Antony Sylvan D’Souza, Dean, FMMC
“The coordinated efforts of our obstetrics, radiology, and neonatology departments made this possible. It’s a proud moment for the hospital.”
— Dr. Udaykumar, Medical Superintendent, FMMCH
