Recently [July 12], a woman gave birth to septuplets at Georgetown University Hospital, here in Washington D.C.. After a risky pregnancy and delivery, mother and her babies are well. But the danger is not over.
All seven babies, five boys and two girls, were delivered by Caesarian section within a three-minute period. Dr. Helain Landy of Georgetown University Hospital, was the patient's attending obstetrician. Dr. Landy says she had to deliver the babies as quickly as possible in order to minimize the risk of blood loss, on the part of both the mother and the infants. "As we were cutting through the placentas, the babies were actually losing blood as we were trying to get to them," Ms. Landy said. "So, we made quite a large incision on the mother's abdomen as well as in the uterus, to be able to deliver each of the babies in a safe manner and a relatively quick fashion as well." Twenty-five doctors, nurses and other medical professionals assisted with the births. But, as Dr. Landy points out, the dangers involving a multiple pregnancy and delivery, are great. "Certainly delivering septuplets is a once in a lifetime situation, and as a high risk specialist, it truly is an incredible experience," Dr. Landy says. "In fact, this is really not the ideal situation, and in all, although it is sensational to have seven babies, this was a long, risky pregnancy for this patient."
Dr Landy says that her patient, referred to her in the 25th week of pregnancy, was running a high risk of developing gestational diabetes, the inability of the body to handle sugar due to pregnancy. According to the medical specialist, this type of diabetes increases as the pregnancy goes on, because it relates to the size of the placenta. The higher the number of placentas in the uterus the higher the risk of gestational diabetes. Also, says Dr. Landy, the chances of having high blood pressure, and pre-eclampsia, which is a rejection of the fetus by the mother's body, increase significantly in a multiple pregnancy. Another concern is anemia. "Anemia is always of concern because not only is the mother becoming anemic and has less blood volume and oxygen carrying blood to support her own organs," Dr.Landy says,"but there is lower blood to support the developing babies."
Towards the end of a multiple pregnancy, doctors perform frequent sonograms visual scanning of the fetuses in the uterus - to assess the fetal growth, and to make sure that the babies have no structural abnormalities.
Also, Dr. Landy says that as a multiple pregnancy progresses, the fetuses are competing for the supply of blood and the nutrients in the uterus. So, she points out, it is not uncommon for one or more babies to be smaller than average. "Assessing in this particular case the well-being of all seven babies, was extremely difficult," Dr. Landy says. "Because it is very hard to be sure that during a sonogram you are looking at the same baby each time. There is a lot of crowding; there is a lot of movement and interference from all other babies. So, it was difficult for us to say 'yes' all of them are growing appropriately."
Born at 28 and a half weeks, and weighing on average a little over a kilo each, the seven pre-term babies will spend the next two months at the neonatal intensive care unit of Georgetown University Hospital. But, Dr. Landy says their dependence on oxygen ventilators, intravenous feeding and catheters, can cause infections which could undermine their neurological development. Also, pre-maturity itself can lead to cerebral palsy, blindness, deafness and mental retardation. All these are complications that can manifest themselves, as the children grow older, says Helain Landy, the high-risk birth specialist. So, it is still too early to assess their chances.