THE moment Meenakshi and Hitesh Valand had been waiting for eight years, and a 20-member team at Pune’s Galaxy Hospital for 17-18 months, finally passed within minutes in the early hours of Thursday. At 12.12 am, after a 12-minute Cesarean section operation, India had its first baby born following a uterine transplant — a 1.4-kg girl who let out a robust cry at birth. Tears rolled down her cheeks as she heard that sound, said Meenakshi, 27. “It was like music to my ears.”
So it was for Dr Shailesh Puntambekar, the director of the hospital and a laparoscopic surgeon, too. “We did it,” he said. “Creating life out of a transplanted organ is the biggest medical feat we have achieved. Rest of the organs give life to a patient. We have created life out of a patient — yes, that is the biggest feeling I have.”
The first uterine transplant in the world was done in 2002. Since then, there have been 27 such transplants, with only 11 women going on to have successful deliveries. Meenakshi, a beautician from Bharuch in Gujarat, is now the 12th, points out in-vitro fertilisation specialist Dr Pankaj Kulkarni, who was part of the team monitoring Meenakshi. Nine of the other 11 babies were born in Sweden, and two in the US.
In Meenakshi’s case too, it was a roller-coaster ride. On May 18 and 19 last year, she along with Shivamma Chalgeri from Solapur in Maharashtra underwent the country’s first uterine transplants. In both cases, the women’s mothers donated their uterus. Shivamma was the first to receive embryo transfer, in January this year, but lost the child after two months of pregnancy.
In April this year, an embryo was transferred into Meenakshi’s womb and resulted in a pregnancy. She has spent the past five months now in Room No. 406 at Galaxy Hospital, under strict monitoring. In the middle, after she developed mild diabetes because of the immuno-suppressant drugs she was on, tests for liver and kidney functions were performed.
The maximum doctors wait before they carry out C-secs in uterine transplant cases is 34 weeks. While Meenakshi was in the 32nd week of pregnancy, the C-sec had been already scheduled for October 21 as she had pregnancy-induced hypertension plus the doctors did not want to take a chance with the transplanted uterus having last seen a pregnancy 25 years ago.
On Wednesday, after Meenakshi’s blood pressure shot up and her amniotic fluid declined sharply, they decided to do an operation immediately.
Dr Nita Varty, a Mumbai-based laparoscopic gynaecologist and also part of the uterine transplant programme, was summoned immediately, while a neonatal team headed by Dr Sandeep Kadam came in from Pune’s Ratna Memorial Hospital.
Dr Varty said the baby was in the breach position, with the head up and feet down.
“We were also worried as a transplanted uterus may not behave like a normal one. Fortunately, the uterine transplant was done laparoscopically (with minimum incision) and hence there were no adhesions inside. It was like a normal delivery,” she said.
Gynaecologist Dr Milind Telang said the rest of the process was also smooth. “The uterus was sutured in 26 minutes and the blood loss was barely 100 ml.”
Dr Kadam says the baby, which is underweight, had some respiratory distress but it was minimal and settled soon. “She is now being fed mother’s milk through a tube. It will take at least 10-12 days for the baby to stabilise on oral feeds.”
Recalling their long wait to hold their child in their arms, Hitesh, who runs a beauty salon, says Meenakshi had a scarred uterus (Asherman’s syndrome). “We lost two babies after full-term pregnancies, and my wife underwent another four abortions.”
The desire for a child took them to Surat, Vadodara, Viramgam and several other places, Hitesh says, “till we were directed to Pune”. As their daughter came into the world, waiting to welcome her along with Hitesh were Meenakshi’s parents Jayesh and Susheela and her brother Chirag.
Dr Puntambekar says the success with Meenakshi means the pain of women desperate for motherhood can be lessened. “What seemed an impossibility has been achieved. We as technology-givers are trying to bring cheer to their lives and making it happen.”
According to him, there are 600 applications with them for uterine transplants, of which they had shortlisted 12 and performed operations on six. The sound of the loud cry Wednesday midnight from a Pune delivery room would have reached them all.