Breaking News:High-Risk First-Trimester Emergency Managed Successfully at Medicover Hospitals– What Just Happened

In a rare and high-risk case, a team led by Dr. Rao Saheb Rathod, Consultant Gastroenterologist, Hepatologist & Therapeutic Endoscopist at Medicover Hospitals, successfully treated a 39-year-old woman who was 12 weeks pregnant and presented with severe abdominal pain, vomiting, jaundice, diarrhea, and fever.

Prompt evaluation and coordinated intervention helped safeguard both the mother and her unborn child during a critical stage of pregnancy.

Diagnosis: Life-Threatening Bile Duct Infection

Investigations revealed that the patient had developed choledocholithiasis with cholangitis—a serious infection caused by a gallbladder stone blocking the common bile duct. This obstruction led to obstructive jaundice and required immediate medical attention.

Notably, gallbladder stone disease occurs in approximately 1 in 1,200 pregnancies, and infection develops in nearly 5–10% of such cases. Because the patient was in her first trimester—a crucial period for fetal organ development—the medical team had to carefully balance urgent maternal treatment with fetal safety.

A Precious IVF Pregnancy at Risk

Mrs. Karuna Shah (name changed), a 39-year-old resident of Navi Mumbai, was pregnant for the first time through IVF, making the pregnancy emotionally significant for her and her family. Initially, she assumed her symptoms were related to minor pregnancy-related gastric issues. However, despite consulting a local doctor and taking basic medications, her condition deteriorated.

As her abdominal pain intensified and fever and weakness increased, her family grew deeply concerned about the safety of the unborn child. Consequently, they rushed her to Medicover Hospitals for specialized care. Given the high-risk IVF pregnancy, a multidisciplinary team immediately evaluated her condition to ensure comprehensive maternal and fetal monitoring.

Clinical Assessment and Immediate Stabilisation

Dr. Rao Saheb Rathod stated that when the patient arrived on January 2, she had severe abdominal pain, fever, and obstructive jaundice—conditions that can rapidly progress to life-threatening complications.

Blood tests revealed a significantly elevated white blood cell count of 21,000/microlitre, indicating active infection, along with deranged liver function tests. An ultrasound examination confirmed multiple gallbladder stones and a large stone lodged in a dilated common bile duct. Viral markers tested negative.

Based on these findings, the team diagnosed her with choledocholithiasis with cholangitis. They immediately initiated intravenous antibiotics and fluids. However, Dr. Rathod emphasized that cholangitis cannot be treated with medication alone; relieving the obstruction is essential. Therefore, the team planned an urgent ERCP (Endoscopic Retrograde Cholangiopancreatography) with stone extraction and stenting.

Near-Zero Radiation ERCP in the First Trimester

Performing ERCP during pregnancy presents significant challenges. Moreover, conducting the procedure during the first trimester requires exceptional caution because fetal organ formation is actively underway. Radiation exposure during this stage may increase the risk of congenital malformations such as microcephaly, eye abnormalities, and intellectual disabilities.

Typically, ERCP requires fluoroscopy (X-ray guidance). However, to minimize fetal exposure, the team modified the standard protocol. They used protective lead shielding and restricted imaging to a single, carefully controlled X-ray shot. This precision-based approach required advanced expertise and seamless coordination.

Within just 15 minutes, the team successfully removed six obstructing stones and placed a stent to ensure bile drainage. By intervening early, they prevented serious complications such as liver failure, sepsis, or pancreatitis.

Swift Recovery and Positive Follow-Up

As per the press release, the patient showed rapid improvement following the procedure. She was discharged on the third day after 48 hours of observation. At a seven-day follow-up, repeat blood tests and liver function tests returned completely normal results.

Doctors advised her to avoid a fat-rich diet and to report immediately if she experienced fever, abdominal pain, or jaundice again.

Hospital Leadership Highlights Advanced Capabilities

Sandip Joshi, Centre Head at Medicover Hospitals, Navi Mumbai, stated that the case underscores the strength of the hospital’s advanced endoscopy unit and multidisciplinary coordination. He noted that managing acute cholangitis in a first-trimester IVF pregnancy demands both clinical expertise and technological precision. He reaffirmed the hospital’s commitment to delivering safe, evidence-based, and patient-centered care, particularly in high-risk and emotionally sensitive cases.

Patient Expresses Gratitude

Reflecting on her experience, Mrs. Karuna Shah shared that she felt extremely frightened upon learning about the serious infection during her pregnancy. She described the baby as very precious to her family. However, she said the doctors carefully explained each step of the treatment and reassured her about the measures taken to protect her unborn child. She expressed deep gratitude to Dr. Rao Saheb Rathod and the entire medical team for their timely intervention and compassionate care.