A TIMELY CUT
As an ‘absolute last resort’, a pregnant woman’s throat was sliced open by a doctor who had never before performed the life-saving procedure. The thankful mum and her baby boy survived and are now doing well.
The day after Darshi Wewalage’s 40th birthday, she lay unconscious on an Auckland operating table with her unborn baby boy trapped inside her. Both their hearts were minutes away from death.
“I remember there being a calmness in the room. We had to act quick or she and her baby would die,” Auckland District Health Board consultant anaesthetist Dr Jack Hill told the Herald.
It was July 4 and Wewalage — who was 29 weeks pregnant — had developed a rare and life-threatening pregnancy complication called HELLP (haemolysis, elevated liver enzymes, low platelet count) syndrome, affecting her ability to get oxygen to her and her baby’s lungs.
The Auckland banker’s condition worsened when doctors were unable to get a breathing tube through her mouth because of her swollen throat, Hill said.
Instead, close to 20 Auckland DHB staff — including surgeons, anaesthetists, junior doctors, nurses and orderlies — had fewer than five minutes to do a task none of them had ever performed.
“It was a team effort, everyone played their part,” Hill said.
Another anaesthetist had to cut across Wewalage’s throat and insert a breathing tube into her lungs.
It’s called an emergency surgical cricothyrotomy and is only used in life-threatening situations when the patient’s airway is blocked.
Hill, whose career spans more than 20 years, said it was a crisis procedure a doctor might only see “once in a lifetime, if that”.
“As an anaesthetist, you train for it but you never think you will actually have to do it. It was an absolute last resort and no one knew if it would work,” he said.
“But the patient would die otherwise so it had to be done.”
Wewalage’s husband, Rukshan Don Wijesinghe, and their 6-year-old daughter Hailey sat in the waiting room, anxiously awaiting their loved ones’ fate.
Wewalage had been admitted to Auckland City Hospital on July 1 with high blood pressure and a concerning heart rate. Four days later, she had just finished her birthday dinner at the hospital and said goodbye to her husband, who was returning to a pub where he works as head chef.
That’s when doctors felt Wewalage’s unborn baby was not moving.
Without being able to kiss her husband goodbye, Wewalage was rushed into surgery.
Hill said the crisis procedure they performed on Wewalage was so rare it only happens in 3.4 out of every 100,000 caesarean sections.
“It’s a task we can only practise on artificial models.”
We had to act quick or she and her baby would die. Consultant anaesthetist Dr Jack Hill
Within seconds of the anaesthetist inserting a tube into her neck, the beep of the heart monitor returned to a steady pace and the whole room let out a big sigh of relief, Hill said. “It was an incredible moment.” But the medical team was “not out of the woods yet”, Hill said.
The baby, who was not due until September 20, then had to be delivered by caesarean section. The infant was taken to the Neonatal Intensive Care Unit where he spent eight weeks.
Obstetrician and gynaecologist Sarah Corbett, who was not involved in Wewalage’s surgery, said she had never seen the crisis procedure done before.
“That’s really impressive they were able to pull it off and recognise she was getting into that state in time to make that decision,” Corbett said.
Wewalage went to the intensive care unit to recover.
“I didn’t get to see my baby for five days after he was born,” she told the Herald.
When the now mum-of-two finally got to look into her son Joel’s eyes, she said it was magic.
“I can’t describe it. He is so beautiful. Every morning he is the first one to wake and you always find him smiling. I am just so thankful to all the hospital staff involved. They were just so amazing.”
The baby is now at home, healthy and happy.
Wewalage’s husband Wijesinghe said he couldn’t imagine life without his wife and newborn son. “Words cannot describe it. Those doctors are gods and the nurses are angels.”