What started as a routine exam for a 30-year-old pregnant Filipina ended with a diagnosis of Covid-19, three hospital transfers, the discovery of heart failure, emergency surgery and the birth of a child. ‘a baby named in honor of the Cleveland Clinic Abu Dhabi, an integral part of Mubadala Health.
Michelle Baldemor was pregnant with her second child when she started having a dry cough and difficulty breathing that turned into a high fever. During a routine visit to the doctor to monitor her pregnancy, she tested positive for Covid-19. Fearing that she might suffer complications from her 26-week pregnancy, her doctor referred her to a local maternity hospital for observation.
Her condition continued to deteriorate and her oxygen requirements continued to increase, requiring her to be placed on a mechanical ventilator to support her lungs. In addition to severe Covid-19 pneumonia, his chest x-ray revealed an enlarged heart.
Michelle was transferred to another hospital in the area – the second in just 24 hours – for further management and assessment. There, an echocardiogram revealed that she was suffering from heart failure due to a severe tightening of her mitral valve. Blood and fluid were building up in his lungs and the right side of his heart was failing, preventing his lungs from getting enough oxygen to his blood, which was made even more serious by his Covid-19 pneumonia. A decision was made to transfer her to the Cleveland Clinic Abu Dhabi.
“When Michelle arrived at the Cleveland Clinic Abu Dhabi, she was in critical condition. Our team worked on her through the night to stabilize her and remove as much fluid build-up in her body as possible and stabilize her blood pressure and its oxygen levels. ”said Dr. Vivek Kakar, director of critical heart care at the Cleveland Clinic Abu Dhabi.
“We had a surgical team from a nearby maternity hospital on standby in case we had an emergency delivery. Luckily, we have it stable enough that it wasn’t necessary at this point.”
Since traditional surgery was not an option, the team decided to attempt to open his heart valve using a balloon. They hoped it would stabilize her condition and allow her to carry her baby to term before having surgery to repair or completely replace the valve.
“If Michelle had not been pregnant she would have been scheduled for heart surgery right away. It was not possible to do the surgery without putting the baby in danger and we know that operating on Covid-19 patients In the first 4-6 weeks leads As a result, we looked at other options for opening the valve and decided that using a percutaneously placed balloon was the only one available to us if we needed to protect it at the both her and the baby, ”said Dr. Kakar.
Realizing that this was a high-risk operation, Michelle’s healthcare team gathered in the operating room to try to open her heart valve. They were joined by a surgical team from a local maternity hospital who were ready to perform an emergency cesarean to deliver the baby if her condition worsened.
Doctors advanced the balloon into a vein in Michelle’s leg, a minimally invasive approach dictated by her condition. The balloon was then used to open the sealed mitral valve. However, once in place, doctors discovered that Michelle was now suffering from mitral valve regurgitation, causing blood to flow back into her valve. It was decided that an emergency delivery was now the only way to protect Michelle and her baby.
Birth of a miracle baby
Caleb Angelo Cleveland Baldemor was born at just 27 weeks old.
As he was the first baby to be born in the hospital since it opened in 2015, he was placed on a ventilator to support his breathing and transferred to the NICU at a local maternity hospital.
After the birth, Michelle still had severe Covid-19 pneumonia to treat, but with continued efforts her condition improved significantly and she was able to continue her recovery at the Cleveland Clinic Abu Dhabi.
“The problem with heart failure and pregnancy is that pregnancy makes heart failure worse by causing more fluid retention. The delivery of the baby definitely helped the mother’s condition. After the birth, we were able to focus the treatment on the Covid pneumonia, and as her condition improved, we were able to remove the ventilator for her while her baby continued to be well too, ”added Dr. Kakar. .
“To see mother and baby doing so well after such an ordeal is extremely rewarding and very, very special.”
After recovering from Covid, Michelle focused on rebuilding her strength and caring for her newborn son. Michelle recently underwent successful surgery to replace her mitral valve at the Cleveland Clinic Abu Dhabi. She was discharged within two weeks of her operation and continues to do well.
“I really feel that I have been given a second life. If I had not tested positive for Covid, who knows if I would have discovered my heart until it was too late,” said Michelle.
“We named my son Caleb which means courageous because he has faced so much before. His middle name is Cleveland to commemorate all the team did to support us both when he came into the world.”