The medical team at Father Muller Medical College achieved a major milestone by successfully performing a rare autologous amniotic patch infusion using the advanced AmnioSeal procedure. The case involved a 40-year-old woman with a complicated triplet pregnancy. During a routine anomaly scan referred by the Department of Obstetrics and Gynaecology, doctors discovered a dichorionic triamniotic pregnancy—with one monochorionic pair sharing the same placenta.
Premature Membrane Rupture Raises Critical Concerns
The following day, the patient presented with a premature rupture of membranes (PV leak) in one of the monochorionic sacs. Although she was initially managed conservatively, the leak persisted, causing the amniotic fluid level to drop to dangerously low levels. Recognizing the urgent threat of pregnancy loss, the fetal medicine team proposed an innovative solution—an autologous amniotic patch infusion aimed at sealing the leak and minimizing immunogenic response.
Innovative Regenerative Procedure Carried Out
As reported by TOI, the advanced regenerative intervention involved harvesting the patient’s own platelets through apheresis, a process that separates blood components. The medical team then infused a carefully prepared combination of autologous platelets and cryoprecipitate directly into the affected amniotic sac. The fetal medicine team, led by Dr Muralidhar G.K, Dr Ram Shenoy, and Dr Prathima Prabhu, executed this pioneering intra-amniotic therapy with precision in collaboration with the obstetrics team comprising Dr Sujaya V Rao and Dr Joylene D’Almeida.
Navigating Complex Risks and Challenges
The procedure posed several critical challenges. The severely reduced amniotic fluid made sac entry extremely difficult. There was a high risk of injuring fetal parts or the umbilical cord. Additionally, fetal bradycardia during extended intrauterine handling added to the complexity. Additionally, co-twin movements and the presence of three amniotic sacs significantly increased procedural risk. Despite these difficulties, the team navigated the complications with expert coordination and technical finesse.
Positive Post-Procedure Outcome
After the procedure, the patient responded favourably. The team restored amniotic fluid levels, detected no signs of infection, and observed stable fetal vitals. Continuous monitoring confirms sustained fetal well-being.
A Breakthrough in Regenerative Fetal Therapy
“This case marks a major advancement in regenerative fetal therapy,” said Dr Ram Shenoy, Professor and Head of the Department of Radiology. “Performing such a targeted intervention in a triplet pregnancy is extremely rare, and to date, no similar studies have been found.”
Future Implications
This successful procedure demonstrates the potential of autologous amniotic patch infusion to prevent preterm birth and associated complications in high-risk pregnancies. The patient remains under close observation as her pregnancy progresses.