Dr. Nguyễn Thị Sim (left) performing a fetal intervention. — Photo vov.vn

Since the 2010s, fetal medicine has developed and gained many achievements.

However, in Việt Nam, accessing information as well as learning the techniques of fetal intervention was still difficult.

At that time, many cases that came to the hospital for prenatal diagnosis were already in serious condition so fetuses that had anomalies but could not be kept or faced serious defects.

Witnessing the suffering of mothers and their families, Sim and her colleagues had a great desire to apply fetus intervention techniques in Việt Nam.

“At that time, no obstetric facilities in Việt Nam had fetal intervention centres. Many families had to accept stillbirth or a baby with permanent defects," Sim told vov.vn.

In 2018, the Hà Nội People's Committee had international co-operation with the management agency of public hospitals of Paris, France, and Sim was the first and only doctor selected to study in France on fetal intervention and baby disease treatment from the womb.

Along with human resource training, Hà Nội Obstetrics and Gynecology Hospital was also fully prepared with European standard sterile operating rooms and equipment such as positive pressure air filtration to deploy fetal intervention techniques in Việt Nam, Sim said.

The first cases of fetal intervention were done by a French professor. Since then, successful interventions have brought healthy babies into the world, she said.

"All cases of fetal intervention have been successful, the babies were revived," said Sim.

Recalling the success of the first fetal interventions, the doctor said that the first case was a teacher with twins fetuses that were discovered to have blood transfusion syndrome.

The mother was terribly shocked and afraid of losing her children because at that time this syndrome could not be cured in Việt Nam and the family could not afford to go abroad for treatment, the doctor said.

Fortunately, these first cases of fetal intervention were provided through a national project, so all funding was free.

The mother and her family were very happy.

“During the intervention, the mother only needed local anesthetia and was always awake. She was hearing everything the doctor said,” Sim said.

The surgery was successful and after one to two days in the hospital, the two fetuses were in good condition.

By the time they were born, the two babies were totally healthy. After that, the mother took the children to see the doctor and said that both of them were Sim's children.

“Until now, the doctors and nurses still keep in touch with the family and are regularly updated with developmental milestones of the children from crawling, talking and walking,” Sim said.

The efforts of the whole team and the proper investment of the hospital have reaped valuable rewards.

The number of babies saved in the womb increased year by year from one baby, then 10 babies, 100 babies to thousands of babies.

For doctors, this confirms that Việt Nam’s medical capabilities are approaching a world-class level .

Sim said that at present, the centre had received foreign patients from Japan, Singapore and Mongolia to get the intervention.

Mother Sim

For Dr. Sim, every baby that comes to her is a blessing.

The couples are in different circumstances and moods. Some women have had many miscarriages, some have been infertile for a long time, or some are shocked because they suddenly discovered abnormalities with their babies.

Each person has a different story.

“Whenever a baby is born, parents let him or her call me a mother because I accompany the pregnant women and their families for a long time. So I myself have always considered the babies as my own,” the doctor said.

Now, Sim's fanpage is filled with images of little angels born in the overwhelming happiness of many couples, which seemed impossible before.

After the success of the first intervention cases, by early 2022, the Centre for Prenatal and Neonatal Screening and Diagnosis was established and Dr. Sim was assigned as the deputy director.

So far, the centre has performed hundred of fetal intervention cases.

Fetal intervention is a very deep field of obstetrics.

Fetal intervention doctors have to solve many problems of pregnant women and fetuses such as treating diseases for pregnant women and fetuses, performing techniques such as ultrasound and prenatal diagnosis, providing treatment and implementing fetal interventions, and giving advice for high-risk pregnancies as well as diet and medicine for mothers.

Fetal interventions need co-operation and consultations among experts in genetics, paediatrics, diagnostic imaging and pathology to provide patients the right treatment.

According to the doctor, the fetal intervention includes using drugs to treat mothers to save babies from metabolic diseases, applying external techniques of obstetrics support to help the mother overcome complications, and finally, intervening directly to the fetuses.

Previously, a diagnosis would be carried out with amniotic fluid for a 17- week or older fetus. But now it is possible to perform a biopsy of the placenta at 10-14 weeks and can make genetic diagnosis for the fetuses as well.

This technique brings many benefits for detecting diseases early. If the fetuses have no possibility of intervention or severe malformations, it is possible to terminate the pregnancy early avoiding complications due to late intervention.

Dr. Sim herself experienced two pregnancies with many difficulties and obstetric complications, so her sympathy with her patients is great.

“There are women at 32-34 weeks that find out that the fetuses have defects with serious genetic diseases that can not live when born. But at that time, if the pregnancy was stopped, the risk of complications for the mothers would be great. Knowing a child's prognosis is not good but still having to maintain pregnancy every day is really painful," Sim said.

The current concept of obstetrics has changed.

In the past, fetuses with only a few grams or 1kg could not be nourished. But now, the fetus is taken care of from the womb.

After the intervention, mothers and fetuses continue to be counselled and cared for to mature. Until birth, babies will continue to be cared for by the neonatologist in the most timely and best way for the babies, according to the doctor. — VNS