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2 critical minutes decide success of rare heart surgery on Singaporean mother's fetus by HCMC doctors

By Le Phuong   May 30, 2025 | 03:00 pm PT
Vietnamese doctors made critical decisions to successfully save a Singaporean woman's fetus suffering from a rare heart defect, including a breathless two-minute procedure that marked the turning point in a complex intervention.

Dr. Do Nguyen Tin from HCMC Children's Hospital 1 vividly remembers the procedure that he conducted jointly with colleagues from the city's top obstetrics hospital Tu Du on May 28.

The specialized needle had just pierced the unborn baby's heart in the mother's womb when the fetal heart rate started dropping dangerously low. Tin momentarily paused, concerned about imminent cardiac arrest.

"Should we continue or stop?" He recounted his quick discussion with Dr. Trinh Nhut Thu Huong, Head of Prenatal Care at Tu Du Hospital, and other doctors.

At this moment, the fetus was in a rare favorable position. Removing the needle would allow the fetal heart rate to recover, but re-positioning the baby later would be nearly impossible. To achieve this ideal positioning, the medical team had already made painstaking repositioning efforts, with more than two hours spent gently maneuvering the fetus and infusing amniotic fluid before the optimal alignment was achieved.

"We must act now, hesitation will cost us this chance," Dr. Huong urged.

A tense silence filled the room. The doctors knew that failing to dilate the aortic valve this time would likely mean losing the baby due to hypoplastic left heart syndrome.

As the fetal heart rate slowed under pressure, Dr. Tin moved swiftly, inserting the needle through the uterus directly into the fetus's heart. Unusually, no blood flowed back through the needle, indicating a critical situation. Immediately, Tin threaded a guidewire, placed a balloon precisely at the narrowed aortic valve, and inflated it to dilate the valve. The entire team watched closely, holding their breaths.

From the needle insertion to removal took just 2 minutes and 40 seconds, the fastest intervention the team had ever performed under such intense pressure. Following the procedure, the doctors quickly resuscitated the fetus, administering adrenaline into its thigh. Remarkably, after a single injection, the fetal heart rate recovered fully to 141 beats per minute.

The medical team embraced in relief. Ultrasound images showed blood flow restored through the aortic valve immediately following the intervention, prompting tears of joy from the expectant parents.

Y bác sĩ ôm chầm nhau khi can thiệp tim thành công cho bà bầu Singapore
 
 

2 critical minutes decide success of rare heart surgery on Singaporean mother's fetus by HCMC doctors

Doctors from Tu Du and HCMC Children's Hospital No. 1 embrace each other after successfully performing a heart intervention on a Singapore mother's fetus on May 28, 2025. Video courtesy of doctors

The Singaporean couple, both 41, had traveled to Ho Chi Minh City and stayed for nearly a month for the procedure. Pregnant with her first child thanks to IVF, after over a decade of infertility treatments, the mother had been closely monitored at major Singaporean hospitals like KK Women’s and Children’s Hospital and Singapore General Hospital.

Severe cardiac issues were detected by week 21, prompting doctors in Singapore to reach out to Dr. Tin for Vietnam's advanced fetal heart intervention technique.

"This was the most challenging of the nine cases we've treated so far," said Dr. Do Thi Cam Giang from Children's Hospital 1. The fetus weighed only 600 grams, and the narrowing of its aortic valve was severe.

Vietnamese doctors held multiple remote consultations with top specialists from Australia and Italy, all agreeing early intervention was essential. The risks were high, but the parents were determined, expressing willingness to accept potential outcomes, even fetal loss.

Các y bác sĩ tập trung cao độ nhìn vào màn hình trong cuộc can thiệp ngày 28/5. Ảnh: Bệnh viện cung cấp

Doctors from Tu Du and HCMC Children's Hospital No. 1 perform a heart intervention on a Singapore mother's fetus on May 28, 2025. Photo courtesy of doctors

The first intervention on May 22 was abandoned due to issues with the fetus positioning, yet the mother's resolve remained unwavering.

The second procedure required carefully rotating the fetus approximately 120 degrees, an action with significant risks, including fetal heart stoppage due to umbilical cord entanglement. Doctors had to gently maneuver the fetus until finally, the position was ideal.

Though successful, this heart intervention procedure marks only the first step. Post-birth, the child will require additional interventions in Singapore to fully address the congenital heart defect.

Dr. Tin attributed the success partly to their cautious approach during the first attempt. "If we had pushed aggressively earlier, we might have lost the baby. Careful reconsideration allowed for better preparation and precision," he said.

This marks the ninth fetal heart intervention performed in Vietnam, and the first case involving a foreign patient. Tang Chi Thuong, Director of Ho Chi Minh City’s Department of Health, highlighted that referrals from leading Singaporean hospitals underscore international confidence in Vietnam’s capabilities in advanced fetal medicine.

 
 
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