The Balwant Singh Hospital administration yesterday said that a rare postpartum condition led to the death of Slellene Jagjit-Ragoobeer on Wednesday.
The hospital stated that the baby born to now deceased Jagjit-Ragoobeer is doing well and is currently under observation in the intensive care unit (ICU).
Obstetrician/Gynaecologist Dr Madhu Singh told Stabroek News that Jagjit-Ragoobeer went into heart failure on Wednesday morning after suffering from a condition which manifested postpartum known as HELLP. The HELLP syndrome is characterised by haemolysis, the breaking down of red blood cells, elevated liver enzymes and low platelet count. Dr Singh stated that the condition only presented postpartum and Jagjit-Ragoobeer did not suffer from preeclampsia prior to her caesarean section on Tuesday. She said “only 20 per cent of these patients have any evidence of preeclampsia and she didn’t have any evidence.”
Singh said that on May 18, Jagjit-Ragoobeer was admitted to hospital after she told doctors that a physician had advised her that she had high blood pressure. After admission and being monitored for two days “her pressure was perfectly normal,” the doctor said.
Dr Singh said that no antihypertensive medication was required while the patient was being monitored for the two days. She said it was not until an ultrasound and tests were done to check the baby’s heart rate that doctors discovered that the amniotic fluid was low and that the baby could be in distress. Doctors then decided that the patient would have a C-section and “there were no complications”, Singh stated calling it an “uneventful” C-section. After the delivery of the baby the patient was doing well, the doctor said, adding that HELLP presents within 48 hours and in Jagjit-Ragoobeer’s case that was what happened.
Singh said the baby was delivered at 11:00hrs on Tuesday and that evening around 20:30hrs the young woman’s pressure began to fall. She said that after treatment her “pressure came up, but then urine output became very, very less”. Singh noted that this was the flag which assisted doctors in diagnosing HELLP.
“The next morning when we did more tests and the blood pressure again started to fall… and we found HELLP syndrome,” Dr Singh further said.
Doctors noticed that the patient’s abdomen was swelling due to fluid build-up and took her to the operating theatre to drain the clear fluid after a small medical camera was used to assess her abdomen. However, Jagjit-Ragoobeer then began to bleed from her stomach. Singh said that once the bleeding began the young woman’s blood pressure fell again. “Because the liver fails and there is low platelets, these patients don’t clot; the blood doesn’t clot. She started bleeding from the stomach” and doctors were unable to stop it.
Singh said treatment was immediate, but because of a young mother’s fatty liver, her clotting agent was severely undermined and her bleed out from the stomach meant that her blood pressure could not be maintained. Treatment was given in the form of fresh frozen plasma, platelets and also a blood transfusion.
HELLP presents in less than one per cent of all pregnancies and only 30 per cent postpartum. Research has shown that with early detection deaths are also relatively rare.
Jagjit-Ragoobeer’s family say they are awaiting the results of the post-mortem examination, which is scheduled to be done today. Her father, Roopram Jagjit told Stabroek News he was awaiting the arrival of his new grandson.
“We are here to carry out my daughter’s wishes. This would have been her first baby and she had so many wishes and plans for him,” he said.
He said Balwant Singh hospital was his daughter’s primary care facility while she was pregnant and he was hoping that they would provide details of her medical state prior to her death and if all potential complications were addressed.
Jagjit-Ragoobeer was a systems development officer at the Region Five Regional Democratic Council. The 27-year-old first-time mother was said to be excited and in good spirits even laughing prior to the C-section on Monday.
