By Janet Tappin Coelho
Brazilian doctors have become the first in the world to keep a brain dead pregnant woman alive on life support for 123 days – the longest period in medical history – before delivering twins successfully by emergency caesarean section.
The boy and girl were born at seven months in February this year and discharged from hospital at the end of May.
Their father, Muriel Padilha, 24, spoke this week of how his wife, Frankielen da Silva Zampoli Padilha, 21, died during pregnancy in October last year after suffering a stroke.
He told how doctors took the ground-breaking decision to save the nine-week-old embryos after their little hearts continued to beat in their mother’s womb as they battled against the odds to stay alive.
The bereft husband, who was heartbroken by the loss his wife but overjoyed with the birth of Asaph and Anna Vitoria, described his children’s birth as a miracle.
The babies’ fight for life reduced doctors at the Nosso Senhora do Rocio hospital in Campo Largo, south Brazil, to tears as they provided unprecedented levels of care that included decorating the space around Frankielen’s bed with her pictures; taking turns to sing to the unborn babies as they caressed her belly and talking to the growing foetuses in an amazing bid to substitute the absent mother’s love with huge doses of tender loving care.
The unique case involved many complications stabilised only through the continuous intervention of medications to prevent the young mum’s body from shutting down.
After the ventilator was switched off in February, her heart and kidneys were donated to save the lives of two others.
Muriel, who has a two-year-old daughter, Isa Beatriz, with his deceased wife recalled: “I was on my way to work last October when Frankielen called begging me to come back home urgently.
“She said her head was killing her. I told her to take a tablet. But she said there was a sharp pain at the back of her neck and it was so strong she felt she was going to collapse.”
Muriel, an agriculture farmer, rushed to his home in Contenda, to find his wife shaking, crying, dizzy and vomiting from the pain.
“As I drove her to hospital, she said ‘I want you to be prepared to accept this because I will be staying there, I won’t be coming home.’
Then she passed out and those were the last words she spoke to me and the last time I saw her alive,” said the devastated dad.
Doctors diagnosed Frankielen with a cerebral haemorrhage – a vein had burst inside her head and she arrived at the hospital with severe bleeding on the brain.
After three days conducting a battery of tests and scans, physicians declared the young mum brain dead and warned Muriel there was no hope for the twins.
The distraught husband said: “They told me they would give the babies three more days of life because they had given my wife multiple CT scans, sedated her with powerful drugs and pumped her full of antibiotics and this meant everything had ended up in our babies.
“They said as soon as their little hearts stopped beating, they would turn off the gadgets and I would be able to bury my wife.”
Only the babies’ hearts didn’t stop.
Dr Dalton Rivabem, head of Neurological ICU, who was responsible for the case revealed: “We did an ultrasound on the embryos thinking they would be failing in the womb but to our surprise they were clinging to life.
“Frankielen’s organs were all intact and working as if she was still with us. We took the decision to keep her alive to save her unborn children. And every day we watched them grow normally.”
As it was unknown territory for the medical team, Dr Rivabem sought help from a physician in Portugal who had handled a similar case where a foetus gestated for 107-day before being born.
“There have been other cases, but ours is the longest one with 123 days – four months, and we started with embryos at two months and delivered twins,” said Dr Rivabem, adding the exchange of information with his Portuguese counterpart was ‘very helpful’.
He continued: “It was an extremely challenging case which required intensive multidisciplinary work.
“There were many complications with continuous support of medications to maintain pressure, maintain oxygenation, maintain continuous nutrition and hormonal balance. We used antibiotics during the entire hospitalisation period.”
Medical treatment was based on 24-hour hemodynamic monitoring, measuring blood pressure in the veins, heart and arteries, along with blood flow and the amount of oxygen coursing through the body. The twins were checked by ultrasound every day.
Dr Rivabem explained: “One of our main concerns was to keep the organ functions continual for the babies to grow and develop.”
The other concern was to find ways to ensure the infants felt the love and affection their mother could not give.
Muriel and his family visited every day and over 20 professionals were involved in the caring for the patient and her babies.
On the ward, doctors, nurses, nutritionists, physiotherapists and a raft of health professionals developed a remarkable routine of singing, talking and caressing Frankielen’s pregnant belly.
Chaplain and music therapist, Erika Checan, said: “We found children’s songs and played them to the babies in the womb. We even made up tunes exclusively for them.
“And we decorated the area around Frankielen’s bed. The ICU was filled with love, affection and encouragement for the babies and their family to succeed. We said, ‘we love you’ every day they were here.”
Dr Rivabem added: “The success of this case was down to great teamwork and, of course, to a divine purpose.”
He admitted, everyone, including himself, cried when the babies were born.
Scores of well-wishers across Brazil, touched by the family’s plight, raised thousands of pounds in support, with many donating baby clothes, nappies and accessories for the little ones.
Muriel is using some of the funds to renovate the family home to house his expanded brood.
Ana Vitoria was born weighing 1.4 kg with her brother, Asaph tipping the scales at 1.3 kg. Their health was compatible to that of premature babies of the same age.
The newborns were kept in incubators for three months to avoid the risk of infection, to build up their strength, help them gain weight and to wean them off the medication administered to their mum during their gestation.
The pair are now being looked after by Frankielen’s mother, Angela Silva, while Muriel works to keep bread on the table.
Angela said: “I’m so proud of my daughter. It’s been hard losing her but she was a warrior right until the end, protecting her beautiful children and giving them life until the day she finally died.”
Cradling his youngsters at home with his eldest daughter, Muriel revealed he has had visions of his wife, his teenage sweetheart of six years.
He said: “Frankielen has appeared to me on many occasions especially when I was despairing and crying out for God to bring her back to me.
“One night she sat on my bed and said: ‘Baby I can’t come back to you anymore. I must stay. I am in a beautiful place now.
‘You’ve got a big mission still to complete. You have to look after our children and you have to be strong and move on and live your life.”
Muriel added: “Frankielen was a generous and loving person. I believe God chose her for this purpose so a miracle could happen.”