Malian nonuplets born in Morocco: from Timbuktu to Casablanca, the story of a medical epic
At the private clinic Aïn Borja in Casablanca in Morocco, a medical team of 30 people was mobilized on Tuesday, May 4, 2021 to give birth by cesarean section to the 9 babies of Malian Halima Cissé.
© Aïn Borja Clinic
Text by: Amélie Tulet
13 mins
After this extraordinary childbirth Tuesday, May 4 in Morocco, the mother and the babies "
are doing well
", according to the gynecologist-obstetrician of the private clinic Aïn Borja.
The mother, Halima Cissé, had been evacuated at the end of March from Mali.
Nine babies born alive from the same pregnancy, a first made possible by the mobilization of several doctors from Timbuktu to Casablanca via Bamako who did everything to give the mother and the babies all their chances of survival.
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The story begins in Timbuktu, in northern Mali.
Halima Cissé, a secretarial student, and her husband, Abdelkader Arby, an accountant in the army, want a second child.
They are already parents to a two-year-old girl.
The months go by, the wait seems long to them.
Dr Seydou Sogoba, head of the gynecology department at the Timbuktu regional hospital who had followed the couple's first pregnancy, offers them therapeutic support by induction of injectable hormones.
When the new pregnancy begins, Dr. Seydou Sogoba performs an ultrasound and then counts, to her surprise, seven embryos.
“I was like '
ah there's something I don't understand
'.
I called a radiologist colleague.
We did the ultrasound again together.
He said to me
"ah my dear colleague what you saw, that's it
".
We then explained the situation to Ms. Halima Cissé.
She said "this is amazing!"
and she laughed.
"
She was confident, she never worried.
Dr Seydou Sogoba, head of the gynecology department of the Tombouctou regional hospital
Amelia Tulet
Seven embryos spotted, but Dr Sogoba knows there may be more.
The quality of the device used for ultrasounds at the Timbuktu Regional Hospital is limited and in such cases of multiple pregnancies it is very difficult to distinguish with certainty all the embryos.
Dr Sogoba, aware of the risk of spontaneous termination of the pregnancy, decides to proceed with a strapping at the thirteenth week and even if he describes Halima Cissé as a patient
"smiling, confident and serene",
he knows that it is a high risk pregnancy.
By mutual agreement, it was decided with the future parents to favor discretion and not to publicize this extraordinary medical situation before knowing the outcome.
First transfer: from Timbuktu to Bamako
Weeks go by.
The embryos continue to develop normally.
Dr Sogoba contacted his “master” as he called him, Prof. Tiounkani Thera, head of the maternity department at the Point G University Hospital Center in Bamako.
The two doctors agree that for the follow-up of Mrs. Cissé, the capacities of the CHU of the Malian capital are more adapted.
Dr Sogoba offers the family a transfer to Bamako.
The funds are gathered.
We are in March.
Halima Cissé is in her fifth month of pregnancy.
She is flying for the first time in her life, accompanied by Dr Sogoba.
► To read
also: The case of a pregnant woman with septuplets puts Mali in turmoil
Once in Bamako, she was taken care of in Prof. Thera's service, who alerted the Ministry of Health and asked her colleague, Dr. Drissa Diarra, an obstetrician-gynecologist, to monitor the patient.
“Halima
(he calls her by her first name)
was in her 23rd week, she was fine, she only suffered from anemia and had a blood transfusion for it. "
Quickly, the situation is reassessed by the medical team.
“We had to weigh the risk to the mother as well as to the fetuses,”
explains Dr. Diarra
.
The uterus of Halima Cissé, which receives nine fetuses without her knowing it at that time, is so large that the risk of postpartum hemorrhage is high.
The diaphragm is increasingly compressed, threatening to cause respiratory distress.
In addition, for her first child, Halima Cissé has already undergone a cesarean section, the uterine scar is fragile.
The Bamako University Hospital medical team also knows that in the event of an imminent birth, the Point G technical platform is not adequate to take care of premature babies born so small and so early.
An evacuation to Morocco decided between doctors
Prof. Thera is active in his contacts in several countries.
It is in Morocco that the response will be the fastest.
The director of the Aïn Borja clinic in Casablanca, whom he has already visited, confirms that he can take care of Halima Cissé and the future newborns.
The Malian Ministry of Health is informed and on the instructions of the president of the transition Bah N'Daw, the evacuation by plane is organized.
As Halima Cissé's husband cannot leave his post upon departure, it is decided that he will join his wife later.
It is therefore Dr. Diarra who accompanies Halima Cissé with the latter's sister-in-law.
Dr. Drissa Diarra says:
“She grabbed my hand as it took off.
Psychologically, she was holding up well.
The only thing I was worried about was that the stress of the trip would trigger something on the plane.
I was preparing for this accordingly.
I tried to reassure Halima so that she would forget the risk.
Upon arrival at the airport, the clinic ambulance was ready.
We asked to visit the technical platform, it reassured us.
I thought "
we will win
."
"
She was reassured during the flight, I chatted with her, I asked her if she had any symptoms ...
Dr Drissa Diarra, obstetrician-gynecologist
Amelia Tulet
On March 30, Halima Cissé was therefore taken care of at the Aïn Borja private clinic in Casablanca by the obstetrician gynecologist Dr Yazid Mourad.
The contractions come back regularly.
A therapeutic protocol is put in place to save time.
Five weeks pass, under close surveillance.
Dr Sogoba from Timbuktu, just like Dr Diarra from Bamako, say they have been in daily contact with their patient and their Moroccan colleague.
Nine newborns while we were expecting seven
Monday, May 3, new risk assessment for children and for the mother. Tuesday morning, a cesarean is decided. Father Abdelkadir, who remained in Timbuktu, warns Dr Sogoba, the first to have detected the multiple pregnancy. Back in Bamako, Dr Diarra after speaking with his Moroccan counterpart speaks to Halima Cissé,
“I reassured her, I told her that everything would be fine. “
At midday, Dr. Yazid Mourad says he extracted quickly and without difficulty first seven babies weighing between 700 grams and one kilogram each. He then seeks to remove the remaining placenta and discovers two small heads, two additional babies, also alive, of 500 gr, which had not been seen on the ultrasound.
They are all new, we must avoid infection.
Pediatricians come every day, morning, afternoon and evening.
We can not predict how it will evolve, for the moment even pediatricians are surprised: those of 500 grams are fine.
We hope it will continue.
Doctor Mourad Yazid
Amelia Tulet
►
To read also: Morocco: a Malian gives birth to nine babies, a world first
Five girls and four very young boys who are
"doing well"
according to Dr Yazid Mourad as well as their mother, Halima Cissé, who herself spent 24 hours in intensive care after a hemorrhage during the delivery.
The obstetrician gynecologist recalls that in such circumstances, "
no one can predict the outcome, it is day to day".
Newborns are under close surveillance, followed by a team of three pediatricians.
The greatest risk is infection or internal bleeding as their organs are so fragile.
The father, Abdelkader Arby, still in Timbuktu, "while
awaiting the authorizations which must be issued by the Moroccan authorities to make the trip"
said he was "
confident and calm
".
He talks every day with his wife.
As for their little girl of two years and five months,
"I haven't told her anything yet, she will realize when she sees with her own eyes her little brothers and sisters, God willing."
His condition is improving day by day.
She is tired but it's okay.
The babies are doing very well, in an incubator, they are stable.
Abdelkader Arby, father of nine babies
Amelia Tulet
From a medical point of view, this is unprecedented.
For Dr Yazid Mourad of the Moroccan clinic Aïn Borja,
"we are going to learn a lot of things".
►
To read also: Malian nonuplets born in Morocco: on the third day, "the babies and the mother are doing well"
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