Malian nonuplets born in Morocco: an unprecedented challenge for caregivers
At the private clinic Aïn Borja in Casablanca in Morocco, a medical team of 30 people was mobilized on Tuesday, May 4 to give birth by cesarean section to the nine babies of Malian Halima Cissé.
© Aïn Borja Clinic
Text by: Amélie Tulet Follow
17 mins
From Timbuktu to Casablanca, via Bamako, several doctors have mobilized to give Halima Cissé and her babies every chance of survival.
This 26-year-old Malian gave birth to nonuplets on May 4.
A look back at a pregnancy and childbirth that are unique in the world to date.
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From our special correspondent in Casablanca,
On his cell phone, Dr. Yazid Mourad keeps the video of this morning of Tuesday, May 4, a cesarean that he will remember all his life.
An intervention to the sound of the voice of the Lebanese singer Elissa.
“
I always put on music when I operate.
The only thing that I regretted was not to have put on Malian music.
"
Feedback on a single childbirth
Amelia Tulet
That morning, the block is full.
Along with Dr Mourad, reinforcement to deal with the inevitable postpartum hemorrhage that awaits Halima Cissé with such a distended uterus.
And a team of 19 nursery nurses and three pediatricians who are preparing to welcome seven very premature babies for what is already shaping up to be an exceptional childbirth at 30 weeks of pregnancy.
► To read also: Meet the Malian nonuplets, three months after their birth in Morocco
Seven ... This is the estimate made in view of the various examinations during pregnancy.
But at the time of delivery, after releasing seven babies, the obstetrician-gynecologist discovers two additional newborns.
“
It was a shock.
"
Halima Cissé, a student from Timbuktu, therefore wore nonuplets: five girls, four boys.
When the Malian Ministry of Health in Bamako made the announcement the next day, it was therefore a world first.
Previously, the record was held by an American who had eight babies from in vitro fertilization.
Except that Halima Cissé and her husband, Abdelkader Arby, did not seek performance.
This multiple pregnancy, when they discover the extent of it during an ultrasound performed by Dr. Seydou Sogoba at the Tombouctou regional hospital, is a surprise.
No in vitro fertilization here.
Halima Cissé leaves her room in the maternity ward every day to visit her nonuplets in the neonatal intensive care unit.
“An incredible patient, calm and confident,” say all the caregivers who have accompanied her.
© RFI / Amélie Tulet
The couple already have a two-and-a-half-year-old daughter.
They want a second child.
“
When I was told that there are several babies, maybe six at least, it was totally unexpected,”
says Abdelkader Arby, in a tone that is always very measured.
With the doctors and the family, we organized the transfer to Bamako.
"
► To read also:
Malian nonuplets born in Morocco: from Timbuktu to Casablanca, story of a medical epic
Story of successful medical cooperation
Amelia Tulet
Halima Cissé is cared for by Prof. Tiounkani Thera and Dr. Drissa Diara at the maternity unit of the Point G University Hospital in the Malian capital. The Ministry of Health is alerted and immediately comes to see the situation. Very quickly, the medical team, the authorities, the family realized: to give Halima Cissé and her babies all their chances of survival, they had to leave the country. No establishment in Mali has the material means to accommodate so many very premature babies at the same time.
In Morocco, Prof. Alaoui, director of the private clinic Aïn Borja in Casablanca, which Prof. Thera had the opportunity to visit, is the first to respond positively to Halima Cissé's request for care.
At the end of March, she was six months pregnant when she arrived in Morocco at the expense of the Malian state, which has since fully covered the cost of hospitalization.
Dr Yazid Mourad: "
What I wanted was for it to last until the morning
"
In Casablanca, the clinic team is facing a challenge. If the birth comes too early, babies are at risk because they will be born too small. But to wait too long is to endanger the mother's life. The obstetrician-gynecologist, Dr Mourad, has set himself the goal of holding five weeks to reach 30 weeks of pregnancy. For this, it combines several drug protocols. "
The pressure on Dr Mourad was enormous, he handled this in an exemplary manner
," says pediatrician Dr Khalid Mseif.
The day before May 4, Dr Yazid Mourad knows that we must not wait any longer.
“
I was stressed all night at the idea of being called.
What I wanted was for her to last until morning.
On the morning of May 4, everything was ready in the block.
“
We had time to prepare, everything was there to meet the babies' first needs, the first complications,
” explains Dr. Mseif.
Dr Yazid Mourad is the obstetrician-gynecologist who performed the Caesarean section on May 4.
“It was shocking” he said to discover two additional babies weighing 500 g each while the medical team was preparing to welcome seven. © RFI / Amélie Tulet
On the video of that day, we see Dr. Mourad quickly take out tiny babies, one by one, immediately wrapped up and taken away by a caregiver. In thirty minutes, all the babies are massaged, resuscitated, oxygenated, under an infusion and in heated incubators in the neonatal intensive care unit. Then, “
it's stress, sometimes extreme stress
,
”
admits Dr. Mseif. For babies with weights ranging from 500 to 1,100 g at birth, “
it's day to day
” with sometimes very serious complications. "
There is one, I will always remember it,"
says the pediatrician.
Suddenly, his condition deteriorated, a complication in the lungs.
I was next.
It was necessary to intervene immediately.
Otherwise we would lose him.
"
They are babies who need a lot of care and tenderness.
A team of nurses take care of babies 24 hours a day from day one
Amelia Tulet
For us, the issue was that they would manage to live without sequelae.
Interview with Dr Khalid Mseif, pediatrician at the private clinic Aïn Borja, mobilized from day one to give these babies all their chances
Amelia Tulet
An acute tension that also tells the nurse major of the service who takes care of the nonuplets full time since the first day. “
Nine babies at the same time, with birth weights so low, it's difficult, critical. Now, thank God, it's okay, we're less stressed. Every three hours, we change them, we feed them and we monitor their temperature and blood pressure. They are stable. We're just waiting for Hawa.
»Little Hawa, feather-baby at birth, 500 g, still under oxygen three months later, with a probe to feed her so that she does not lose strength while breastfeeding. Her siblings now suckle their bottles on their own. An essential criterion to consider leaving the clinic. Almost all now exceed 2.5 kg. The "heaviest" weighs 3.6 kg.
"
We are very happy, very proud of what we have done, to bring these babies there, it is really a very good thing
", says moved, Dr Mseif.
“
For us, the challenge was to keep them alive, but above all that they live without after-effects.
And so far, all the neurological exams are good.
"Turning to the parents, he adds:"
Well done to you, and courage.
You're going to need some help, you're going to need some help.
"
Dr Khalid Mseif auscultates one of the nine babies of Halima Cissé and Abdelkader Arby.
"We are very proud to have brought our babies here, we are very happy" says the pediatrician.
© RFI / Amélie Tulet
How to explain such a pregnancy?
"
We lack perspective,
answers
Dr Mourad,
even my Moroccan colleagues asked me if this was true.
But if it is a thing to experience for a gynecologist, such pregnancies are undesirable from the point of view of the doctor, because they are dangerous for the mother and the babies.
It must remain extremely rare.
"
What will be the next step for nonuplets and their parents?
At least the first year, they will need to live near a health center able to monitor the development of babies.
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