Shila A., 20

Shila is a 20-year-old woman living with her stepmother in a mud house in a rural village. Following the death of her biological mother, she was raised by her stepmother while her two siblings went to live with other relatives. The family survives through subsistence farming, which provides little income and is often insufficient to meet their basic needs. Shila completed Form Four but was unable to pursue further education because of financial constraints. She remains active in church, drawing strength and hope from her faith. As a first-time mother, Shila noticed missed menstrual periods, persistent fatigue, nausea, and loss of appetite. Her stepmother encouraged her to seek medical care, where pregnancy was confirmed. After informing the baby's father, he abandoned her and ceased all communication. Despite the emotional distress, Shila accepted the pregnancy and attended regular antenatal clinics. Later in pregnancy, she developed severe weakness, dizziness, headaches, easy fatigability, and shortness of breath. Evaluation revealed severe anemia requiring blood transfusion. However, before the transfusion could be administered, she went into labor and required urgent obstetric management to safeguard both her life and that of her baby.

Shila presented with severe anemia in late pregnancy, placing both her and her unborn baby at high risk of life-threatening complications. The onset of labor before the planned blood transfusion made her management particularly challenging and required urgent multidisciplinary obstetric care. Following appropriate delivery, blood transfusion, and supportive treatment, her condition improved. With adequate iron supplementation, nutritional support, regular postnatal follow-up, and monitoring in future pregnancies, her prognosis is favorable, although subsequent pregnancies should be managed as high risk. The prognosis is fair to good