In August 2022, Shruti Gupta and her husband, Nitish Saraf, were eagerly anticipating the birth of their second child. At 38 weeks pregnant, Shruti began experiencing contractions and a small amount of bleeding, prompting the couple to head to Memorial Hermann Memorial City Medical Center, where they planned to deliver. Not long after, a cervical exam revealed she was in the early stages of labor. Shruti, who had previously given birth to their first child at the same location in 2018, was admitted for monitoring overnight and told that her baby would likely be born the next day.
The next morning, her Ob/Gyn, Sharon McCloskey, MD, broke her water at 6 a.m. to prepare for the delivery. Shruti received an epidural for pain management from anesthesiologist Donald Tallackson, MD. Everything seemed routine, and Nitish stepped out briefly to grab something to eat.
But at around 8:50 a.m., Shruti began to feel uneasy and dizzy. She pushed the call button to let the nurse know, and Lindsey Ann, RN, responded immediately. Within that same minute, Shruti lost consciousness.
The medical team at Memorial Hermann Memorial City sprang into action, rushing to deliver medical care. Still unconscious, Shruti exhibited something called abnormal posturing, which is characterized by an involuntary, rigid body position and is a sign of a serious medical emergency. She was rushed to an operating room and within minutes, her baby boy was born by emergency cesarean section. Despite their quick action, he had a low Apgar score, which is a quick test performed on a newborn to assess their health by checking heart rate, respiration, muscle tone, reflex response, and skin color. The delivery team administered immediate intervention, including breathing support, and his score quickly improved.
"Dr. McCloskey was right across the hall, and the anesthesiologist, Dr. Tallackson, was also on the floor—they were able to jump into action immediately," Nitish recalled. "It was a very quick response, and Dr. McCloskey's quick thinking made all the difference. By 8:55, Shruti had coded, and by 9:02, they had already delivered the baby. There were nearly 50 people in and out of the OR caring for them."
Advanced Care When It Matters Most
While their baby boy was transported to the NICU for around-the-clock monitoring and care, Shruti's condition was critical. She needed to be intubated, as her heart had stopped beating properly. The medical team performed chest compressions for 16 full minutes, with nurses taking turns to keep her alive and maintain oxygen flow to her brain. All the while, no one yet knew why she had suddenly lost consciousness.
Eventually, return of spontaneous circulation was achieved, but she continued to face significant challenges. An ultrasound revealed no blood clots, but Shruti was bleeding from both her surgical incision and IV sites, and her blood counts showed low hemoglobin and platelets. A massive transfusion protocol was initiated, providing multiple blood products, including packed red blood cells, fresh frozen plasma, and platelets, to stabilize her over the next two days.
Shruti remained on a ventilator and was closely monitored in the ICU.
“I vividly remember one of the ICU nurses, Amanda, didn't sit for a second during her entire 12-hour shift. She was literally taking care of Shruti the whole time—checking lines, putting in data. It was incredible to see that level of dedication,” Nitish said.
At that time, Shruti’s doctors could not predict what her recovery would look like—she had been without proper circulation for more than 16 minutes, which posed risks of neurological or organ damage.
"Her brain was in a state of 'low-power sleep mode,' and the uncertainty weighed heavily on all of us, including her doctors,” Nitish recalled. “Would she wake up? Would she be able to walk or talk again? Nobody knew.”
When Shruti finally regained consciousness, she recognized her loved ones, but her short-term memory was severely impacted. Over the next week, she gradually regained more of her memory, and her physical recovery progressed well—her kidneys, liver, and heart were functioning normally. Their baby remained in the NICU for nearly a week, needing support for jaundice and other minor issues after being born in a distressed state, but otherwise he, too, made an impressive recovery.
"Shruti experienced a life-threatening event that required immediate and aggressive treatment," said Labor and Delivery Clinical Nurse Manager Morgan Smit, BSN, RN, who was there that day and helped provide treatment to Shruti. "Her story is a testament to the rapid response and the specialized care available at our facility."
A Rare and Serious Diagnosis
Ultimately, Shruti’s physicians determined that she had experienced an amniotic fluid embolism (AFE). An AFE occurs when amniotic fluid, fetal cells, or other debris enter a mother's bloodstream, causing a severe reaction that can lead to heart failure, respiratory issues, and severe bleeding. It is an extremely rare condition, occurring in approximately 1 in 40,000 births, but it can be life-threatening, with a high risk of complications. Due to its sudden onset and unpredictable nature, AFE requires specialized care, rapid intervention, and a highly coordinated medical team to improve the chances of survival.
"The fact that Shruti survived was incredible," Nitish said. "Most of the staff had never seen a case like this before—many had only read about it. It took full multidisciplinary care, with an entire team from different departments collaborating and making Shruti's case a high priority."
Nitish noted that the care Shruti received in the ICU was especially crucial in her survival and recovery, including advanced care by critical care physicians Kolawole Omodayo Atandeyi, MD, and Kathryn Balinger, MD.
He admitted that he doesn’t like to imagine what might have happened to Shruti and their family if they hadn’t chosen to deliver at Memorial Hermann Memorial City Medical Center.
"Had we been in a smaller facility without the resources here, the outcome might have been very different," Nitish said. "The quality of CPR, the quick response, and the specialized care all played a huge role in ensuring that Shruti didn't suffer lasting damage.”
"In cases of amniotic fluid embolism, every second counts," added Dr. McCloskey. “Our top priority is always the safety and well-being of both mom and baby. That is why we have put numerous mechanisms in place to ensure our patients receive the very best care. We have in-house Ob/Gyn and neonatology coverage and dedicated OB anesthesia in preparation for any possibility, just in case. The Rapid Response team played a very important role in Shruti's resuscitation, and the ICU team took excellent care of her, which was crucial for her survival."
Recovery and Gratitude
This past August, Shruti and Nitish celebrated their son's second birthday, reflecting on how far they have come since that terrifying day.
"We're doing well now," said Nitish. "One of the long-term things we've been concerned about is whether there would be any lasting impacts on Shruti's health or our son's health. Even though he got out of the NICU pretty quickly, there was still a period where he wasn't breathing right after he was born, and we are always on the lookout for any potential complications as a result of that."
Nitish explained that they continue to monitor their son's progress closely, watching his development and major milestones, like sitting up, crawling, walking, and speaking.
“He’s been doing really well and mostly ahead of schedule,” Nitish said. “His speech is still developing, but overall he's healthy and thriving, and just a great kid.”
For Shruti, the journey to recovery was filled with both physical and mental challenges, but today, she’s healthy and thankful.
"It took a while for her to recover," Nitish noted. "There was so much trauma, but by six months out, she was almost 99% recovered physically, though she still had some blood pressure issues. We weren't sure if it was related, but it's been something we've watched."
During the first few months, Shruti also experienced minor forgetfulness, something that worried her family.
"Her memory has been strong overall, which was a big relief," said Nitish. "We had a big fear about that."
Although Shruti has no memory of her time in the hospital before and after losing consciousness, she has been told every detail from that day, and she feels immense gratitude toward everyone who helped save her life.
“Had there been any delay after I called the nurse, I may not be here today,” Shruti said. “We are here today and who we are today because of them.”
At some point during the recovery, Nitish asked the team how long they would have continued to perform CPR in an effort to save Shruti.
"They said it would've taken a long, long time for them to give up,” Nitish said. “That kind of commitment—it shows. Nobody can look at Shruti today and know that something like this happened. She functions normally today because of the incredible care we received."
Nitish and Shruti have even taken their son back to the hospital to meet the team who saved both of their lives.
"We wanted everyone to see what they did for us,” Shruti said. “The staff is like family to us now. We wanted our son to celebrate his 1st birthday with them, and they were all there, from the doctors to the pharmacy team. It was amazing to see everyone again, and it meant so much to us to show them that we were okay because of what they did. There was not a dry eye in that room that day.”