Gorilla emergency: OB/GYN rushes to perform life-saving c-section for gorilla with preeclampsia
Key Takeaways
An OB/GYN performed a successful cesarean section on a 33-year-old gorilla named Sekani at the Fort Worth Zoo.
Preeclampsia is a leading cause of both maternal and neonatal morbidity and mortality.
Experts say there is little difference in the anatomical structures of humans and gorillas, making this surgery possible.
On January 5, 2024, an OB/GYN performed a successful cesarean section on a 33-year-old gorilla named Sekani at the Fort Worth Zoo in Fort Worth, TX. The doctor, Jamie Walker Erwin, MD, is a Fort Worth native and Texas Health Care Obstetrics & Gynecology employee.[]
Sekani, who’d previously had three other offspring, was experiencing life-threatening complications due to preeclampsia, which can occur in both humans and primates, the Zoo says.[]
Preeclampsia is a leading cause of maternal and neonatal morbidity and mortality, marked by sudden-onset hypertension. Other symptoms include proteinuria, maternal organ dysfunction, or uteroplacental dysfunction. It can lead to increased risks of early death, stroke, diabetes, and cardiovascular disease. Infants born of a preeclamptic pregnancy also face risks, such as premature birth, neurodevelopmental disability, and other health conditions later in life.[]
Zookeepers say they noticed that Sekani was moving slowly and holding her head as if she had a headache, a common symptom of preeclampsia.[]
“Following testing to support a preeclampsia diagnosis, Zoo veterinarians knew intervention was necessary. Because of the diagnosis, along with the prematurity of the baby gorilla, Zoo staff and veterinarians consulted with a local obstetrician and neonatologist and agreed that an emergency cesarean would need to take place to save Sekani and give her unborn baby the best opportunity for survival,” the Zoo notes on its website.[][] This wasn’t the first time the Zoo worked with medical professionals for humans, particularly in cases regarding primates. In fact, the Fort Worth Zoo has a long-standing relationship with Dr. Erwin.[]
According to the Zoo’s website, Dr. Erwin worked with the Zoo’s veterinary team (along with neonatologist Robert Ursprung, MD; Dennis Occkiogrosso, CRNA; and others) to perform Sekani’s cesarean. Her birth marked the third gorilla birth in the Zoo’s 115-year history and the first to be performed via cesarean section, an experience the Zoo calls “historic and emotional.”[]
The baby gorilla, Jameela, was born four to six weeks early and required immediate care. Dr. Ursprung aided with “resuscitation and stabilization, respiratory support, radiographs, and serial examinations of the premature gorilla,” the Zoo says. After Jameela’s birth, Dr. Ursprung helped optimize temperature regulation and nutritional strategy on a volunteer basis, the Zoo says.[]
Jameela was provided around-the-clock care and feeding while her mother recovered. However, the mother and baby haven’t yet bonded. “Sekani never experienced the necessary hormonal cues that come during natural and full-term birth, therefore resulting in disinterest in the baby,” the Zoo’s experts postulate.[]
Alexander Juusela, MD, MPH, FACOG, an OB/GYN at Detroit Medical Center and Wayne State University and a 3rd-year Maternal-Fetal Medicine Fellow, says that while humans and gorillas split evolutionarily, the basic body structures remained conserved.
“The bicep muscle is still the bicep, the femur bone is still the femur. Thus, the structures remain in the same layout, just with different dimensions and orientations,” Dr. Juusela says. “Evolution led to differences in the shape and dimensions of bony pelvis, which affect the birthing process, but not to the anterior abdominal wall structures.”
He says that when performing a cesarean, the structures of a gorilla are layered in the same way as they would be in a human: skin, subcutaneous tissue, rectus sheath, and peritoneum.
“[Although they differ] in texture, density, and elasticity, the structures would be laid out, and the surgery performed, in a familiar fashion,” he says. On why the skills of a physician for humans could translate to the primate world, Dr. Juusela notes, “Our surgical training teaches us to be calm, adaptive, critical thinkers.”
Kecia Gaither, MD, MPH, MS, MBA, FACOG, Director of Perinatal Services/Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx, NY, says she thinks this collaboration between vet and human teams represents possibility. “I think, in certain instances, collaborations between veterinary medicine and obstetrical medicine would prove a beneficial alliance; clearly, it has shown itself to be true in this circumstance,” she says.