A team of doctors carried out multiple interventions on a baby while he was in his mother’s womb, and after he was delivered, to remove a lump of mass that had grown inside his thoracic cavity and was causing cardiac failure. The four-cm growth had occupied more than half of the baby’s peach-sized thoracic cavity, thus pushing the lungs and heart to one side.
“The patient was in her 27th week of pregnancy when she came to us in December 2018. The condition of her baby was extremely bad and we would have lost him in a day or two without any interventions,” Dr. Vandana Bansal, director of the foetal medicine department of Surya Hospital, Santacruz, said.
The baby was diagnosed with a rare condition called pulmonary sequestration, which involves an unwanted growth of segmental lung tissue. Due to this, there was a lot of fluid accumulation in the baby.
“We first decided to aspirate the liquid to ensure that the baby can be delivered in a better condition so that the neonatologists get some time and scope for interventions. We went through the womb and reached the baby’s thigh to administer the anesthesia,” Dr. Bansal said.
Nearly 90 ml of fluid was removed. However, there was more fluid accumulation in the next 24 hours. So instead of more in-utero interventions, the team of medical experts decided to deliver the baby preterm on December 2, 2018. “Before delivery, we aspirated more fluid in-utero,” Dr. Bansal said.
While babies born at 28 weeks of gestation have a survival rate of nearly 90%, in this case, the doctors were unsure about the condition the baby would be born in. “The baby had no cry after birth. We had to put a breathing tube and required high-frequency ventilation to manage him,” neonatologist Dr. Hari Balasubramanian said, adding the baby was born weighing 1.675 gram of which nearly 675 gram was the fluid accumulation.
On the eighth day after birth, the baby was taken in for a surgery to remove the unwanted growth. “The mass had taken up part of the blood supply. As we removed it, the baby’s ventilation improved as the lungs expanded considerably,” paediatric surgeon Dr. Jui Mandke said.
Six months after the surgery, the baby is now healthy and his brain, heart, and other organs have developed normally. Doctors said in the medical literature, they could find only about 32 odd such cases, and preterm babies are even rarer.
