Calicut, 20 June , 2023: Every day, our world witnesses countless miracles, but few are as inspiring as the story of ‘Baby D’ who was pulled from the brink of death by the incredible teamwork and expertise of the doctors at Aster MIMS Calicut.
Baby D was born with a complex congenital tumor in the neck called Cervical Teratoma which was made all the more difficult due to its large size as compared to the baby.
It was picked up late (30th week ) in pregnancy during a routine ultrasound scan. At that time, it was estimated to be a 150-gram tumor which was compressing vital structures in the neck, including the trachea, esophagus, nerves and the major blood vessels to the brain. The sheer size and position of the tumour meant that baby would literally be unable to draw in a breath at the time of birth; and if deprived of oxygen in the first three minutes after birth it would be fatal.
The parents, a young couple from Kerala settled in Bangalore, had sought help from several hospitals in vain. When they finally approached Aster MIMS, Calicut, a multidisciplinary team of doctors at MIMS analyzed all possible eventualities and arrived at a clear modus operandi.
After a detailed counseling of parents, the team held a dry run with all equipment and personnel, the day before surgery, rehearsing each and every step of the procedure so that maximum efficiency could be ensured in the minimum possible time frame.
The immediate onus was on ensuring a patent and functional airway at birth. The best option decided upon is called EXIT (Extra Uterine Intrapartum Treatment). Here, the baby is delivered partly from the uterus but leaving the placenta and umbilical cord uncut, thereby ensuring circulation from the mother to continue for a few very vital minutes! The baby will therefore continue to receive oxygen through the placenta, allowing time for the team to secure an airway. During the EXIT procedure, despite the tumor size and location, the airway team was able to maneuver the breathing tube into the trachea, ensuring oxygen delivery. Once airway was ensured, the delivery completed, baby stabilized and transferred to the Neonatal intensive care unit.
The next major step was the delicate and precise surgery of excising the tumour while preserving the vital blood vessels to and from the brain, nerves, trachea, and the esophagus.
"This was an extremely complex and challenging case, but our team was fully committed to saving this precious life. It was a true test of our expertise and our ability to work together as a team. This case is a testament to the high standards of medical care at Aster MIMS Calicut,” said Dr. Abraham Mammen, Senior Consultant & HOD - Paediatric Surgery, CMS, and Head - Quality Assurance Department.
The complex procedure was achieved by a team of about 20 people, including neonatologists, pediatric surgeons, anesthesiologists, and skilled nursing care.
Dr. Abraham Mammen, Dr. Roshan Snehith and Dr. Binesh A from Pediatric Surgery, Dr. Preetha Remesh, Dr. Vishnumohan and Dr. Anand from Neonatology , Dr. Kishore Kl, HOD Anesthesiology, Dr. Nazer T, HOD Obstetrics & Gynaecology and Dr. Sindu P.C, Consultant - Obstetrics & Gynaecology led the procedure, supported by Dr. Sajith Babu head and neck surgeon and Dr. Anoop M P from pulmonology.
Baby is now a thriving 2 month old infant and is on a regular follow up.
This heartwarming story is a reminder of the incredible impact that medical professionals can have on the lives of their patients, and the sheer impact teamwork and skill has on saving lives.
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