Rohit Shishodia
A team of Paediatric Surgeons at Motherhood Hospitals, Pune, have given a new lease of life to a 1-day-old baby girl by removing fluid filled cysts being formed in her left lung cavity (a kind of congenital defect) and later performing a lung lobectomy (surgery to remove one of the lobes of the lung).

After the surgery, the baby can breathe freely. She is now at her home and doing well.

Dr Rajeshwari Pawar, Gynaecologist -Obstetrician, Motherhood Hospital, said, “The foetus was diagnosed to have a type 1 Congenital Cystic Adenomatoid Malformation (CCAM). This is a developmental defect where there is a benign lung lesion that appears before birth as a cyst or mass in the chest.”

“It is also known as Congenital Pulmonary Airway Malformation (CPAM). The macro cyst present on the left side of the segment of the lung affected the lung tissue, pressed the heart vessels and shifted the heart from its normal position, thereby occupying a lot of space in the chest,” she said.

The doctors said that this type of CCAM happens 2 to 3 in one lakh live births. If left untreated, it would have compromised the growth of the underlying healthy lungs which would have become unusable.

The doctors pointed out that heart compression could have invited foetal heart failure. Therefore, a decision was taken to operate upon the baby immediately after birth and the couple was referred to Dr Pranav Jadhav, Paediatric Surgeon, for further counselling.

According to the Motherland Hospital, at the 6th month of pregnancy i.e 24th week old fetus, the sonographic weight estimate of the fetus at this time was 964 gms. A decision was taken by the fetal medicine consultant Dr Rajeshwari Pawar to aspirate the fluid from cyst by a fine needle through a sonographic guided procedure after anaesthetising the fetus with an intramuscular injection in the fetal thigh muscle, so that she (fetus) doesn’t move.

“It was a delicate procedure which posed high risk to the life of the baby. The procedure was successful and was done thrice and substantial fluid from cyst was removed. But the cyst recurred, and then Shalini was continuously monitored from 6th to 9th month of pregnancy, every week by Dr Pranav and me," said Dr Pawar.

Dr Tushar Parikh, Chief Neonatologist at Motherhood Hospital, Kharadi, Pune, said “A multidisciplinary counselling was given to her and after that a baby girl Ruchika, weighing 2.5 kg, was successfully delivered on December 13, 2019. The baby was shifted to the NICU as she encountered difficulty in breathing and had to be given continuous positive airway pressure therapy (CPAP), to help her breathe easily, and expand the lungs!”

“Once the baby was stabilized, a lung lobectomy surgery was performed on 2nd day of birth by Dr Pranav Jadhav and Dr Kalpesh Patil (Paediatric Surgeons). Surgery took around one hour,“ he informed.