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Motherhood Hospital removes rare cyst from new-born’s lung

A baby girl was born with a congenital defect, wherein fluid-filled cysts were being formed in the lung cavity

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A team of paediatric surgeons at Motherhood Hospitals, Kharadi, Pune, recently operated on a one-day-old baby girl. The baby was born with a congenital defect, wherein fluid-filled cysts were being formed in the lung cavity. The doctors at the hospital helped the baby breathe freely by initially removing fluid from the cyst that was present in her left lung by aspiration process and later performing a lung lobectomy (surgery to remove one of the lobes of the lung) immediately one day after birth.

Dr Rajeshwari Pawar, Gynaecologist -Obstetrician, Motherhood Hospital, highlighted, “The foetus was diagnosed to have a type 1 Congenital Cystic Adenomatoid Malformation (CCAM), and it 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. This type of CCAM happens two to three in 1,00,000 live births. If left untreated, it would have compromised the growth of the underlying healthy lungs and would have become unusable. Likewise, heart compression could have invited foetal heart failure. 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.”

At the sixth month of pregnancy, the sonographic weight estimated of the foetus was 964 gms, a decision was taken by the foetal medicine consultant Dr Rajeshwari Pawar to aspirate the fluid from cyst by a fine needle through a sonographic guided procedure after anaesthetising the foetus with an intramuscular injection in the foetal thigh muscle, so that she (foetus) 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 the woman (mother of the baby) was continuously monitored from sixth to ninth month of pregnancy, every week by Dr Pranav and me,” said Dr Pawar.

Dr Tushar Parikh, Chief Neonatologist, Motherhood Hospital, added, “A multidisciplinary counselling was given to her after the baby, weighing 2.5 kg, was delivered in December last year. The baby was shifted to the Neonatal Intensive Care Unit (NCU) 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 stabilised, a lung lobectomy surgery was performed on the second day of birth by Dr Pranav Jadhav and Dr Kalpesh Patil (Paediatric Surgeons).”

Dr Pranav added, “It is a delicate and complicated procedure to remove the lobe of the lung that is the portion of the diseased lung. The baby was growing well and accepting feeds soon after surgery.”

Dr Parikh also said, “Post-operatively, baby quickly stabilised and required oxygen therapy in the NICU. Once she was shifted in the normal ward, her mother was explained about the right way to feed the baby.”

Expressing her gratitude, the mother of the baby said, “A series of tests performed on the baby ensured that whether baby had only CCA. I thank the doctors and my family and friends for supporting us through thick and thin. After getting discharged, we also went for follow-ups, and the baby is fine now, and accepts feeds. Our lives have completely changed after the arrival of our baby and we are happy and blessed.”

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