Bhubaneswar, Nov 5: Doctors at the Institute of Medical Sciences and SUM Hospital campus -1 here have successfully battled to turn around a baby girl delivered at 34 completed weeks through emergency Lower Segment Caesarean Section weighing only 1476 grams.

The baby, born to a 28-year-old primi mother through IVF conception, was kept in mechanical ventilation after being admitted to the hospital. The antenatal SCAN at 20 weeks of gestation showed a mixed cystic Congenital Pulmonary Airway Malformation (CPAM) and an echogenic lesion in the left lung along with a dextroposed heart.

The baby, who required intubation after delivery, was later upgraded to High Frequency Oscillation (HFO) ventilation. A Contrast-Enhanced Computed Tomography (CECT) scan of thorax revealed left-sided Congenital Pulmonary Airway Malformation with right-sided pneumothorax.

Pediatric cardiology consultation aided by 2D echocardiogram revealed pulmonary hypertension. On day 15 of its life, the baby underwent Left Pneumonectomy for definitive management of the extensive CPAM by the pediatric surgery team. The left upper and lower lobe of the lung was excised. The baby was treated for post-operative pulmonary hypertension and infection coagulopathy requiring multiple blood component transfusion.

Fluid and Parenteral nutrition (PN), a medical treatment that delivers essential nutrients directly into the bloodstream through an intravenous (IV) line completely bypassing the normal process of eating and digestion was initiated with appropriate ventilatory management. There was progressive improvement in the infant’s respiratory status and subsequent de-escalation of respiratory support. The baby was extubated on Day 24 of its life and was weaned to room air when it completed 50 days.

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The baby was successfully discharged from the hospital a week later when it was accepting breastfeeding and bottle feeds with expressed breast milk while gaining weight appropriately. It was neurologically normal and was maintaining saturation in room air without any signs of respiratory distress. A team led by Dr. Antaryami Pradhan of pediatric surgery had performed the surgical intervention.

Collective team work involving doctors from departments of neonatology, pediatric surgery and anesthesia ensured the baby’s survival though it was an extremely challenging case. The Head of Neonatology department Dr. Debasish Nanda expressed immense pleasure and congratulated the team for its success. The team comprised Dr. Ratan Kumar Das, Dr. Payal Pradhan, Dr. Bhabagrahi Mallick, Dr. Bineet Panigrahi, Dr. Shrutiprajna Kar, Dr. Suresh Tripathy, Dr. Sitikantha Nayak, Dr. Sudipta Sahoo, Dr. Sarath Chandrika, Dr.  Kalpita Sahoo, Dr. Adyasha Kanungo, Dr. Subhalaxmi Sahoo and Dr.  Pujitha.