Bhubaneswar: In a remarkable feat of neonatal and surgical care, doctors at SUM Ultimate Medicare (SUMUM) in Bhubaneswar have successfully turned around a preterm baby weighing 1520 grams with complex and congenital conditions.
The baby, born at 33 weeks, was diagnosed with Pierre Robin Sequence, a rare anomaly which is found in 1 in 14,000 live births, a press release from SUMUM said on Friday.
The baby was born with a significantly small lower jaw causing downward displacement of the tongue and causing life-threatening upper airway obstruction. Additionally, the baby had a cleft palate further complicating the breathing and feeding process.
Due to the baby’s extremely small mouth opening, conventional methods of intubation or ventilation were not possible. Hence, the doctors in a pioneering move—which could be one of the first of its kind in Odisha–performed a delicate tracheotomy by creating a small airway and inserting a tube through an incision in the neck to allow the baby to breathe.
“The medical team attempted a tracheotomy, but the smallest available tracheotomy tube (2.5 mm) could not be inserted because of the baby’s anatomy. In a critical on-table decision, the team performed a retrograde intubation through the tracheal port to secure the airway,” said lead surgeon Dr Radhamadhab Sahu, Senior Consultant, ENT and Skull Base Surgery.
“As a smaller sized tube was not available anywhere nearby, the 2.5 mm tube was successfully inserted using rare tracheal splitting technique— a first-of-its-kind intervention in Odisha,” he said.
“The baby endured a stormy NICU stay but responded well to intensive care. With better nutrition and airway management with non-invasive ventilation techniques, the baby is now three and half months old, gaining healthy weight and breathing independently,” said Dr Himanshu Sekhar Sahoo, Associate Consultant, Pediatrics and Neonatology, and the treating physician.
Meanwhile, Dr Pradeep Kumar Dey, the head of Pediatrics & Neonatology department at SUMUM described the case as a challenge for the medical team, both medically and emotionally. The hospital’s multidisciplinary team’s coordination and NICU’s advanced support system made it possible, he said.
The baby’s successful treatment has underscored SUMUM’s growing reputation as a centre of excellence for high risk neonatal care in eastern India.
