Mumbai: Neonatal surgery is performed on the newborn baby shortly after birth. These are the most specialized and sophisticated surgeries to treat those conditions which are developmental in origin(congenital) and need to be addressed immediately after birth. These may also be performed to correct issues that develop post birth. Such surgeries include correction of heart and brain defects, lung lesions & tumors, intestinal & esophageal defects, and many more. Recently, an expecting mother was stunned to find out during routine investigations at 32 weeks of pregnancy that the unborn baby has an intestinal obstruction and the baby would require a surgery for this congenital malformation immediately after birth. The fetus was reported to be suffering from Duodenal Atresia, wherein a part of duodenum (initial part of intestine) is not formed causing mechanical blockage preventing the passage of milk and other digestive fluids further. Earlier scans (done elsewhere) missed to report on that. The case was immediately referred to the Department of Fetal Medicine at SRCC Children’s Hospital, managed by Narayana Health for delivery and neonatal surgery. The delivery of the baby was handled efficiently. The baby was transferred to NICU and was investigated for the associated anomalies. The baby was fine without any associated problems and was taken up for the surgery by the team under Dr. Rasik Shah (Sr Consultant, Pediatric Surgery), Dr Ravi Ramadwar (Sr Consultant, Pediatric Surgery), Dr. Vinit Samdani (Consultant Pediatrics), & Dr. Nandini (Sr Consultant & Head, Pediatric Anesthesia). Laparoscopic abdominal surgery was performed on the neonate within the first 24 hours successfully, which is a scar less & painless procedure.
As per Dr. Rasik Shah, SRCC Children’s Hospital, ‘’ The baby was taken to NICU in stable condition post surgery and discharged some days later. Post operative baby did well. The contrast x-ray done after five days showed a good flow of contrast from the stomach into the small bowel. The baby was started on oral feeding which was gradually increased and was discharged on full feed on day 11 after birth.’’
‘’The prevalence of congenital anomalies is 3-5% worldwide, but may differ country wise. The prevalence rate in India is reported to be 3.6%. More than 50% of newborns probably don’t even reach the hospitals. As the baby was delivered and operated in the same hospital, it was possible to avoid the trauma of transfer of the neonate,’’ he added.
‘’Due to the complexity and seriousness of the conditions that we treat, these procedures come with potential risks for the baby. In addition to surgical complications, other prenatal risks might also occur with the mother such as early labor & delivery, gestational diabetes, uterine rupture etc. The patients & families must discuss the specific risks and complications well beforehand to be able to decide the place of delivery so as to minimize the hazardous effects on both mother as well as the new born baby,’’ he further added.
SRCC Children’s Hospital is one of its kind of medical facility at Mumbai which has a well equipped fetal medicine department and has all state-of-the-art modern facilities, NICU, Surgical & Anesthetic teams to treat such high risk newborns, who require such specialized surgeries under all specialities immediately after birth.
