Milestone for womb surgery boy

Published Jul 28, 2014

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Durban - Timothy Clarke, the local baby who made medical history last year, has chalked up another landmark event: his first birthday.

And the little boy, who would have died if he had not had the highly sophisticated surgery in the womb, celebrated the milestone with staff and other little patients at Netcare Parklands Hospital in Durban on Tuesday, with his VIP guest, Dr Ismail Bhorat, the foetal-maternal specialist who was called in when the situation looked grim.

Timothy’s parents, Suzanne and John Clarke of Doonside, eManzimtoti, who had already lost twin girls when they were born prematurely, faced the same sad scenario when they learnt that the baby they were expecting was suffering from severe heart failure and that dangerous fluid was collecting in his lungs, his skin and around his heart.

The baby had developed a rare condition, pleural effusion, associated with hydrops fetalis, which is effectively cardiac failure.

Babies who develop such symptoms generally die.

Bhorat and Dr Samad Shaik, a paediatric surgeon, and the rest of the medical team got together to discuss the options and debate if the foetus could withstand an intervention.

A year earlier, the doctors had given another little boy, Joel Ford, the chance of life when they performed tricky pinhole surgery on the critically ill foetus.

Fluid had begun filling his chest cavity, compressing a lung and displacing his heart. Neither was able to grow and his heart was not pumping properly.

An 18cm-long needle was inserted through his mother’s uterine wall and through a space in the baby’s ribs and into his chest cavity. The fluid was then drained out into his mother’s amniotic fluid.

A shunt was inserted through the needle and when the needle was withdrawn, the shunt was left in place to continue draining the fluid.

The shunt was clamped before Joel emerged into the world by Caesarean section.

But whereas Joel had one life-saving shunt, Timothy had to have two. It was impossible to just insert one shunt to drain the fluid from one lung as the other would have filled with even more fluid, Bhorat explained at the time.

The procedure – which the specialists believe was a world first – was a success and Timothy was born at Parklands Hospital five weeks later, weighing in at 2.65kg.

Now, the birthday boy is a healthy 9.6kg, boasts six teeth, can say “Mom” and is on the verge of taking his first steps.

He is taller than some of his friends in the local playgroup and although his parents feared they might have to deal with a sickly son, Timothy’s only sign of sickness has been a cold and tonsillitis.

“We are very pleased. We cannot imagine life without Timothy,” his proud dad said as neonatal ICU and theatre staff helped celebrate Timothy’s birthday in the hospital’s paediatric ward and marvelled at how much he had grown.

Bhorat said Joel – who has just celebrated his second birthday – and Timothy had “opened the door” for other operations.

Another double shunt operation and two single shunt operations had since been successfully carried out.

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