An uMhlanga couple’s new baby boy, who developed a potentially fatal rare medical condition, has just undergone a life-saving operation – even before he was born.
It is the first time that the operation has been performed in KwaZulu-Natal, and possibly the first time it has been done in the country.
Still largely experimental, it involved pinhole surgery: inserting an 18cm-long needle through his mother’s stomach and uterine wall, then through the baby’s ribs and into his chest cavity to drain out fluid via his mother’s amniotic fluid.
A specially-imported shunt was then inserted down through the needle to continue draining out fluid.
The needle was then withdrawn, leaving the shunt in place to continue its life-saving work until the little boy is born by Caesarean section. It will be clamped off just before he is delivered.
The baby’s father, well-known pilot Hayden Ford, 35, who used to work for Netcare911 and SA Red Cross Air Mercy Ambulance – and who has flown countless trips to save the lives of incubated, premature and new-born babies – learnt last week that his own unborn son’s life was in serious danger.
Ford and his 32-week pregnant wife, Tarryn, knew that the procedure was their third child’s only chance of survival.
“It was daunting, but we were just happy there was an option on offer,” said Ford, who is now a media company director.
“We knew that if we waited any longer, he would not survive.”
Although nervous about the risky procedure, his 30-year-old wife said there was no debate.
“We had to give the baby the best chance we could,” she said as she recovered at Netcare’s Parklands Hospital in Durban.
With time running out, a medical team of experts was assembled within 24 hours.
It was headed by paediatric surgeon Dr Samad Shaik, of Parklands, and included foetal specialist Dr Ismail Bhorat, and Dr Carlos Hartmann, the mother’s obstetrician.
Six doctors were either involved or were on standby in the theatre and four nurses were called in.
By then, the vital UK-manufactured pleuroamniotic shunt had been flown in.
The shunt can only be used for humanitarian purposes, meaning that the little patient had to fulfil certain criteria before it could be used: his life had to be under major threat and the benefits of the surgery had to outweigh leaving him without the surgery, Shaik explained.
The baby, whose name is being kept under wraps until he is born, had developed a “very rare” condition called chylothorax or pleural effusion, which is associated with hydrops fetalis, which is effectively cardiac failure.
Fluid had developed in his chest cavity which was preventing his lungs from growing. It was also compressing his heart, preventing it from pumping properly.
Ninety percent of babies who developed the condition died before they are born, Shaik said.
The 90-minute procedure took place on Saturday.
“A lot of things could have gone wrong,” Shaik said. “The mother could have gone into premature labour, there could have been a problem with the actual technical operation and the placenta could have been punctured, causing it to separate.”
The operation involved anaesthetist Dr Mark van Staden, who administered an anaesthetic to the mother, which also ensured that the baby did not feel any pain, because the needle that was used was particularly sharp.
Scans taken during the operation showed a large black area in the baby’s chest cavity, which was the fluid that had accumulated. It also showed that the heart was pushed to one side and the lungs were squashed.
The needle was 2.5mm wide and the shunt that had to go down in and inside the baby was 2.1mm wide.
“The shunt is made of a special type of plastic which is coiled at both ends. Once it is inside, the needle is removed and the shunt curls up outside the chest cavity, preventing it from coming out,” Shaik said.
“There are lots of little holes in the shunt which drain the fluid out into the amniotic fluid.”
The procedure was a success and a post-operative scan showed that the baby’s lungs had already expanded and he was out of danger.
The baby’s mother is expected to be discharged from hospital this week and will have to stay in bed for another five or six weeks when she will have a Caesarean.
The shunt will be clamped before the baby is lifted out to prevent him sucking in air through it and stopping his heart from beating.
He will then be taken to the paediatric intensive care unit for monitoring and to enable doctors to work out what had caused his condition.
The Fords have two other children – Jade, 10, and two-year-old Fynn.
“My baby’s life has been saved. He is a little fighter,” his mother said.
Netcare Parklands Hospital manager James van Vught, described the unique operation as “phenomenal”. - Daily News