New Delhi: In order to address the critical issue of neonatal mortality in India, the Apollo Hospitals Delhi organized a press conference on March 31st in Delhi. The team of neonatal intensivists, surgeons and gynaecologists attended the event along with new-born patients who have been treated at Apollo Hospitals Delhi for complex surgeries.
Addressing the media, Dr Sujit K Chowdhary, Senior Consultant – Paediatric Urology, Indraprastha Apollo Hospitals Delhi commented, “Medical expertise and clinical excellence has increased the neonatal survival rate. With more than 850 newborn babies operated in the last 10 years, Apollo Hospitals Delhi achieved an outstanding success rate of 95% against the national average of 65%; emerging as the national leader for newborn surgeries. Three consecutive babies born with complex medical condition as right side diaphragmatic hernia and liver in the chest have been treated successfully and discharged from the Apollo neonatal intensive care in the last week. This is an event which any neonatal intensive care in the world, cannot claim to have ever seen.”
A team of senior consultants, neonatal specialists including Dr Vidya Gupta, Dr Saroja Balan and Dr Sushma Kaul who were also present at the conference added, “The time period close to delivery is very critical and any failures in the healthcare system during this short time frame can lead to death of new born. Preterm births cause about 50 per cent of neonatal mortality and need timely medical intervention.”
The neonatal period (0-27 days) is the most vulnerable period for a newborn and over the years million babies across the world have died during this period due to medical anomaly & complexities. India has the highest number of neonatal deaths in the world. Over the years, there has been dramatic and accelerating progress in reducing neonatal mortality.
The neonatal team at Apollo shared three recent case studies of babies born with right side diaphragmatic hernia and liver in the chest suffering from multiple complications, that is, hypo-plastic lung, pulmonary hypertension, small abdominal cavity abnormal gastrointestinal tract etc. have been discharged from the Apollo neonatal intensive care in the last week post successful treatment.
Case 1
A 30 week old premature baby was born with respiratory distress at birth and put on ventilation at Faridabad was shifted to Apollo Hospitals Delhi due to unstable health conditions. At Apollo Hospitals, the baby was stabilised with high frequency oscillatory ventilation, infusion of paralytic agents, intra-arterial blood pressure monitoring, central venous pressure monitoring and administration of blood pressure regulatory drugs in the main vein. The baby was readied for further investigations & surgery through anaesthetic and cardiac evaluation 48 hours later. Meticulous and long surgery with mobilisation of liver and intestine was followed by creation of diaphragm using a layer of abdominal wall to create an artificial diaphragm. Abdominal cavity expansion was achieved with Goretex used to closed holes in the heart in new-borns. He has gradually come off all cardiorespiratory support and discharged last week after 12 weeks in nursery.
Case 2
Term baby born at Dehradun, with respiratory distress at birth which was thought to be lung malformation. The baby had to be transported by air ambulance in the early hours of the day due to unstable condition and was put on ventilator. On arrival at Apollo Hospitals Delhi, the baby was stabilised. Further investigations confirmed the entire right lobe of liver, right kidney and abdominal viscera were inserted in the chest with hypo-plastic lung. The baby underwent cardio physiological stabilisation, and surgery to mobilise the liver & kidney into the abdomen along with its vascular supply and drainage system. Apollo Doctors then proceeded to repair the diaphragmatic defect and closure of abdomen with a specialised technique called component separation; in order to expand the abdominal cavity to accommodate the new organs which were earlier inserted in baby’s chest. The baby has done well and sent home last week.
Case 3
Term baby born in Columbia Asia Hospital in Gurgaon was referred to Apollo Hospitals Delhi under critical circumstances as he was found to have right side diaphragmatic hernia with liver, and abdominal viscera migrated in the chest. He underwent stabilisation with supportive treatment by a team of neonatal intensivists, cardiologist and anaesthetist. CECT revealed the entire right lobe of the liver migrated in the chest. He underwent surgery with mobilisation of liver, reduction of all migrated viscera from chest into abdomen and repair of the defect in diaphragm in the chest. After two weeks of gradually decreasing supportive care the baby has been discharged.
