AIIMS, New Delhi recently got a referral where a 27-week fetus was suffering from bronchopulmonary sequestration (BPS) and had a large lung mass that was causing a massive collection of fluid in the chest leading to compression of the heart and lungs.

Dr Vatsala Dadhwal, professor, maternal-fetal medicine division, department of gynaecology and obstetrics, said that a temporary measure was to insert shunts to drain the fluid from the lungs so that compression on the heart can be removed to prevent heart failure. The other option is to burn the blood vessel supplying the tumour or abnormal lung tissue under ultrasound guidance inside the womb, which required a high level of expertise and could be done by laser energy, which has been reported previously. Yet another technique was Radio-Frequency Ablation (RFA) which uses radiofrequency energy for ablating the vessel. This procedure was chosen to operate on the fetus as the vessel supplying blood to the tumour was quite big. Additionally, the doctor said that till date only one baby survived among three cases reported previously. This was the second successful case in the world and the first case of the same from India.

AIIMS performed the surgery on December 23. The baby was delivered on February 5. Dr Dadhwal explained that the following day, after the surgery, the fluid had started decreasing and completely disappeared by day seven and the lungs also expanded. Further, the tumour had completely disappeared by the time of birth and the baby was discharged in a healthy condition.

AIIMS, New Delhi has been the first centre to start fetal blood transfusions in the country having performed more than 1,500 procedures so far. The doctors from AIIMS said that parents should be aware that many conditions of the fetus could be treated inside the womb. While in some cases temporary interventions could be done inside the womb and definitive management provided after birth so that the baby can survive in the womb till delivery. This knowledge should be used both by patients and the general physicians to refer patients to fetal medicine centres like AIIMS, New Delhi in time for possible treatment.

Source: ET Healthworld