A 23-year-old woman is now the mother of a healthy baby boy, something she wouldn’t have expected after the shock she got in the 28th week of her pregnancy But doctors from several hospitals across the city got together to perform an exutero intrapartum treatment or Exit as it is more commonly known.The operating room was crowded but each doctor knew when to start and when to stop and the nurses all knew their roles. This was because the team conducted a detailed mock drill the day before the operation.To get time for the procedure, the doctors decided to intervene even as the baby was receiving oxygen from the mother. “We had about 20 minutes to intubate the baby. We had meticulously planned the procedure a day before with a mock drill. We made a flowchart of what should be done at each step. All doctors and nurses had their roles defined,” said senior obstetrician Dr Uma Ram of Seethapathi Nursing Home.During a routine ultrasound in the 28th week on the 23-year-old woman (name withheld), doctors noticed swelling on the fetus’s neck. It was large, restricting his ability to swallow and affecting growth. The fluid around the baby also swelled.“Tests showed gross enlargement of the thyroid gland. As per standard protocol, we began intrauterine treatment. Two shots of thyroid hormone replacement in a two-week interval was given. This reduced the amount of fluid, but the swelling in the neck did not reduce significantly,” said Dr S Suresh, fetal medicine expert at Mediscan Systems.The 36th-week scan showed compression of the trachea, which could make breathing difficult. The woman was then referred to the Dr Mehta’s Hospital for planned caesarean section. After Dr Uma pulled out the baby’s head, ENT surgeon Dr S Thirunavukkarasu used bronchoscope guidance to intubate the baby.“The bleeding was heavy as expected but the mother did not require blood transfusion. The swelling on the neck has now reduced to the size of a pea,” said neonatologist Dr Lakshmi. Doctors are yet to find the cause of the swelling as they are awaiting test results.“As of now, the baby requires long-term hormone replacement therapy. But with these medications he should be able to lead a normal life,” she said.

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