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Saving babies before birth

Published: Jan. 12, 2021 at 10:37 AM EST
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Congenital pulmonary airway malformation, also called C-PAM, is a rare birth defect that only occurs in up to one in every 35,000 births, causing a mass to form on the lung of a fetus. This condition can also be accompanied by hydrops, where fluid builds up in a baby’s tissue causing extreme swelling as well as excess fluid inside the placenta. And in cases of C-PAM with hydrops—95 percent of babies die before, or soon after, birth. Now, learn about a breakthrough procedure for one family that was preparing for the worst.

Adrianna Mashburn and her husband, Micah, were getting everything ready to welcome little Maverick into the world when a third-trimester checkup turned their world upside-down.

Maverick was diagnosed with congenital pulmonary airway malformation or C-PAM. A mass was crushing Maverick’s lungs, heart, and esophagus.

“Things can just go wrong, and Maverick’s heart could stop. He’s got a big mass in his chest, he’s hydropic, there’s a risk that he could die,” described Darrell Cass, MD, director of fetal surgery at Cleveland Clinic.

Then at 37 weeks—almost full term—mom and baby had EXIT-to-resection surgery. Maverick was partially delivered allowing Dr. Cass to open his chest and remove the mass, all while Maverick was still receiving oxygen from his mother through her umbilical cord.

“Maverick’s surgery was very tricky,” Dr. Cass recalled.

Halfway through surgery—Adrianna’s placenta started to fail. Doctors delivered Maverick and cut the cord, but the newborn’s airway was already secure.

“We stabilized him and then I completed the surgery to remove this mass,” Dr. Cass explained.

Maverick thrived after surgery and Adrianna ...

“Recovered beautifully! She was there at Maverick’s bedside right away,” Dr. Cass expressed.

Doctors say one challenging part of this procedure is maintaining placental blood flow. This requires an experienced anesthesia team to keep mom asleep and her uterus relaxed throughout surgery.

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