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Delivery room drama draws tears of joy

Halfway through birth, Tel Aviv doctors open baby’s tumor-blocked airways

With the baby’s head in doctors’ hands and the body still in the mother’s uterus, a staff of 30 bypassed his tumor, avoiding fatal oxygen deprivation

Nathan Jeffay is The Times of Israel's health and science correspondent

The baby born October 14, 2020, after an ex utero intrapartum procedure at Tel Aviv Sourasky Medical Center (courtesy of Tel Aviv Sourasky Medical Center)
The baby born October 14, 2020, after an ex utero intrapartum procedure at Tel Aviv Sourasky Medical Center (courtesy of Tel Aviv Sourasky Medical Center)

A baby with a tumor blocking his airways has been safely delivered in Tel Aviv, after doctors stopped the birth halfway through to perform a rare, life-saving operation.

“The baby, apart from his head, was still in the uterus, as we opened his airways,” Ariel Many, director of delivery rooms at Sourasky Medical Center, told The Times of Israel. “We had to open his airways before we cut the umbilical chord, as otherwise he wouldn’t have been able to breathe.”

Many said that the ex utero intrapartum procedure, which took place during a c-section birth on Wednesday, is rare, and has only been performed in Israel a handful of times. He thinks the success of his team hinged on numerous simulations — aided by a model of the baby’s neck produced at his hospital’s  3D printing center — held since scans showed a few weeks ago that the baby had the tumor.

He said: “We needed to insert a special tube, with great precision, that would bypass the tumor and allow the baby to breathe.

“If we had delivered him fully and cut the umbilical chord without the procedure, ending his oxygen supply from the placenta, the baby would have had no oxygen for the 15 minutes it would have taken to insert a tube, which is a death sentence, or at least the cause of serious damage.”

A life-saving delivery room procedure taking place at Tel Aviv Sourasky Medical Center on October 14, 2020 (courtesy of Tel Aviv Sourasky Medical Center)

But the procedure that kept the baby connected to the placenta also came with risks that were outlined to the parents, a couple in their 30s. “We had to tell the family that success isn’t guaranteed and it could end with the death of the baby,” said Many.

The birth took place by caesarean section, which was paused as soon as the head of the baby emerged so that the 30-strong team could begin the procedure. “It was very tense,” said Many. “But once we saw everything was fine, people had tears in their eyes.”

The team that carried out the ex utero intrapartum procedure at Tel Aviv Sourasky Medical Center on October 14, 2020 (courtesy of Tel Aviv Sourasky Medical Center)

The baby is breathing well through the tube, sometimes alone and sometimes with the help of a ventilator. Many said that doctors may carry out an operation to remove the tumor, “though we actually think it may well go away on its own.”

He added: “I’ve been here for 25 years and this was one of the most emotional moments.”

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