First bedside operation of baby as she could not be moved to OT

Lightweight baby fighter gets new heart and hope

Mishika smiles in her cosy incubator, unaware of the academic discussions her birth 125 days ago have triggered. Weighing 550 grams and born three months before schedule, she is perhaps the lightest Indian to have undergone a heart procedure right on her birth bed. 

"She was a micro-preemie as she weighed less than 900 grams at birth. But she is one of the biggest fighters," said pediatric heart surgeon S Mohanty who operated on Mishika when she was a month old at Kokilaben Ambani Hospital in Mulund. She now weighs 2 kilos and is likely to be discharged next week, said her mother Charu Sharma-Agarwal. 

Mishika had a condition called patent ductus arteriosus. A common condition among premature children, it's a hole between two major blood vessels-the aorta and the pulmonary artery—that adversely affects blood flow across the body. "Excessive blood would accumulate in her lungs while her intestines would get little. This led to another condition called necrotising-enterocolitis of her bowels," said Dr Vinay Joshi, neonatologist who has been taking care of Mishika since her birth on August 28. 

Even though duct closure operations are performed when a child is older, Mishika has created a record of sorts. "The duct closure would, in fact, allow her to heal faster and gain weight faster," said neonatologist Dr Preeta Joshi. The Joshis believe Mishika is the lightest premature child born in the city. 

Dr Bhupendra Avasti, a senior neonatologist in Mumbai, said it's encouraging that children so young can be resuscitated. "Nowadays, most PDAs closure is done with medicine, but only in rare cases do we need to operate," he said. Dr Suneet Singhi, who is the head of pediatrics in P G I Hospital, Chandigarh, said, "It's difficult to say off-hand, but I would think she is the smallest baby to have undergone such a procedure in India." 

Mishika was born at 27.6 weeks of pregnancy when her mother, 32-year-old Charu, developed severe health complications. "I was admitted to Kokilaben Ambani Hosptial on August 27 with preeclampsia (a condition among pregnant women characterized by high blood pressure and protein leakage in urine)," said Charu. 

The doctors told her husband that the baby would have to be delivered immediately if his wife had to be saved. As Charu recuperated for 10 days, the NICU doctors tended to Mishika. 

"Mishika's health chart was not always encouraging and it was difficult for the young couple to hear good news one day and bad news the next," said Dr Preetha. 

It was Mihika's low weight that prompted doctors to operate on her right in the NICU. "The journey from her hospital room to the operation theatre could be fatal for such micro-preemies due to the difference in temperature," said Dr Mohanty. Hence, the team of surgeons and anesthetists gathered in Mishika's room to fix the hole in her heart vessels. "It wasn't an open heart surgery, but it was a difficult procedure because no instruments are designed for operation on such small children," he said. 

Dr Vinay said Mishika has been gaining weight since the operation. "We want Mishika's case to spread the message that weight needn't be the criteria for operating on a child's heart," he said. 

For Charu, the news that Mishika can leave soon is not

hing short of a miracle. "Thanks to God and doctors, my daughter survived even though she had such low birth weight. We hence called her Mishika, which means God's blessing," said Charu.