Sewri couple’s first child faced breathing problems after certain fluids entered his lungs; nitric oxide gas therapy cleared the airways

Ababy who was born gasping for breath because of a lung complicationwassuccessfully treated with the help of a little–known therapy, in which tiny amounts of nitric oxide gas is used to clear blocked lungs.

Sewri resident Annvilla Rohit Bhat, 28, gave birth to her first child, a boy, at a maternity home in Shivaji Park at 1.16 pm on November 14.

But the baby could not breathe properly, and doctors diagnosed him with meconium aspiration syndrome, a serious condition in which an infant inhales or ingests certain fluids while still inside the womb, but around the time of birth.

The fluids’ mixture blocked his lungs, leading to respiratory problems. Doctors at the maternity home drained out some of it through suction, but could not completely clear his lungs. In the next 12 hours, Annvilla’s husband, Rohit, rushed their babytotwoprivatehospitals,butthey had little success in treating the child, whose condition worsened.

Shortly after midnight, the yet–tobe–named boy was taken to Santacruz’s Surya Children’s Hospital, wheredoctorstookthequickdecision to try the nitric oxide therapy. "As soon as nitric oxide gas was passed through the baby’s lungs with the help a ventilator, the pulmonary arteries began to dilate and the pressure in the arteries went down," neonatologist Dr Bhupendra Avasthi said on Thursday. "The child is recovering well now."

The six-day-old baby boy is now recovering at Surya Hospital in Santacruz

Meconium aspiration syndrome occurswhenanewborningestsmeconium and amniotic fluid. Meconium, adarkgreensubstance,isthefirststool passed by a newborn soon after delivery, while amniotic fluid is the liquid that surrounds the embryo. Sometimes, a baby passes meconium while still inside the uterus and inhales or ingests it, which is what happened in the case of the Bhats’ baby boy.

It is a common condition among newborns, but in Mumbai –– which sees more than 2 lakh deliveries every year – there are only a few hospitals that offer the nitric oxide therapy to treat it. Surya, Andheri’s Kokilaben Dhirubhai Ambani Hospital and Mulund’s Fortis are among the hospitals.

"It is an expensive gas and needs a separate delivery system, due to whichmanycentrescannotaffordit," said Dr Jayshree Mondkar, head of Sion hospital’s neonatology department. A cylinder of nitric oxide costs up to Rs 15,000.

Meconium staining is seen in 14 per cent of deliveries. The mixture accumulated in the lungs of the Bhats’ son,causingseverepulmonaryhypertension, an increase of blood pressure in the pulmonary artery, which resulted in shortness of breath.

"Our baby was born by caesarean intheafternoon.Wespentthenext12 hours running from one hospital to another, but doctors there could not completely clean the lungs," Rohit said.

From the Shivaji Park maternity home, the family first went to a hospital in Byculla. From there, the newborn was taken to a hospital in Mahim. "At both the hospitals, the baby was admitted to neonatal intensive careunit.WefinallytookhimtoSurya Hospital, which offered the nitric oxide therapy," Rohit said.

Dr Avasthi said meconium aspiration syndrome could prove fatal if not treated in time. "If not tackled right away, the baby could die of respiratory failure," he said.

According to him, the use of the "nitric oxide molecule" for treating the condition began in the West in 1991.Itwas,infact,declaredthe‘Molecule of the Year’ at the time.