Abu Dhabi baby has rare medical procedure while partially in womb

A cyst on the infant's neck was a quarter of his weight

Team from SKMC and Corniche hospital during EXIT surgery on Jordanian baby born with massive cyst on the neck. Credit: SKMC

Doctors in Abu Dhabi have successfully performed an intricate procedure on a baby boy while still partially inside the mother’s womb.

Medics were forced to intervene after scans revealed a substantial 700g-cyst on his neck.

The growth, a quarter of the baby's body weight, risked blocking the infant's airway, preventing him from breathing once born.

Specialists recommended a partial birth to allow them to perform the difficult procedure and avoid the risk of further complications.

"We were told that the baby would not be delivered the natural way and needed special surgery," said Ashraf, 40, the boy's father, who did not want to give his full name.

“It was a shock. The cyst was like another head. I don’t think we ever expected the magnitude of the problem.”

Doctors undertook the rare procedure, known as Exit surgery, at the Sheikh Khalifa Medical City in the capital in February.

The Jordanian infant’s parents only discovered there was a potential problem eight months in to the pregnancy.

SKMC assembled a multi-disciplinary team of 20 doctors, including some from Corniche Hospital, Abu Dhabi's largest maternity hospital, to work on the case.

Medics established that the unborn child had a cystic hygroma – a fluid-filled sac caused from a blockage in his lymphatic system.

The cysts most commonly form in the neck or head, but can also appear elsewhere in the body.

In this case, the growth was blocking the baby’s airway, making Exit surgery necessary, said Dr Irfan Basha, a consultant ENT surgeon who was part of the team at SKMC.

“Speed and organisation was very important here,” he said.

During the procedure, the baby remained attached to the umbilical cord, which serves as life support by providing oxygen.

Doctors delivered the boy on his head and had only a minute to intubate him, a process involving a flexible tube being inserted down the throat to maintain an open airway.

Only after the baby was able to breathe independently was he separated from his mother.

The surgery was precisely planned with doctors describing the procedure as a ballet in which each medic had a specific role to perform.

Once the doctors managed to intubate, they completed the delivery. Two days later, after the baby stabilised, doctors were able to surgically remove the cyst.

Dr Leanne Bricker, consultant and chair of foetal medicine at Corniche Hospital, helped plan the procedure and deliver the baby.

“In some cases, the tumour will affect the vocal cords but in this specific case, it didn’t,” she said.

“This baby had no complications. He is growing and feeding normally. We are very pleased,” said Dr Basha.

Ashraf said his family was delighted by the success of the procedure and that his newborn was happy and healthy.

Surgeons said it was only the third time the operation had been performed in the Abu Dhabi.

“You could never tell that he had the surgery,” said Ashraf.