Chantelle Arden with her one-year-old daughter Hannah, who had life-saving surgery before she took her first breath. PIC: Megan Slade Source: The Courier-Mail
IT was life-saving surgery on a tiny baby before she'd even taken her first breath.
In a dramatic start to life, Hannah Arden needed an operation mid-way through her caesarean birth to survive.
Obstetrician Renuka Sekar delivered Hannah's head and shoulders, but kept the rest of the baby inside her mother, attached to the umbilical cord and placenta, to allow colleagues to perform the emergency procedure.
Surgeon Hannah Burns had only minutes to insert a breathing tube into the baby's windpipe after a scan six weeks earlier showed the little girl had a large tumour growing out of her mouth and nose.
The benign growth, bigger than a man's fist, prevented her from being able to breathe normally once she was born and the umbilical cord was cut.
"The baby won't take a gulp of air as long as that cord's working," Dr Burns explained.
"While the cord's in place and the blood supply's good, you've got a window of opportunity to do something before the baby starts to try to breathe.
"Without the procedure she had, she would have died at birth. There was no other option for her."
Dr Burns said fewer than half a dozen similar surgeries, aptly described as EXIT procedures - ex-utero intrapartum treatments - had been performed in Queensland but not all were as successful.
Hannah Burns was part of the team that performed life-saving surgery on a premature baby a year ago. PIC: Jonathon Searle
Half the babies died.
Hannah's mother, Chantelle, who was 34 weeks pregnant at the time, was anaesthetised for the procedure at the Royal Brisbane and Women's Hospital on April 18 last year, unsure whether she and her daughter would survive.
"There was a risk that I was going to haemorrhage," she recalled.
"I fell asleep knowing that I might not ever wake up again, or I might wake up and not have my daughter."
Although Dr Burns has performed many tracheostomies - cutting a hole in the windpipe to insert a breathing tube - this was her first EXIT procedure.
"Hannah's windpipe was less than the size of your little finger," the ear, nose and throat specialist said.
"We got the trachy in within about five minutes. I wouldn't have wanted to take longer than that because she was wriggling.
"She wasn't in the easiest position to perform a tracheostomy because she was still attached to mum. You couldn't extend her head back very far.
"It's so satisfying to have such a good outcome for such a terrible condition."
Dr Burns credited Hannah's survival to meticulous planning and the skill of many health professionals, including anaesthetist Makarla Stead . About 20 doctors and nurses were in the theatre for the procedure.
Hannah had the tumour removed a week after her birth and spent three months in hospital before being allowed home on the Sunshine Coast.
RBWH neonatologist Pieter Koorts said she was kept alive on a ventilator for more than two months and needed 70 days of intensive care.
"She had really difficult lungs to manage," Dr Koorts said. "She was really quite unwell."
But Hannah, who recently celebrated her first birthday, shows few signs of her traumatic entry into the world.
Chantelle, 21, and Hannah, now one, will picnic on Sunday for Mothers' Day..
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