Fortis Escorts Jaipur Achieves Medical Milestone

Premature Newborn with One-in-Four-Million Genetic Mutation and life-threatening Gangrene Successfully Treated





Jaipur,



The newborn baby boy was delivered in a city-based hospital in Jaipur through an emergency C-section at 35 weeks (8 months) of gestation but developed breathing difficulty soon after birth. He was kept on a ventilator, and surfactants (that help keep the airways open) were administered into the lungs. During his primary hospital stay, the newborn developed multiple comorbidities – shock, blackening/darkening of both the lower limbs, low urine output with high urea and creatinine, critically low Platelets (15000 ml) along with continuous bleeding from multiple sites which resulted in intraventricular hemorrhage and seizures. In dire need of specialized care, he was transferred to Fortis Escorts Hospital Jaipur in an extremely critical state.

Dr. Shyam Sundar Sharma, Consultant Neonatology at Fortis Escorts Hospital Jaipur, shared insights into the complexities of the case, stating, "Upon arrival at Fortis Escorts Jaipur, the newborn was in an extremely critical state. His survival was uncertain due to multiple severe health issues, including respiratory difficulties, lack of blood flow to the legs, low blood pressure, kidney failure, gangrene in both lower limbs, brain hemorrhage, and ongoing seizures. To address his breathing difficulties, we continued mechanical ventilation. We managed the hypovolemic shock, caused by significant bleeding from various sites, and septic shock from infection, with multiple inotropic supports to regulate the heart's contraction force. Once we corrected the shock, the kidney failure began to improve.



Upon diagnosing Purpura Fulminans, indicative of gangrene, we discovered a deficiency in protein C. Further genetic testing of the baby's parents revealed a heterozygous mutation, exacerbating blood clotting and leading to gangrene. The ideal treatment, protein C infusion, was unavailable in India, prompting us to use Fresh Frozen Plasma (FFP), which contains protein C. This was administered over a rigorous 21-day period alongside injectable LMWH, a type of blood thinner. All gangrenous body parts recovered, except for a portion of the left foot, for which we advised consultation with a plastic surgeon. The timely and accurate diagnosis and treatment were crucial to the newborn's survival."