CLEVELAND — Adrianna Mashburn and her husband, Micah, were getting everything ready to welcome little Maverick into the world when a third-trimester checkup turned their world upside-down.
Maverick was diagnosed with congenital pulmonary airway malformation or C-PAM.
A mass was crushing Maverick's lungs, heart, and esophagus.
"Things can just go wrong, and Maverick's heart could stop," said Cleveland Clinic Fetal Surgery Director Dr. Darrell Cass said.
"He's got a big mass in his chest, he's hydropic, there's a risk that he could die."
Then at 37 weeks, almost full term, mom and baby had exit-to-resection surgery.
Maverick was partially delivered allowing Dr. Cass to open his chest and remove the mass, all while Maverick was still receiving oxygen from his mother through her umbilical cord.
"Maverick's surgery was very tricky," Dr. Cass admitted.
Halfway through surgery Adrianna's placenta started to fail.
Doctors delivered Maverick and cut the cord.
Luckily by then the newborn's airway was already secure.
"We stabilized him and then I completed the surgery to remove this mass."
Maverick thrived after the surgery.
And his mom did well too.
"Recovered beautifully!" said Dr. Cass.
"She was there at Maverick's bedside right away."
C-PAM is a rare birth defect that only occurs in up to one in every 35,000 births.
It's a high-risk and complicated surgery that requires a team of experts in cardiology, maternal fetal medicine and obstetric anesthesia.
During exit-to-resection surgery, the anesthesia team must keep mom under a deep general anesthesia to keep the uterus relaxed while it is opened and to preserve uterine placental blood flow.
If the uterus contracts it tends to constrict the uterine blood flow.
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