A premature baby successfully underwent an emergency lifesaving operation at the Norfolk and Norwich University Hospital’s Neonatal Intensive Care Unit (NICU) at one day old, after deteriorating rapidly with a congenital surgical condition.
Amelie Dewbery was born prematurely by emergency caesarean on 3 March 2024. Her parents Matthew and Sarah had already had to come to terms with complications in the pregnancy with referrals to Great Ormond Street Hospital to look at variations to Amelie’s heart, identified during her routine 20 week scan.
Within a few hours of her birth, she became so unwell that very quickly, she was on a ventilator which progressed to an oscillator (a much higher form of ventilation for critically ill babies). She was also on nitric oxide to relieve pressures in the lung circulation and on three drugs to support her heart.
Sarah and Matthew were given the horrendous news that their baby did not have long to live. They were given some options, one of which included attempting an emergency thoracotomy to deal with the condition but due to Amelie’s prematurity and rapid deterioration, this was extremely risky.
Amelie was too sick to be transferred to the operating theatre. Consultant Neonatal Surgeon Mr Ashok Daya Ram, supported by surgical, anaesthetic and neonatal teams, decided to open her chest in NICU itself, to save not only her life, but her vital organs.
Amelie’s dad Matthew said: “We were told that the operation was very, very, risky and there was a low chance of survival, but we wanted to try, knowing that whatever happened we’d given our baby the best chance of living a normal life. The operation went well. We feel like someone was looking down on us that day.”
Matthew added: “It has been an incredibly emotional few weeks but Mr Ram and the whole team have all played a part in helping us get through this. We cannot thank them enough. It’s a miracle really. There are no words to thank them for what they’ve done for us. The commitment and care they give to the babies and families is incredible.”
Mr Ashok Daya Ram, Consultant Neonatal Surgeon, said: “Opening the chest of a one-day old premature baby who is on oscillator, lots of drugs and too sick to move to theatre and deteriorating rapidly is not a procedure that is usually undertaken and successful, but she has made a remarkable recovery. The team expects a full recovery and for Amelie to have a normal life.
“I am extremely grateful to the parents for putting all their faith and trust in me to undertake the procedure. I’m also very grateful to the surgical, anaesthetic, and neonatal teams who supported my decision and helped in the operation. The anaesthesia in these procedures is also extremely challenging and it was made possible by the brilliance of our Paediatric Anaesthetists Dr Eric Stickles, Dr Inga Van Rooven and Dr Jonathan Payne.
“The neonatal medical and nursing care have been challenging but brilliant and is crucial to the successful outcome.”
After the initial lifesaving operation Amelie was operated on for a second time a few days later, this time in theatre, for a definitive procedure which went very well. She has now been discharged.
Mr Azad Mathur, Service Director for Paediatric Surgery, said: “It gives me great pleasure to be part of this team. This case will be remembered in the history of the department.”
Dr Priya Muthukumar, Chief of Service, added: “As Consultant Neonatologist looking after Amelie on both the days of her surgery and as Chief of Service, I was immensely humbled and proud of the exemplary contribution from members of NICU, anaesthetics, the clinical and operations team from surgical division, all working together, above and beyond, in bringing the best outcome for Amelie.”
Dr Eric Stickles, who anaesthetised the baby on both operations said: “Although challenging, this was one of the most rewarding cases that I have experienced. It was wonderful to be part of such a collaborative effort and shows the expert level of care and expertise we can provide for the babies, right here at NNUH.”
Dr Bernard Brett, Interim Medical Director, said: “I cannot thank our clinical team enough for the hard work and dedication they have demonstrated to deliver such a wonderful outcome for Amelie and her family– it both humbles me and gives me great pride when I see fantastic examples of high quality, and complex care focussed on the very best outcomes for our patients such as this.”
The family intends to fundraise as a thank you to support the unit and other families going through difficult times in future.
