The child was brought to the Emergency Room (ER) in a distressed state with significant respiratory difficulty and a swollen abdomen, prompting concerns of acute liver dysfunction. He had jaundice for five days, with dark-coloured urine and fatigue. Following this, he had also developed increasing abdominal distension and shortness of breath for nearly four days. A low-grade fever persisted throughout this time.

Under the expert care of Dr. Aditya Kulkarni, Consultant- Paediatric Gastroenterology and Hepatology the medical team immediately conducted a range of investigations. Initial laboratory results revealed highly elevated liver enzymes (ALT 2400 IU/L, AST 2100 IU/L), a total bilirubin of 11 mg/dL and low albumin level among others. Blood testing for serology confirmed a diagnosis of acute hepatitis A.

Imaging studies showed an enlarged liver, moderate ascites-fluid inside abdomen and pleural effusion (fluid between lungs and chest wall) which are rarely seen in hepatitis A. The young patient was admitted to the Paediatric Intensive Care Unit (PICU) for observation and specialized care. Treatment included intravenous fluids, albumin infusions to correct low protein levels, along with use of drugs to relieve fluid buildup in the abdomen and lungs. Nutritional support was also a priority, with a specially designed high-calorie, low-sodium diet supervised by dieticians.

On the second day of admission, Dr. Aditya performed procedure to carefully remove 400 mL of fluid from the abdomen to ease the child’s breathing. This intervention lasted around 30 minutes and significantly improved the patient’s  breathing.

The child’s hospital stay lasted ten days, with the first three days in the PICU, followed by seven days in the general paediatric ward. By day seven, the patient showed marked recovery — jaundice and abdominal swelling had significantly reduced,. Liver function began to normalise by the tenth day and the child was discharged in stable condition.

The dedicated team, including Dr. Aditya Kulkarni, Dr. Soonu Udani Medical Director and Head of Critical Care, paediatric nurses, dieticians, and psychologists, ensured comprehensive care, addressing not only the child’s physical needs but also the emotional well-being of his entire family.

The parents shared an emotional statement of gratitude: “We are deeply grateful to Dr. Aditya and the entire team at Narayana SRCC Hospital for their dedication in treating our child with hepatitis A. Their expertise and quick response to the rare complications turned our frightening situation into a successful compassionate recovery.”

Dr. Aditya Kulkarni, Consultant Paediatric Gastroenterology and Hepatology Narayana Health SRCC Children’s Hospital, Mumbai said, “We often box hepatitis A into a neat, predictable corner, but this case challenged that perception. Witnessing a child present with fluid accumulation in abdomen/lungs, typically red flags for long standing liver diseases, in the context of acute hepatitis A was a curveball. Our team didn’t innovated a rigorous monitoring and collaborative strategy, transforming a potentially dire situation into a beacon of hope and showcasing the extraordinary depth of pediatric capabilities.”

Reflecting on the case, Dr. Soonu Udani Medical Director & Head of Critical Care & Emergency Services, Narayana Health SRCC Children’s Hospital, Mumbai, said, “This case was a rare and challenging one — it reminded us how unpredictable hepatitis A can be. Our team’s coordination, meticulous monitoring, and targeted intervention ensured that the child was not only saved but recovered beautifully.”

Dr. Zubin Pereira, Facility Director of Narayana Health SRCC Children’s Hospital, Mumbai , said “This case is a testament to the high-quality paediatric specialty care we offer at our Hospital. Our multidisciplinary team’s approach, patient-first mindset, and quick response in such a rare presentation demonstrate our commitment to clinical excellence and compassionate care.”

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The patient, who had conceived naturally for the first time after eight years of marriage, was ecstatic to start her journey towards motherhood. However, during her initial scan, a huge intramural fibroid on the uterus was identified, with apprehension regarding the progress of the pregnancy and eventual delivery method.

In spite of the diagnosis, all scans including nuchal translucency (NT) scan, double marker, and anomaly scan were normal. At 12 weeks, she had a low pulsatility index (PI) of bilateral uterine arteries, for which low-dose aspirin (75 mg) was started to improve placental blood supply and foetal growth.

During the course of pregnancy, the mother had intermittent bursts of severe backache due to the enlarging fibroid. These were treated conservatively with 650 mg of Paracetamol twice daily. Aspirin was discontinued at 32 weeks according to obstetric practice. By 36 weeks, a growth scan had confirmed the fibroid’s severe obstruction of the birth canal, and vaginal delivery was considered impossible. With the malpresentation and the central position of the fibroid on the anterior wall, an elective LSCS was planned, with full appreciation of the likely surgical challenges.

Dr. Kekin Gala, Consultant Obstetrics and Gynecology, at Narayana Health SRCC Children’s Hospital Mumbai , clarified, “This was a very difficult case because of the location of the fibroid. It was in the very area where classical and lower segment incisions are usually made, making it a dilemma. We had to plan a modified incision pathway to deliver the baby safely.”

During intraoperative management, the surgeons identified a minor spot below the fibroid and cautiously made the cut in that space. After a successful delivery, the team made a deliberate choice to delay myomectomy to another time, to avoid causing intraoperative morbidity. The patient had an uneventful recovery and was discharged within 72 hours.

The family and patient expressed their appreciation: “We waited eight years to experience this beautiful moment, so we were initially apprehensive when we heard of the fibroid and the possible complications. But the Narayana Health SRCC team tackled the issue with so much calm and confidence that we were reassured. Their professionalism gave us the biggest blessing —a healthy baby.”

Dr. Zubin Pereira, Facility Director at Narayana Health SRCC Children’s Hospital, “Pregnancy fibroids are known to complicate gestation and delivery and create malpresentation, pain, obstructed labour, as well as heightened surgical risks. A well-coordinated effort and preoperative planning by our hospital medical team, were crucial in the prevention of a bad outcome. With this case, Narayana Health SRCC Children’s Hospital, Mumbai, once again shone through as an example of exceptional competency in high-risk obstetric care.”

The post Narayana Health SRCC Children’s Hospital, Mumbai, Successfully Handles Complex Delivery Involving Large Uterine Fibroid in First-Time Mother appeared first on newsmantra.in l Latest news on Politics, World, Bollywood, Sports, Delhi, Jammu & Kashmir, Trending news | News Mantra.