Little Nathalia was urgently born at 30 weeks with a huge tumor on her back that weighed more than half her weight. No one believed she would survive, but the little fighter clung to her life.
“She was losing a lot of blood, her heart was beating too fast, she was having difficulty breathing […] At some point I expected that we would lose her,” breathes Nazih Botros, Nathalia’s father.
He and his wife Mariam Khalil, already parents of two children, were expecting twins in December last year. At 20 weeks of pregnancy, her daughter's fetus was diagnosed with sacrococcygeal teratoma.
Nazih Botros and Mariam Khalil with their twins Nathaniel and Nathalia in Dollard-des-Ormeaux. PHOTO AGENCY QMI, TOMA ICZKOVITS
This is a rare but benign tumor that develops in the lower back during pregnancy. “I was afraid it would hit his spine,” recalls the mother from Dollard-des-Ormeaux.
The tumor grew so quickly that Ms Khalil believed it was her baby's head, which she saw during the ultrasound scan.
Too big, too fast
Doctors at Montreal Children's Hospital's plan was to wait until week 34 to deliver to ensure the best possible development of their twins. But the tumor took up too much space and prevented the blood from circulating properly.
She no longer only threatened Nathalia, but also her twin brother Nathaniel.
After 30 weeks, delivery could no longer be delayed. Still, doctors hoped to wait a month to operate on her daughter to give her a chance to grow some before performing this delicate operation to remove the huge mass.
When Nathalia was born she weighed 950g (2 pounds) and her tumor weighed more than half her weight at 550g.
Bleeding
Then the tumor started bleeding. A bleed that the medical team couldn't fix. The parents never saw their daughter again after birth, only a crowd of doctors at her bedside trying to save her.
His condition was so critical that the baby could not even be taken to the operating room. She needed immediate surgery, straight to the neonatal intensive care unit, where she was resuscitated and received several transfusions.
Full of worry, the parents ended up waiting just two hours before sharing the good news. “Everything happened so quickly, even the doctors were surprised that everything went so well,” says Ms. Khalil.
Nathalia and her twin brother recently celebrated their first birthday, two inseparable people in excellent health.
PHOTO AGENCY QMI, TOMA ICZKOVITS
“It was a real miracle”
The pediatric surgeon who operated on little Nathalia a few moments after her birth is still surprised that the operation was successful.
“It was a real miracle,” says Dr. Sherif Emil from Montreal Children's Hospital. I can not explain.”
Teratomas like the little girl's are rare in Quebec, and the few pregnancies that do occur are sometimes terminated because of the risks. But Dr. Emil has had experience in Africa, where follow-up visits are rarer and these tumors are surprises at birth.
He points out that if the tumor is initially benign, after birth it can become malignant and dangerous for the baby.
Dr. Sherif Emil is a pediatric surgeon at Montreal Children's Hospital. Free photo
The doctor who monitored the progression of the teratoma during pregnancy hoped to operate on Nathalia much later than 30 weeks to improve her chances of survival.
But the enormous amount of blood the tumor requires poses a risk of heart complications. “The tumor and the baby were almost the same size,” he remembers.
Since her premature birth, Nathalia's condition has remained unstable. His tumor was bleeding profusely and nothing could stop it, so he had to operate on it immediately.
“We didn’t know whether she would survive or not. It was a Hail Mary [l’ultime chance]», Starts the specialist.
He remains surprised that there were no complications during the delicate procedure. “She’s a unique baby,” he says of Nathalia.
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