Adrianna Mashburn was constantly asked if she was pregnant with triplets — even at just 28 weeks.
“That’s how big my belly was,” says the pharmacy technician of North Lima, Ohio. “I looked ridiculous.”
Adrianna, 29, soon learned a buildup of amniotic fluid was the cause of her very large bump. A mass in her baby's right lung was squishing his esophagus, so he couldn't properly process the amniotic fluid. The tumor was also pushing his heart to the side.
Adrianna’s baby was diagnosed with Congenital Pulmonary Airway Malformation (CPAM), a rare congenital birth defect that includes a cystic mass of abnormal lung tissue. It occurs between 12,000 and 25,000 pregnancies.
Doctors told Adrianna and her husband Micah Mashburn there was about a ten percent chance that their son would survive, Adrianna remembers.
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“They were telling us they didn’t think he was going to make it,” Adrianna says. “They told us to prepare ourselves for the worst. We were devastated – not knowing why this was happening or what our options were.”
There is no genetic cause for masses like these, explains fetal lung malformation expert, Dr. Darrell Cass, Director of Fetal Surgery and Director of the Fetal Care Center of the Cleveland Clinic. “It’s just bad luck."
Still, the Mashburns were determined to stay optimistic and save their son.
“I felt the baby moving around a whole lot. I said, ‘I really feel like he’s a fighter,’ ” Adrianna recalls.
The couple first met with Cass when Adrianna was 33 weeks and 5 days pregnant. Although previous specialists had advised waiting until after the baby was born to remove the tumor, Cass suggested surgically removing the tumor before the baby was entirely born. It would mean actually performing the surgery while the baby's umbilical cord was still attached to Adrianna.
This would allow the baby to receive oxygen and nutrients from the placenta, while limiting potential complications that could arise if the baby was born and breathed on its own.
"I said, 'I’ve seen this before. Many times. And yes, it’s concerning, but I believe we can get you and your baby through this with a good outcome,' " Cass remembers. He has successfully performed this procedure 19 times. "It’s absolutely the best for a case like this where the mass is squishing the heart."
Micah Mashburn says he liked Cass’s “proactive approach.”
“He had a good game plan,” says Micah Mashburn, 30, who owns and operates a truck-driving business.
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Adrianna spent the the last two weeks of her pregnancy in the hospital since she could go into labor at any time due to her high amniotic fluid levels.
On June 11, when Adrianna was 36 weeks and 2 days, the EXIT-to-resection procedure began.
“I was super nervous,” Adrianna says. “I’ve never really had surgery before.”
A C-section was performed and Cass quickly brought the baby’s head and chest out while the baby remained attached to the placenta. Cass opened up the baby’s chest and removed the 8 cm mass, about the size of a grapefruit, he says.
Then he took the 5-lb., 9-oz. baby to an operating table a few feet away in the same room, and completed the procedure.
“It went so smooth,” Adrianna says.
The couple named their newborn Maverick. He spent six weeks in the NICU before going home July 28.
Now three months old, Maverick weighs about 10 lbs. and is a smiley, happy baby who is just starting to grab for the toys brought by his 2-year-old brother, Micah Jr.
“He recovered perfectly,” Cass says. "Maverick suffered no brain damage and no complications. He will be a healthy, normal kid."
His parents say they owe a great deal to Cass and his team.
“We can’t say thank you enough to Dr. Cass,” Adrianna says. “Every time we see him, we’re thanking him. It feels like those words aren’t enough for what he did for us. We’re so grateful.”
Her husband adds: “They gave us a child.”
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