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MUMBAI: When baby Sunita's parents were told that she might need a pacemaker in her heart soon after birth , her Thane-based parents were initially not convinced about the need for the operation so soon."In the two years that Jupiter Hospital's pediatric heart unit has been operational, I have found foetal heart abnormality in 10 cases, but only two parents followed it through. The others just dropped out," paediatric cardiologist Dr Srinivas L said.Twenty minutes after her birth in a Thane hospital on March 5, baby Sunita literally got a refurbished heart .A permanent pacemaker, weighing 12.8gm, was fitted into her tiny 1.5kg-frame to help her heart beat normally. Sunita was born six weeks prematurely to a Thane couple who were initially not convinced that their child needed an operation right at birth."She is the world's smallest baby to receive a permanent heart pacemaker," said pediatric heart surgeon Dr Asutosh Singh who operated on Sunita (not her real name) at Jupiter Hospital in Thane. He added that this case is possibly the second-fastest instance in the world of a neonate getting a pacemaker. In 2012, a Stanford University's doctors fitted a pacemaker in a 1.58kg baby within 15 minutes of her birth.Sunita's case highlights how better technology and health practices can save lives. Pediatric cardiologist Dr Srinivas L diagnosed the heart anomaly during a fetal scan he performed during her mother's 28th week of pregnancy. "As the heart rate was far below normal, we counselled the parents over the next few months on the possibility that their child would need a pacemaker immediately at birth," he added.The doctors were not too sure the parents would listen. "In the two years that the Jupiter Hospital's pediatric heart unit has been operational, I have found fetal heart abnormality in 10 cases, but only two parents followed it through. The others just dropped out," said Dr Srinivas.In Sunita's case, her mother had an autoimmune disease called Sjogren's Syndrome, a condition in which the body produces antibodies that damage tissues. "During pregnancy, these antibodies cross over to the fetal circulation and damage the unborn child's conduction system, causing the heart to beat slower than normal," said the doctors.At 4.57pm on March 5, Jupiter Hospital's team was in a state of readiness to transport the baby at the slightest hint of distress to the neighbouring operation theatre. "Her heart beat was 55 at birth (against 140-150 which is normal) but within a few minutes it plummeted to 27, indicating that she needed a pacemaker," said Dr Singh.Sunita's father said, "It was a difficult moment for us. She was tinier than usual and doctors wanted to operate on her, but I also realized that she was in danger."Dr Swati Gharekar, pediatric cardiologist with Fortis Hospital in Mulund, said it is great that heart problems are being picked up antenatally. "It shows a great team work," she added. Pediatric cardiac surgeon Dr Suresh Rao said, "Pacemaker operations are now routine even in newborn children. The time that it is fitted—whether in the 20th minute after birth, the next day or in the seventh year of life—is a matter of the medical team's clinical judgement."Dr NO Bansal, who heads the cardiology department of state government-run JJ Hospital in Byculla, said, "This child would have needed a pacemaker some time in life. As it was in distress right at birth, it's good that it got a pacemaker at the right time."As for Sunita, she was discharged on March 20. "She has been gaining weight and doctors are satisfied with her progress," said her father. Her surgeon Dr Singh said unlike other children who undergo two procedures, one to fix a temporary pacemaker and a permanent one 10 days later, Sunita directly got the latter. "This takes away the parental concern of the child undergoing two operations within a span of 10 days," he added.