A baby with a large rare cyst growing in its mouth has been safely delivered at St George’s.

Marian Bayley, 31, was transferred to St George’s for specialist care from her local hospital after her five month scan when they realised that the baby had a mass growing in his mouth.

Marian said: “At first, we thought the baby was wriggling and yawning with his mouth open, but doctors realised that he wasn’t yawning and it was actually a mass meaning he couldn’t close his mouth.”

Marian was transferred to St George’s to be seen by fetal medicine specialists the next day to identify the mass and monitor the rest of her pregnancy.

Dr Amar Bhide, Consultant Obstetrician who led Marian’s care, said: “We could tell that the mass was non-malignant and that it was growing under the baby’s tongue, though we would only know the extent of what to expect – and exactly what it was – when baby was born.

He added: “The cyst was 16mm in diameter and although it wasn’t initially blocking his airways or food pipe, that could have changed if it grew larger and caused complications, so we continued to monitor as we may have needed to carry out an EXIT procedure.”

An EXIT (ex utero intrapartum) procedure is performed when it is thought that the baby will have an immediate, critical problem once separated from the mother at birth. The procedure is carried out via caesarean section, while the baby is still partially in the womb the baby is operated on – in this case, to remove or drain the cyst – while maintaining oxygenation from placental support, before being delivered once safe to do so.

Fortunately for Oliver, as the cyst wasn’t blocking his airway and it didn’t grow any larger, he was born when Marian went into natural labour without intervention.

Oliver was born on 26 September after a 50 hour labour weighing 7lbs 2oz at 37 weeks’ gestation.

The cyst was initially thought to be a mucus retention cyst and although not painful or blocking airways, it was large.

This meant that Oliver could not breast-feed and required a nasogastric feeding tube until the cyst was operated on.

Marian said: “Discovering our baby had a mass in his mouth at our five month scan was overwhelming and worrying to say the least. Thankfully our care at St George’s has been nothing short of outstanding and filled us with hope and reassurance when we needed it the most.

She added: “From the thorough monitoring by Dr Bhide throughout my pregnancy, to the countless hours being supported by the neonatal doctors, nurses and breastfeeding councillors in Oliver’s first weeks of life, it makes you truly grateful for the NHS and the wonderful work that this hospital does.

She added: “We’re thrilled at the remarkable work Oliver’s surgeons have done, and it makes us so emotional and relieved to see him beginning to smile and close his mouth in the last couple of weeks. A truly special early Christmas present!”

Mr Hamid Daya and Mr Prince Modayil, Consultant Paediatric ENT Surgeons, said: “At first, we carried out a minimally invasive procedure to drain the cyst which is often sufficient for such cysts in the mouth and laryngeal area. However, the cyst recurred and a more definitive procedure was required to remove it permanently.”

It was found to be a foregut duplication cyst (part of the gastrointestinal tract in the wrong place). These are extremely rare and the team had seen only two in the last 15 years.

Dr Bhide said: “In twenty years, I’ve only seen only a handful of cases of a facial tumour. St George’s is a specialist centre and able to quickly undertake urgent MRIs and other tests for babies like Oliver who require additional monitoring and accurate diagnoses to ensure that they are delivered safely surrounded by specialist teams and equipment.

He added: “Oliver has had an unusual start to life, but I’m so pleased to see how well he is doing and how happy the family are.”

Jonathan, Marian’s husband, said: “We are so thankful to St George’s for delivering our beautiful son safely. We’ve been on quite a remarkable journey the last few months and I will never forget the wonderful support and care Oliver and Marian have been given.”

Marian, Jonathan and Oliver are at home enjoying family life in Dorking.

Notes to editors

  • Marian was transferred to St George’s from East Surrey Hospital
  • Mr Daya and Mr Modayil manage paediatric ear, nose and throat patients jointly to assure continuity of care and double expertise.

St George’s University Hospitals NHS Foundation Trust is the largest healthcare provider, major teaching hospital and tertiary centre for south west London, Surrey and beyond – and one of the largest healthcare providers in the UK – serving a population of 3.5 million.

Its main site, St George’s Hospital – one of the country’s principal teaching hospitals – is shared with St George’s, University of London, which trains medical students and carries out advanced medical research.

St George’s is one of 11 adult and children major trauma centres in the UK, one of eight hyper acute stroke units and one of the biggest and busiest of the eight heart attack centres in London.

It is also an accredited centre of excellence for trauma, neurology, cardiology, cancer and blood pressure services and is the national centre for family HIV care and bone marrow transplantation for non-cancer diseases.