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WOBURN — Pallavi Macharla faced a Middlesex Superior Court judge Friday and wept as she asserted her innocence and also mourned for Ridhima Dhekane, the 6-month-old girl who died in her care.

“I love Ridhima so much. Dearly. As I love my daughter,” Macharla said in a trembling voice before a packed courtroom of supporters and relatives of both the defendant and the child. “I did not cause any harm to her.”

Macharla, 45, was sentenced to up to four years in prison for the death of Ridhima, who prosecutors said Macharla shook so violently while she was caring for the child in March 2015 that the baby’s brain began to bleed.

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Macharla had been sentenced in May to life in prison after a jury convicted her of second-degree murder. In August, Judge Kenneth Fishman reduced the verdict to involuntary manslaughter.

Prosecutors had called for 10 to 15 years imprisonment. Macharla’s lawyers pleaded with Fishman on Friday to release her from MCI-Cedar Junction in Framingham and sentence her to time served and probation.

Fishman ruled that a “sentence of incarceration is necessary to reflect the serious nature of this offense to promote respect for the law and provide just punishment for the offense.”

The case was the latest one to test the long-accepted theory of shaken baby syndrome, which has divided the medical community as a growing number of doctors express skepticism that shaking a baby alone can cause the kind of bleeding and brain swelling that has led to criminal prosecutions. Middlesex prosecutors have seen other murder cases fall apart after specialists disputed evidence of shaken baby syndrome.

Fishman reduced the conviction in large part because of the conflicting evidence presented during the four-week trial, which he said made a conviction of second-degree murder unjust.

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The trial featured an array of doctors and biomechanical engineers who presented contradictory theories on what could have happened to Ridhima. The infant was one of many children Macharla cared for in the basement of her Burlington home, where she operated a day care center that prosecutors said was illegal.

Ridhima’s parents, Umesh Dhekane and his wife, Jyoti Shinde, came to the sentencing Friday holding their youngest daughter, who was born two years after Ridhima’s death. The child giggled and squirmed out of their arms during the long hearing. The couple, who also have a 14-year-old daughter, declined to make an impact statement and left the courtroom without speaking to reporters.

Middlesex District Attorney Marian Ryan declined comment. A spokeswoman referred to the prosecution’s sentencing memorandum, which argued that although the exact “mechanism, act, or combination of acts” that led to Ridhima’s injuries were unknown, “the only reasonable inference is that the defendant inflicted the extraordinary, catastrophic injuries that caused Ridhima’s death.”

“The defendant committed acts of violence upon a vulnerable, helpless, and dependent 6-month-old who had been entrusted to her care,” prosecutors wrote.

The sentence dismayed Macharla’s friends and relatives, who traveled to the courthouse from Burlington, where Macharla lived with her husband, 12-year-old daughter, and 9-year-old son.

They packed the courtroom, which fits about 200 people, and sat behind Macharla’s husband and her children.

Macharla is “good and innocent,” Lincoln Amere, a family friend and father of three, told reporters after the hearing. “She doesn’t deserve to be in a jail. Prosecutors are trying to punish the innocent in the name of protecting the children.”

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The sentence means that Macharla, an Indian immigrant who trained as a doctor in her native country, will have a conviction for an aggravated felony, which means mandatory deportation, said her lawyer, J.W. Carney Jr. A sentence of less than a year would have avoided that status and improved her chances of staying in the country.

Carney said Macharla was “heartbroken” at the prospect of deportation, and that he would appeal the conviction. The appeal, he said, is likely to be based on the science around the theory of shaken baby syndrome and what he called the judge’s failure to tell the jury that Macharla’s decision not to call 911 could not be considered a basis for conviction.

Macharla testified during the trial that on that March morning, Ridhima seemed unusually tired and napped longer than normal. She said when Ridhima woke up, she fed the baby applesauce.

Ridhima then started vomiting and choking and fell unconscious. Macharla said she tried resuscitating the child and called the baby’s mother, but did not call 911, which prosecutors said showed Macharla was “buying herself time.”

Bhalinder Singh, who attended the sentencing on Friday and described himself as a friend of both families, said in India there is no 911 system.

“If something bad happens, you call the parent,” Singh said. “Pavalli is a doctor by trade, very nice, very gentle. She cannot do anything bad.”

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Before she was taken back into custody, Macharla told Fishman she has been in “mourning” since the child’s death.

“I can understand the pain of her parents,” Macharla said. “I’ve been praying for them.”


Maria Cramer can be reached at mcramer@globe.com. Follow her on Twitter @globemcramer.