Coordinated expertise helps newborn beat the odds

Coordinated expertise helps newborn beat the odds

Today, Delaney is a thriving baby girl who just celebrated her first birthday. But before she was born, she had only a 5 percent chance of survival due to a life-threatening tumor growing inside her. Delaney’s mom, Vera Sanders, says she has her daughter today because of the focused team of physicians who gave 150 percent fighting for Delaney’s life.

In the last weeks of Vera Sanders’ pregnancy, she knew her unborn daughter had only a 5 percent chance of survival. Vera’s 22-week ultrasound had detected a problem – a tumor growing in the lower abdomen and pelvis of her unborn child. Although the prognosis was grave, Vera chose to continue her pregnancy, putting her trust in the physicians of University Hospitals MacDonald Women’s Hospital and UH Rainbow Babies & Children’s Hospital.

“Because this type of tumor is so fast-growing, it can steal blood from the baby, interfering with growth and development. It can also lead to life-threatening heart failure because the heart cannot keep up with the tumor’s demand for blood,” explains Edward Barksdale Jr., MD, Surgeon-in-Chief and Chief of Pediatric Surgery at UH Rainbow Babies & Children’s Hospital.

Throughout her pregnancy, Vera’s obstetrician worked closely with Method Duchon, MD, a maternal fetal medicine specialist at UH MacDonald Women’s Hospital, who closely monitored Vera and her baby.

“With high-resolution ultrasound and other technology, we are able to pinpoint and monitor issues in utero, such as heart function, fluid levels and much more,” explains Dr. Duchon. “This type of close monitoring allows us to manage babies who would not have survived in the past.”

At 28 weeks of Vera’s pregnancy, Dr. Duchon detected a problem in which the baby’s abdomen started to fill with fluid – a sign that the tumor was taking over. If they waited any longer for delivery, the baby would die in utero and put Vera’s life at risk.

A multidisciplinary team of experts

A team of 30 multidisciplinary specialists from UH MacDonald Women’s Hospital and UH Rainbow Babies & Children’s Hospital came together to plan the birth and immediate surgery of the newborn. Specialties on the team included pediatric surgery, pediatric and obstetric anesthesiology, obstetrics/gynecology, neonatology and obstetrics nursing. A cesarean section was planned for the next day.

As Vera prepared for delivery that morning, she talked to her unborn daughter, already named Delaney. “I did not cry because I wanted to give her strength. I told her that we were going to make it through. I asked her to be strong, and I prayed for her,” remembers Vera. “Then, I went into the operating room with my head held high.”

During delivery, the pediatric surgery team was waiting in an adjoining operating room for Delaney. But before whisking the newborn off to surgery, Dr. Barksdale pulled Delaney’s father, Demetrius, aside.

Compassionate care

At 22 weeks pregnant, Vera discovered that her unborn child was carrying two large tumors that were causing the baby's organs to shut down. Given less than a 5 percent chance of survival, baby Delaney is now a happy, healthy toddler.

At 22 weeks pregnant, Vera discovered that her unborn child was carrying two large tumors that were causing the baby's organs to shut down. Given less than a 5 percent chance of survival, baby Delaney is now a happy, healthy toddler.

Dr. Barksdale allowed Demetrius to hold Delaney briefly while he and staff took pictures and video of father and daughter.

“We are in the profession of treating patients, not disease. As a father, I understand how important each child is and how difficult it would be to lose a newborn. If Delaney did not survive, we wanted to give the father memories with her, to create some degree of healing for the family,” explains Dr. Barksdale.

The team acted quickly to get Delaney into surgery, which was focused on carefully cutting off blood supply to the tumor and removing it. The process was complex. Delaney could bleed to death at any moment.

“The tumor was one-third of her entire weight. It was the size of an orange on the inside and protruded outside the body as the size of a lemon,” explains Dr. Barksdale. “Based on our experience, we knew she was likely going to die. But we were not going to allow her to die without a valiant effort. No one ever gave up hope.”

Focused teamwork leads to success

The surgical team successfully removed the tumor and Delaney made it through alive due to the focused, highly coordinated expertise of everyone involved. “Just like a product of a symphony, one instrument cannot produce the sound alone. Everyone played a role,” says Dr. Barksdale.

Although Delaney’s condition was critical for a few days, she rapidly improved in the hospital’s neonatal intensive care unit. And the little girl who had only a 5 percent chance of survival went home after only seven weeks in the hospital.

A celebration of life

Delaney’s family recently celebrated her first birthday, and they are happy to report that Delaney is thriving.

“You would never know she was a preemie or went through so much. She is so busy playing, crawling around and pulling up to stand,” says Vera. “Dr. Barksdale told me they would give me 110 percent. I believe they gave me 150 percent. Because of them, I have my daughter.”

Method Duchon

METHOD DUCHON, MD
Maternal Fetal Medicine Specialist, UH MacDonald Women’s Hospital
Clinical Assistant Professor, Case Western Reserve University School of Medicine

Edward Barksdale

EDWARD BARKSDALE JR., MD
Surgeon-in-Chief and Chief, Pediatric Surgery, UH Rainbow Babies & Children’s Hospital
Professor, Case Western Reserve University School of Medicine

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