Christopher and Ellen’s joy at the prospect of new parenthood turned to fear when, at 36 weeks, their obstetrician discovered a tumor during a routine ultrasound. It was the size of a golf ball — and growing in their baby’s chest. Ellen’s physician immediately referred her to the Texas Center for Fetal Surgery™, one of only five such centers in the United States.
While baby Garrett was still connected to the umbilical cord and could receive blood and oxygen from his mother, fetal surgeons Drs. Darrell Cass, attending surgeon for Texas Center for Fetal Surgery, and Oluyinka Olutoye, attending surgeon and neonatal ECMO program co-director for Texas Center for Fetal Surgery, performed an EXIT-to-resection (ECMO) procedure. After three weeks in Texas Children's Neonatal Intensive Care Unit (NICU), Garrett and his family headed home.
Although Garrett’s condition is rare, one in 10 babies is born with medical problems — and only half of those are diagnosed prior to delivery. These smallest of patients, less than 1 month old, are often admitted to the NICU within the first 24 hours of birth. The most common conditions causing them to visit the NICU include:
- birth before 36 weeks of gestation, instead of the full term of 40
- difficulty breathing that requires support
- feeding problems
- problems that require surgical correction, such as craniofacial defectsbacterial infections, such as stretococcus or E. coli, or viral infections, such as cytomegalovirus or adenovirus.
While respiratory ailments are the most common conditions seen in newborns, not all NICUs have high-frequency ventilation, nitric oxide or extra corporeal membrane oxygenation available. Transferring a newborn to a NICU that does not have the necessary equipment causes delayed treatment.
“Because obstetricians deliver at specific hospitals, a choice of neonatal hospitals should be made early in pregnancy when the mother selects her obstetrician, if at all possible,” says
Dr. Leonard E. Weisman, neonatologist at Texas Children’s Newborn Center and professor of Pediatrics at Baylor College of Medicine.
Garrett’s mother, Ellen, is pleased that her pediatrician was well informed: “We did not anticipate needing a NICU, but we are so happy our obstetrician knew that Texas Children’s Hospital was the number one choice for fetal surgery and neonatal care.”
