TEXAS CHILDREN'S FETAL CENTER
Lauren
Diagnosed before birth,
Lymphatic malformation or giant neck mass

Like most little girls, Lauren is happiest when she’s playing with her dolls, chasing after friends or trying to mimic her sister Maddie. She giggles often – usually cracking herself up.

“Lauren’s a character,” says her mom, Jennifer. “She’s not yet aware she’s a little different.”

Little Lauren has been extraordinary from the time she was born. Diagnosed with lymphatic malformation — more commonly known as a giant neck mass — even before she was born, Lauren’s birth and subsequent growth is a story of medical innovation carried out by surgeons and their support staff at the Texas Children's Fetal Center.

Twenty-four weeks into her pregnancy, Jennifer and her husband Duke had an appointment with their obstetrician for an ultrasound. The results showed they’d be having a baby girl and identified an alarming abnormality: a large mass growing on the fetus’s neck.

Jennifer and Duke were immediately referred to Dr. Mary O’Day, director of maternal fetal medicine at the Texas Children's Fetal Center, who involved center co-founder and surgeon Dr. Darrell Cass in the case. Understandably shaken and afraid, Jennifer was comforted and encouraged by the doctors’ experience.

As part of the baby’s evaluation, the Texas Children's Fetal Center performed a fetal MRI scan — the only center in the region able to do so with reliability and accuracy — to gain more information about the mass. It was determined the mass was pushing and compressing the baby’s airway. Because there was a significant risk that the baby would not be able to breath after birth, Drs. O’Day and Cass recommended that Jennifer undergo ex utero intrapartum treatment (EXIT).

In this procedure, an incision is made in the mother’s abdomen, and the baby’s head and shoulders are pulled from the mother. The rest of the baby, umbilical cord still attached, remains in the mother as doctors evaluate, via bronchoscopy, and secure, through intubation, the fetal airway before delivering the baby. If necessary, other specialized procedures may be performed to ensure that the baby is able to breathe prior to cutting the umbilical cord.

At 3 months old, Lauren underwent eight hours of surgery to remove the mass and make cosmetic corrections.

Jennifer and Duke give high marks to everyone affiliated with the Texas Children's Fetal Center.

“They walked us through what was going to happen, made sure we understood everything, including the risks, and answered all of our questions,” says Jennifer. “They are very compassionate people.