More than 14 years after opening the Garbose Family Special Delivery Unit (SDU), the world’s first birth facility exclusively for mothers carrying babies with known birth defects, Children’s Hospital of Philadelphia (CHOP) is celebrating its 5,000th delivery.
The SDU opened in 2008 and is the delivery arm of CHOP’s internationally recognized Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment (CFDT), which has been providing care for women expecting babies diagnosed with fetal conditions for more than 27 years. Babies delivered in the SDU are prenatally diagnosed with birth defects, such as spina bifida or congenital heart disease, and will either undergo fetal surgery to treat the condition before birth or need immediate specialized care or surgery after birth.
“Approximately 1 in 33 babies is diagnosed with a birth defect each year,” said Julie S. Moldenhauer, MD, Medical Director of the SDU and Director of Obstetrical Services in the CFDT at Children’s Hospital of Philadelphia. “Traditionally, these mothers will give birth in one hospital, and their newborn will be transferred to a specialized pediatric hospital shortly after delivery. The SDU changed that by allowing mother and baby to be simultaneously cared for at one institution by a team with great experience and expertise.”
The 5,000th delivery
Baby Lyra was a miracle even before surviving a life-threatening prenatal diagnosis. After two years trying to conceive, Lyra’s parents, Tracy and David of Sarasota, FL, were ecstatic to learn they were pregnant with their first child.
Tracy’s first trimester was seamless, but then her 20-week anatomy scan revealed that there was a growth called a sacrococcygeal teratoma (SCT) on the fetus’s tailbone. As SCTs grow, they steal blood supply from the fetus’s heart, which can cause fetal heart failure (hydrops) and put the baby’s life in jeopardy.
Distraught by the diagnosis, Tracy called the CFDT and spoke with Fetal Therapy Coordinator and Fetal Therapy Education Specialist Stefanie Kasperski, MS, CGC. She and her husband flew to Philadelphia for their first appointment and underwent diagnostic tests coordinated by Kasperski. They then met with Attending Maternal Fetal Medicine Specialist Christina Paidas
Teefey, MD, and Attending Fetal and Pediatric Surgeon William H. Peranteau, MD. The physicians explained the diagnosis — a Type 2 SCT.
Although the goal was to have Tracy reach 28 weeks’ gestation without fetal surgery, at 26 weeks’ gestation, Tracy and David relocated to Philadelphia due to a significant size increase of the SCT. Shortly after, doctors noticed a change in the tumor. Concerned with significant fetal blood loss, the doctors transferred Tracy to the SDU for delivery within the hour. The SDU team quickly mobilized for an urgent cesarean delivery of Lyra. She was the 5,000th baby born in the SDU. The cesarean delivery was done under spinal anesthesia, allowing Tracy to meet Lyra while fully awake.
“It was incredible,” says Tracy of the SDU experience. “I got to see her big blue eyes, and then they did her surgery right in the connecting room.”
Lyra’s lungs were severely underdeveloped, and she was unable to breathe on her own. She was admitted to CHOP’s Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU), where she was supported with breathing and feeding tubes. As the result of expert care, Lyra was strong enough to undergo a second surgery to remove the rest of the tumor.
