A team of high-risk birth specialists intervene to remove a large lung cyst and save a newborn's life
When Elizabeth Rodriguez-Garcia was six months pregnant with her first child, she received some frightening news about the development of her baby: The fetus had a large, fluid-filled cyst that was impeding growth of his lung, compressing on his esophagus and pushing on his heart. As the cyst grew larger, the baby developed fluid retention, a condition known as hydrops, and was at high risk of dying in utero.
A week after the cyst was first found, Jane Chueh, MD, director of prenatal diagnosis and therapy at the hospital’s Johnson Pregnancy and Newborn Center and a clinical professor of obstetrics and gynecology at the School of Medicine, inserted a large needle into Elizabeth’s abdomen and into the fetus’ chest using ultrasound guidance, then threaded a small rubber shunt through the needle into the cyst. It was the first use of the procedure at Lucile Packard Children’s Hospital Stanford.
“It immediately started to drain,’’ Chueh said. “It’s like popping a water balloon. Most of the fluid came out in seconds.”
Relieving pressure from the cyst came at a critical time, said Chueh. The dangerous fluid retention that doctors worried was endangering the baby’s life improved dramatically.
After the intervention, mother and baby continued to be frequently monitored and it soon became clear that an emergency surgery would be necessary after delivery to make sure the newborn could breathe properly on his own. At 39 weeks, Rodriguez-Garcia had a scheduled C-section to simplify the transition between delivery and surgery. Nearly three dozen surgeons, obstetricians, anesthesiologists, neonatologists and respiratory therapists worked quickly to ensure mom and baby’s safety:
The operating team, led by surgeon Karl Sylvester, MD, the center’s executive director as well as an associate professor of pediatric surgery, stood by. Within minutes of birth, the baby was quickly moved into Sylvester’s operating room, where he and the surgical team, including assistant professor of pediatric surgery Matias Bruzoni, MD, removed both the cyst and more than two-thirds of the baby’s lung that was adversely affected by the cyst.
“Our ability to provide all these subspecialists in two rooms to care for both the mom and the baby is what led to the successful outcome for this family,” Sylvester said. “It made a huge difference in this young family’s life; without it, he may not have survived at all.”
Today, Rodriguez-Garcia and her husband have a happy, healthy 5-month-old named Elijah. His mother said, “If you see him, you’d never know what he went through and that he doesn’t have most of his left lung. The cyst is completely gone. I feel blessed.”