Babies Firsts

Philadelphia, PA (PRWEB) April 17, 2012

Less than four years after opening the Garbose Family Special Delivery Unit, the worlds first birth facility exclusively for mothers carrying babies with known birth defects, The Childrens Hospital of Philadelphia (CHOP) celebrates 1,000 deliveries. All babies delivered in the Special Delivery Unit 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 one in 33 babies is diagnosed with a birth defect each year, said Julie S. Moldenhauer, M.D., CHOP Maternal Fetal Medicine/Reproductive Genetics Specialist and Medical Director of the Special Delivery Unit. Traditionally, these mothers will give birth in one hospital, and their newborn will be transferred to a specialized pediatric hospital shortly after delivery. The Garbose Family Special Delivery Unit changed that by allowing for mother and baby to be simultaneously cared for at one institution by a team with great experience and expertise.

The Special Delivery Unit opened in 2008 and is the delivery arm of CHOPs internationally recognized Center for Fetal Diagnosis and Treatment, which has been providing care for women expecting babies diagnosed with fetal conditions for more than 16 years. Established in 1995, the Center is the largest and most comprehensive fetal program in the world, having welcomed more than 12,000 expectant mother from all 50 states and more than 50 countries.

When we opened the Garbose Family Special Delivery Unit, we anticipated that this unique, multidisciplinary approach would improve outcomes for mother and baby before, during and after birth, said N. Scott Adzick, M.D., Surgeon-in-Chief at CHOP and Medical Director of the Center for Fetal Diagnosis and Treatment. We are proud and excited to reach this milestone less than four years after opening.

The 1000th Delivery

Like approximately 40 percent of the babies born in the Special Delivery Unit, the 1000th delivery was a newborn prenatally diagnosed with a congenital heart defect.

Kathy Banks of New Britain, Pa., found out nine weeks into her pregnancy that she and her husband, Andrew, were expecting twins. Their 20-week ultrasound raised some concerns about one of the twins hearts and their doctor quickly referred the Banks to CHOPs Fetal Heart Program for further evaluation.

Once at CHOP, the team found that although the Banks daughter was developing normally, their son had Tetralogy of Fallot, a serious structural malformation of the heart.

Although the news was difficult to receive, the prenatal diagnosis allowed the Banks to adjust and prepare for their sons arrival. It also provided valuable time for the team at CHOP to formulate a plan for the babys delivery and postnatal care.

Kathy was carefully monitored by CHOPs Center for Fetal Diagnosis and Treatment team and Fetal Heart Program for the duration of her pregnancy. On March 19, during a regular prenatal appointment, she asked about scheduling her upcoming cesarean delivery and was told it was too soon — she wasn’t due for another eight weeks and the goal was to deliver the twins as close to full term as possible. However, no sooner did she and her husband return home that day, than Kathys water broke. The couple turned right around and drove back to Philadelphia.

Obstetrician Jodi Slepian, M.D., and her team performed a cesarean delivery in the early hours of March 20. Angela Rose and Liam Andrew Banks were born within seconds of each other, both only weighing a little over three pounds. The multidisciplinary neonatal team was ready and waiting to care for both newborns.

Liam, the baby with the congenital heart defect, was born pink and active. The team ensured that his condition was stable. After the parents were able to see both babies briefly, they were taken to CHOPs Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit to be treated for prematurity, while Mom recovered just a few floors away in the Special Delivery Unit.

The babies are gaining weight and plumping up, says Kathy, but they are still peanuts. As she recovers from the cesarean delivery, she is able to visit her twins as often as she feels up to it, for as long as she likes.

Jack Rychik, M.D., Director of the Fetal Heart Program, says The babies need to continue to grow and Liam will need surgery to repair his heart in a few weeks time

Babies diagnosed with birth defects in utero and their moms need specialized obstetrical services, including prenatal and delivery care, continued Rychik says, Without the Special Delivery Unit, and the immediate care offered by experienced specialists in pediatric cardiology and neonatology all under one roof, the Banks outcome could have been much different.

About the Special Delivery Unit

The unique eight-bed labor and delivery unit was the first of its kind to exclusively care for babies born with a wide range of birth defects such as congenital diaphragmatic hernia, omphalocele, and gastroschisis, or genetic conditions and other fetal conditions unique to complicated twin pregnancies such as twin-twin transfusion syndrome. After delivery, the baby is treated immediately in the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit or the Evelyn and Daniel M. Tabas Cardiac Intensive Care Unit, while the mother recovers in a comfortable private room nearby.

“Babies with special needs require very specialized and experienced care, both before and after birth — and so do their mothers,” said Lori Howell, RN, MS, Executive Director of the Center for Fetal Diagnosis and Treatment. “This is our mission and our passion, we are constantly working to improve care, treatment and outcomes for these fragile babies and their families. The high volume of patients we see with incredibly complex, rare conditions makes all the difference. Our experienced team has treated hundreds – and, in some cases, thousands – of patients with a given diagnosis and knew that the addition of the Special Delivery Unit would allow us to provide the very best care for mom, baby and really the entire family.

The Special Delivery Unit is staffed by a highly specialized, multidisciplinary team that includes some of the world’s most experienced experts in fetal surgery and therapy, including maternal-fetal medicine specialists, reproductive geneticists, obstetricians, surgeons, anesthesiologists, neonatologists, fetal cardiologists, genetic counselors, midwives, fetal imaging experts, social workers, child life specialists, respiratory therapists as well as advanced practice, obstetric, neonatal and operating room nurses. All are specifically trained to care for mother and infant pairs in which the baby is prenatally diagnosed with birth defects. The teams decades of experience provide both the fetus and expectant mother with an unparalleled level of care.

Our unit is different from other high-acuity delivery units. We provide care only for mothers whose babies have serious and life-threatening birth defects, said Joanna Horst, RN, MSN, Nurse Manager of the Special Delivery Unit. We never forget that we are caring for two patients: mom and baby. While newborns are receiving the worlds most advanced medical, surgical and nursing care, mothers experience an equally high standard of delivery and postpartum care.

Special Delivery Unit nurses are not only highly experienced in labor and delivery care, but are specially trained in the unique needs of the Unit’s patients, including mothers undergoing fetal surgery. They are also skilled in providing palliative and bereavement care for families facing the most difficult outcomes.

As the field of fetal surgery and therapy continues to advance, specifically in light