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Miracle of birth comes with an EXIT strategy

Posted Nov 13, 2009 by Beth Gaddis

Updated Nov 13, 2009 at 12:50 PM

The miracle of birth is always amazing, but one little girl’s entry into this world was even more special than usual.

She had to have surgery halfway through the delivery.

A team of doctors from USF Health and Tampa General Hospital performed their first ex utero interapartum treatment (EXIT), clearing the airway for the baby, who was born with a large benign tumor around her neck and several organs.

A team of more than 20 physicians, nurses and health professionals did two practice runs before they did the procedure Oct. 1.  This rare procedure has only been performed about 100 times in the United States, hospital spokeswoman Ellen Fiss said.

They partially delivered the baby via C-section, but kept the oxygen-supplying umbilical cord connected.  Then they inserted a breathing tube into the baby and cleared her airway before finishing the delivery and cutting the cord.

“The biggest challenge in this type of procedure is establishing an airway for the fetus while maintaining a steady supply of oxygen so that no neurological damage occurs,” said Valerie Whiteman, the lead USF obstetrician for the delivery.

Everything went well, and the 7-pound, 11-ounce baby was delivered. 

“We were all familiar with our roles, our equipment and what steps needed to be taken when,” Whiteman said. “We prepared for the best- and worst-case scenarios. It took teamwork, teamwork and more teamwork.”

The mother is a 31-year-old who lives in Tampa with her husband and two other children.  They were able to take the baby home Oct. 12. 

The baby has already had one surgery since then to partially remove the tumor, which was attached from her skull to her tongue and surrounded her heart, windpipe and several blood vessels.  Doctors operated Oct. 30 to remove the neck portion of the cystic hygroma. A second operation to remove the rest of the tumor in her chest will take place in two or three months.

Charles Paidas, director of the USF Division of Pediatric Surgery,  performs a follow-up surgery on the baby. Photo from Tampa General Hospital.

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