Fetal intervention saves baby Elijah

Elizabeth Rodriguez-Garcia was nearly six months pregnant when she arrived at a routine ultrasound in July 2013. It would be the first baby, a boy, for Elizabeth and her husband Salvador Alvarez.

But something was wrong. The ultrasound technician found a large dark spot where the fetus’ left lung should be. They were immediately referred to Stanford Medicine Children’s Health Perinatal Diagnostic Center in Salinas. Even though Elizabeth was still 80 miles away from Lucile Packard Children’s Hospital Stanford, a group of experts at the hospital’s Center for Fetal and Maternal Health was already examining a transmission of Elizabeth’s ultrasound images and medical records. The highly specialized center offers counseling, management and lifesaving medical services to mothers with high-risk pregnancies and their newborns.

The couple arrived at the center a few days later and were met by a team of obstetric and pediatric experts who gave them not only a diagnosis, but a plan to save the baby’s life.

The fetus had a congenital pulmonary airway malformation, which meant he had a very large, abnormal cyst in his lung. He was at high risk of dying in utero. Specialists performed a fetal intervention, which involved inserting a shunt and draining the cyst in the fetal lung, thus offering the best chance of survival.

Relieving pressure from the cyst came at a critical time. The dangerous fluid retention that doctors worried was endangering the baby’s life improved dramatically. But, once he was born, the cyst would need to be removed by emergency surgery to allow him to breathe properly on his own.

To simplify the speedy transition between delivery and surgery, the scheduled C-section was performed in an operating room instead of the Lucile Packard Children’s Hospital Stanford labor and delivery center. Within minutes of birth, the baby was quickly moved into another operating room, where both the cyst and more than two-thirds of the baby’s lung were removed.

The baby, named Elijah, was cared for in the hospital for almost a month. His parents now say the 6-month-old is a healthy, happy baby, whose only sign of his near-fatal start in life is the fading scar on his chest.

For Elijah’s family, it’s a happy ending that resulted from early detection, expert collaboration, and an expanding network of extraordinary care that connected patient and providers in time to make a life-saving difference.

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