Mike and Lisa Davila tried for four years to get pregnant, so when they learned about one of their twins having a rare birth defect, they braced themselves for the worst.
“We had gotten used to bad news,” said Mike Davila, of Cockeysville.
But this past week, doctors at Johns Hopkins University in Baltimore performed a rare procedure to fix an even more rare condition, delivering two healthy baby girls.
Doctors discovered an abnormality while performing an ultrasound on Lisa at week 18 of her pregnancy. One of the twins had a congenital high airway obstruction, which meant her trachea — the tube between the mouth and lungs — was either blocked or parts were missing, said Dr. Jude Crino, the Davila’s obstetrician and gynecologist at Hopkins.
The baby wouldn’t be able to breath, and doctors wouldn’t be able to ventilate her using a tube, he said.
“The baby would die, because the conventional method wouldn’t work,” Crino said.
But doctors had a few months to assemble the teams and craft a plan — and a few contingency plans — to treat the baby.
They planned to perform an EXIT procedure — ex utero intrapartum treatment — which means the baby is partially delivered, but the umbilical cord is not cut until after surgery.
The surgery has been performed fewer than 50 times worldwide, and only a few have been successfully done with twins, making this situation even more rare, Crino said.
“We realistically understood the potential for a poor outcome for one or both of these babies,” said Lisa Davila.
But the couple’s confidence grew as the pregnancy progressed.
The babies were healthy, and the Hopkins teams were ready. On Oct. 30, 55 physicians and support staff filled the operating room.
Baby Juliana was delivered first by Cesarean section. Then doctors partially delivered her sister Tessa, exposing her head, upper chest and one arm, so doctors could give her a tiny IV for anesthesia.
Tessa still received oxygen through the placenta, Crino said.
Relying on the placenta for oxygen before baby Tessa could breathe on her own was a simple concept that Lisa said “makes sense.”
Pediatric otolaryngology specialists performed surgery to open her airway, and 18 minutes later, the delivery was completed, Crino said.
“Fortunately, it worked out just like Plan A was crafted,” he said.
Even as he received positive progress reports in the waiting room, Mike was still expecting the worst.
“And then when it was all over, it was the best feeling in the world,” he said.
Tessa is still at the neonatal intensive care unit, but her parents hope she will come home soon. She will have surgery to repair her airway and is expected to fully recover.
“Every day she is growing,” Lisa said, “and getting better and better.”
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