DENVER — When Angelica Vance went under anesthesia for a cesarean section, she didn’t know if her newborn daughter would survive.
Doctors had warned of two outcomes. If successful, her baby, Chloe, would be placed on a ventilator, and surgery would follow to remove a growth blocking her airway. If not, Vance might face severe bleeding, while a machine pumped blood through Chloe’s body.
“That morning was intense,” Vance said. “If ECMO didn’t work, she wouldn’t make it.”
Vance’s pregnancy had been normal until her third trimester, when a sudden buildup of amniotic fluid raised concerns. Tests revealed a mass in Chloe’s chest and neck, preventing her from swallowing fluid in the womb and threatening her ability to breathe after birth.
Dr. Chris Derderian, a fetal surgeon at Children’s Hospital Colorado, recommended an ex-utero intrapartum treatment (EXIT) procedure. This rare surgery allows doctors to secure a newborn’s airway while the baby remains connected to the placenta for oxygen.
The procedure is risky. Doctors must relax the uterus to keep the placenta attached, which increases the chance of heavy bleeding. Children’s Hospital Colorado performs only about one EXIT procedure per year.
On October 15, Vance underwent surgery. Doctors delivered Chloe’s head and shoulders by cesarean, giving them roughly 90 minutes to establish an airway. Around 40 specialists were on hand, ready to respond to complications.
Chloe’s airway was barely the width of a pen tip. After 15 tense minutes, a breathing tube was inserted, and her color improved as oxygen flowed in.
“I don’t think we have got a better scenario,” Derderian said.
Three days later, doctors removed the growth in a surgery that went quicker than expected. Chloe spent 10 days on a ventilator, then transitioned to less-invasive oxygen support. After six weeks in the neonatal intensive care unit, she went home.
Now, Chloe is healthy but continues daily therapy to strengthen her neck and improve swallowing. Vance said she hopes sharing their story will help others facing similar challenges.
“It feels like playing a lot of catch-up, but she has come a long way,” she said.
Related topics:
