Grace's mediastinal teratoma story | The Children's Hospital of Philadelphia

Center for Fetal Diagnosis and Treatment

Saving Grace — How 1 pound, 8 ounce Grace Srinivasan Beat Fetal Surgery, Premature Delivery and the Odds Against Survival

When Laura Srinivasan was three months pregnant, she and her husband, Reuben, decided on a name for their daughter: Grace.

“As it turns out,” says Laura, “that name would be appropriate.”

Grace was indeed a blessing, considering doctors originally didn’t expect her to survive.

After a routine ultrasound performed at 19 weeks at her Michigan doctor’s office, Laura was told her baby had a mediastinal chest mass – a solid growth developing between the baby’s heart and lung.

The doctor told Reuben and Laura “it is a fatal thing” and their options were to abort the fetus or wait for the baby to die in utero, and then deliver her.

Laura and Reuben knew in their hearts there had to be another option, and sought a second opinion. Fortunately, the second doctor they spoke with suggested they travel to The Children’s Hospital of Philadelphia to meet with Dr. Holly Hedrick and her fetal surgery team.

“We were totally distraught. She hadn’t been born yet; we didn’t even know her, yet we had all these high hopes for her. Everyone was saying it was fatal. We had to do everything we could, we had to exhaust all possibilities,” says Laura.

Just days later, they boarded a plane for Philadelphia.

At Children's Hospital, Laura went through a battery of tests, including 3-dimensional images of the baby’s heart. A final meeting with Dr. Hedrick determined that the outcome of any attempt to save Grace would be “unknown.”

“The odds weren’t good,” says Laura, “But we were all willing to try – us and the doctor.”

On June 14, at 23 weeks gestation, doctors operated in utero to remove the mass. The surgery was a complete success – the mass was taken out, and Grace was left to continue growing in her mother’s womb. However, just days later, Laura went into labor. Grace was born on June 25 weighing in at approximately 1 pound 8 ounces.

“We knew premature delivery was a risk,” says Laura. “But we didn’t have a choice.”

According to Kelli Young, MS, CRNP, Grace was in a Catch-22 situation. The surgery is what triggered the premature delivery; but without the surgery to remove the mass, Grace would have died in utero.

For weeks, Laura and Reuben “waited to exhale” as they watched their baby struggle to survive.

“The doctors in the NICU said she was one of the sickest babies they had ever seen,” recalls Laura.

Even though Laura thought her baby’s problems were “insurmountable” and had her doubts Grace would live, Reuben saw the positive side of things: there was no bleeding in the brain.

Then, one “golden weekend” Grace turned things around, says Reuben.

“She decided to live,” adds Laura.

By the end of August, even though she was still on a ventilator, Grace was stable enough to be discharged to a children’s hospital in her home state of Michigan. On October 12, Reuben and Laura brought their baby home for good. Although she was still hooked up to a ventilator and feeding tube, Grace continued to steadily improve.

Today, 2 ½ -year-old Grace is developing normally, and doing everything she can to keep up with her three big brothers. All the concerns about the consequences of having a mediastinal chest mass and having been born premature are in the past, says her parents.

“We’re just so grateful to have found Children’s when we did,” says Laura, adding, “But I don’t think it was a coincidence. We were meant to find (the Hospital); Grace was meant to be here.”

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