Published on in CHOP News
More than 14 years after opening the Garbose Family Special Delivery Unit (SDU), the world’s first birth facility exclusively for mothers carrying babies with known birth defects, Children’s Hospital of Philadelphia (CHOP) is celebrating its 5,000th delivery.
The SDU opened in 2008 and is the delivery arm of CHOP’s internationally recognized Richard D. Wood Jr. Center for Fetal Diagnosis and Treatment (CFDT), which has been providing care for women expecting babies diagnosed with fetal conditions for more than 27 years. Babies delivered in the SDU are prenatally diagnosed with birth defects, such as spina bifida or congenital heart disease, and will either undergo fetal surgery to treat the condition before birth or need immediate specialized care or surgery after birth.
“Approximately 1 in 33 babies is diagnosed with a birth defect each year,” said Julie S. Moldenhauer, MD, Medical Director of the SDU and Director of Obstetrical Services in the CFDT at Children's Hospital of Philadelphia. “Traditionally, these mothers will give birth in one hospital, and their newborn will be transferred to a specialized pediatric hospital shortly after delivery. The SDU changed that by allowing mother and baby to be simultaneously cared for at one institution by a team with great experience and expertise.”
The 5,000th delivery
Baby Lyra was a miracle even before surviving a life-threatening prenatal diagnosis. After two years trying to conceive, Lyra’s parents, Tracy and David of Sarasota, FL, were ecstatic to learn they were pregnant with their first child.
Tracy’s first trimester was seamless, but then her 20-week anatomy scan revealed that there was a growth called a sacrococcygeal teratoma (SCT) on the fetus’s tailbone. As SCTs grow, they steal blood supply from the fetus’s heart, which can cause fetal heart failure (hydrops) and put the baby’s life in jeopardy.
Distraught by the diagnosis, Tracy called the CFDT and spoke with Fetal Therapy Coordinator and Fetal Therapy Education Specialist Stefanie Kasperski, MS, CGC. She and her husband flew to Philadelphia for their first appointment and underwent diagnostic tests coordinated by Kasperski. They then met with Attending Maternal Fetal Medicine Specialist Christina Paidas Teefey, MD, and Attending Fetal and Pediatric Surgeon William H. Peranteau, MD. The physicians explained the diagnosis — a Type 2 SCT.
Although the goal was to have Tracy reach 28 weeks’ gestation without fetal surgery, at 26 weeks’ gestation, Tracy and David relocated to Philadelphia due to a significant size increase of the SCT. Shortly after, doctors noticed a change in the tumor. Concerned with significant fetal blood loss, the doctors transferred Tracy to the SDU for delivery within the hour.
Infant Stabilization Team
The SDU team quickly mobilized for an urgent cesarean delivery of Lyra. She was the 5,000th baby born in the SDU. The cesarean delivery was done under spinal anesthesia, allowing Tracy to meet Lyra while fully awake.
“It was incredible,” says Tracy of the SDU experience. “I got to see her big blue eyes, and then they did her surgery right in the connecting room.”
Lyra’s lungs were severely underdeveloped, and she was unable to breathe on her own. She was admitted to CHOP’s Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU), where she was supported with breathing and feeding tubes. As the result of expert care, Lyra was strong enough to undergo a second surgery to remove the rest of the tumor.
About the Special Family Delivery Unit
Motivated by their own experiences over 25 years ago, hospital Trustee Emeritus Lynne Garbose and her husband Bill saw the need for a comprehensive maternal-fetal center and, inspired by the work being done in the CFDT, provided a philanthropic gift to create the SDU.
The unique labor and delivery unit, opened in 2008, was the first of its kind to care exclusively for babies born with a wide range of birth defects such as congenital diaphragmatic hernia, omphalocele, and gastroschisis, or genetic conditions and other fetal conditions. After delivery, the baby is treated immediately in the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit or the Evelyn and Daniel M. Tabas Cardiac Intensive Care Unit, while the mother recovers in a comfortable room nearby. The SDU is staffed by a highly specialized, multidisciplinary team that includes some of the world's most experienced experts in fetal surgery and therapy.
“As the field of fetal surgery and therapy continues to advance, specifically in light of our advances in prenatal imaging and fetal surgery, we are treating more and more babies before they are born,” said N. Scott Adzick, MD, Surgeon-in-Chief at CHOP and medical director of the Center for Fetal Diagnosis and Treatment. “The Garbose Special Delivery Unit is a very important part of the comprehensive care our Center for Fetal Diagnosis and Treatment is able to provide.”
An update on Lyra
Lyra and her parents recently commemorated her first birthday — and the one-year anniversary of her milestone birth in the SDU — with a return to Philadelphia for an annual checkup with Dr. Peranteau, which she passed with flying colors.
Dr. Peranteau and the CHOP Neonatal Follow-Up team remain involved in Lyra’s care, staying in touch with her local doctors to make sure the tumor doesn’t come back and providing support so that smooth sailing continues for Lyra and her parents.
Contact: Ashley Moore, The Children’s Hospital of Philadelphia, 267-426-6071 or firstname.lastname@example.org