A St. Louis mother and her newborn made history at SSM Cardinal Glennon Children’s Medical Center on Jan. 22, 2010. Ali Davis became the first baby ever delivered at Cardinal Glennon, when he was born at 8:59 a.m.
Ali was born through what is called an EXIT procedure, which involves partially delivering the infant through a cesarean incision, then establishing the baby’s airway before cutting the umbilical cord. The procedure was performed by a team from the St. Louis Fetal Care Institute, a collaboration between Cardinal Glennon, SSM St. Mary’s Health Center and Saint Louis University. The first EXIT procedure in St. Louis was performed by the same team in late November at St. Mary’s Health Center.
Ali’s mother, S'ala Davis of St. Louis, was originally referred to the Fetal Care Institute because an ultrasound at 20 weeks gestation found the baby’s lungs were so small that they were virtually undetectable. The lungs were small because a condition called Congenital Diaphragmatic Hernia allowed the fetus’ intestines to migrate into his chest cavity and block lung growth.
| Ali Davis was delivered at Cardinal Glennon because it was considered likely he would need ECMO (heart-lung bypass) support immediately after birth. After his birth, however, Ali was wheeled to the Cardinal Glennon NICU without being placed on ECMO. This was unexpected, but may be due to the fetal surgery that Ali had 12 weeks earlier.
Through a procedure called "tracheal occlusion," the FCI team blocked the baby’s airway to allow fluid in the lungs to expand and cause the lungs to grow more rapidly than they would have done otherwise, giving the baby a chance to live.
"We’ll have to continue to monitor the baby and see how he does, of course, but we’re very pleased with how things have gone thus far," says fetal surgeon Dr. Ed Yang, a co-director of the Fetal Care Institute along with maternal fetal medicine specialist Dr. Mike Vlastos.
"The baby’s oxygen saturation level was at 92 percent when he left the operating room, which we were very pleased with," says Vlastos, noting that saturation levels in a normal delivery would be around 98 to 99. Ali’s level at birth was expected to be in the 70s, so the high number indicates that the fetal tracheal occlusion procedure may have changed the outcome for Ali.
The St. Louis Fetal Care Institute is the only program in middle America to offer the EXIT procedure, and one of a handful of programs in the country that provides tracheal occlusion. For more information on the Fetal Care Institute, visit www.stlouisfetalcare.com.