Giving Babies the Best Chance
Giving Babies the Best Chance | Emily Farlow, ex utero intrapartum treatment, EXIT, University of Mississippi Medical Center, UMMC Fetal Medicine Center, Dr. Kenneth Liechty, Batson Children’s Hospital, B. J. Mize, Dr. Jennifer Shores, Dr. James Bofill.

Fetal medicine staff include, front row from left, Dr. James Bofill, Dr. Jennifer Shores and Dr. Kenneth Liechty, and back row from left, Dr. Christopher Friedrich, Holly Zimmerman, Dr. Rick Boyte, B. J. Mize and Jackie Carrillo.

UMMC Fetal Medicine Center Offers In-Depth Procedures

When Emily Farlow’s obstetrician detected a previously unseen tumor in the mouth of the fetus during her last month of pregnancy, she normally would have been required to travel from her Hattiesburg home to an out-of-state hospital to undergo an ex utero intrapartum treatment (EXIT) procedure.

The innovative, highly specialized surgery is used to deliver babies who have suspected airway compromise to secure the airway and prevent brain damage from a lack of oxygen. The EXIT is more complex than a standard Caesarian section because the mother is under general anesthesia, which maintains blood flow to the placenta and the infant. The infant is partially delivered with only the head and upper torso visible.

Farlow was able to have the EXIT performed less than 100 miles from home at the new multidisciplinary center at the University of Mississippi Medical Center, which offers in-depth procedures previously unavailable in Mississippi for repairing heart defects, abdominal wall malformations, tumors and other issues in the tiniest of babes.

Since UMMC Fetal Medicine Center was established last year, its team members have evaluated and delivered more than 200 babies, many of them with complex birth defects that would otherwise had required care in medical centers as far away as the east and west coasts and the Midwest.  There’s nothing more terrifying than being an expectant parent and finding out your baby has something wrong,” said Kenneth Liechty, MD, associate professor of pediatric surgery and director of the center. “Unfortunately, many care providers don’t have the experience or resources to provide an accurate diagnosis, prognostic information or management options to these families.”

UMMC and Batson Children’s Hospital collaborated on the multidisciplinary center to provide a higher level of fetal medicine to infants with intricate medical challenges.

“Ultimately, we don’t want families from Mississippi to have to go outside the state for care,” said Liechty, noting the exorbitant medical and travel costs—and the emotional toll—involved for families required to travel hundreds of miles from home.

In 15 percent of pregnancies, the fetus will have something wrong, ranging from a simple skin tag to major developmental disorders that involve multiple organ systems and require surgery and months of intensive care. Some of these patients even require surgery before birth or special delivery procedures.

Liechty, who came to UMMC in 2009 from Pennsylvania, was a member of the Center for Fetal Diagnosis and Treatment at Children’s Hospital of Philadelphia (CHOP), where he cared for several Mississippi moms who traveled out of state for specialized obstetrics care. The opportunity to establish a similar center in Mississippi and bring a higher level of specialized fetal and neonatal care to the South played heavily into Liechty’s decision to move.

“I was a fellow when (CHOP) set up its fetal center and was involved from the beginning,” he said. “So I learned a lot about how a center for fetal medicine should work. In one day, patients can come here and get an answer rather than being referred to several different specialists on several different days. The center coordinates these appointments into one day and at one central location.”

B. J. Mize, nurse manager and center coordinator, organizes visits for each mom, which Leichty remarked is no simple feat, considering the center’s reliance on multiple departments, divisions and specialists.

As the center grows, he plans to extend fetal interventional procedures that can correct abnormalities before the baby is delivered. Because some babies cannot survive some of the most difficult issues and high-risk pregnancies, palliative care specialists also participate in the team approach.

“We give them the best possible chance at life,” Liechty said. “Without the procedures we offer and that level of care, many wouldn’t have had a chance at all.”

Pediatric cardiologist Jennifer Shores , MD, said the Center for Fetal Medicine centralized the care available in many existing specialties. “The pieces of the puzzle were there already,” she said. “The fetal center helps pull them together under the same roof.”

Through her involvement in the center, Shores is seeing a growing number of patients with multi-organ system involvement and also congenital heart defects.

“Previously, fetal heart patients would be diagnosed here, born here, then transported elsewhere for surgery,” she said. “Now we offer that surgery here with Dr. Jorge Salazar. It’s expanded my practice to include more surgical and post operative care of neonates.”

For Farlow, within a week of the birth defect being detected, she was in Jackson consulting with James Bofill, MD, professor of obstetrics and gynecology, and Liechty. Her daughter, Zoey, became only the second infant in Mississippi to undergo an EXIT procedure at Batson Hospital.

Liechty said it took the medical team about half an hour for the procedure. The infant was then delivered and the umbilical cord was cut.

 “You would have never guessed that we went through what we did,” said Farlow. “You can’t even tell there was ever any surgery done.”