Special Delivery Unit: Mila's Story | Cincinnati Children's

https://www.cincinnatichildrens.org/service/f/fetal-care/services/special-delivery-unit

When Madison Zito was pregnant with her second child, a routine 20-week ultrasound brought news of a severe birth defect. She and her husband were heartbroken.

Madison Zito, Mila’s Mom: “We had a perfectly healthy and normal pregnancy with our first. So, this was a completely different thing. And it was just, it was devastating.”

Mike Shick, Mila’s Dad: “It’s a heavy weight on your chest. The world stops, and so we had some big decisions to make.”

They learned their baby had a hole in her diaphragm. She had a congenital diaphragmatic hernia that interfered with lung growth. Her case was severe, making her a candidate for a surgery called FETO – or Fetoscopic Endoluminal Tracheal Occlusion.

The procedure uses a balloon to temporarily block the airway, preventing lung fluid from escaping the lungs and building pressure to make room for the lungs to grow.

Madison: "There was just so much uncertainty, so that was terrifying for us. Our maternal-fetal doctor gave us three options. He said that basically, we could terminate the pregnancy. We could do nothing and see what happens. Or we could go to Cincinnati because they specialize in her diagnosis.”

They knew right away that they wanted to do everything they could to save their baby. So, they came from Akron to Cincinnati to work with specialists here.

Madison: "Dr. Peiro, he was our case leader. He was very knowledgeable. He was very kind. He was very quiet. He brought the fetal procedure from Barcelona to Cincinnati, so he made sure we really understood the process, he made sure we understood the risks.”

Jose Peiro, MD, PhD, Cincinnati Children's Fetal Center: “Usually, we perform this procedure, we place the balloon in the fetal trachea between 26 and 29 weeks of gestation. We want to have this balloon for five to six weeks there. So, at 34 weeks, we plan to remove the balloon with the same strategy.”

In the end, it was a successful procedure, and Mila was born in July 2019.

Foong-Yen Lim, MD, Cincinnati Children’s Fetal Care Center: “If we anticipate a baby to require special care or intervention after birth, our goal would be for the mother to deliver in our Special Delivery Unit at Cincinnati Children's so that the baby can receive specialized care immediately after birth and also to readily access all of the resources required to ensure the best possible outcome. In addition, the fragile newborn will not be exposed to the stress of transport between hospitals, while the mother can recover a little more at ease being close to her baby."

Moms like Madison can now be part of Cincinnati Children’s new Special Delivery Unit. It allows moms expecting babies with complex fetal conditions to deliver their babies here and recover on-site while their baby receives immediate care from our pediatric specialists.

Sammy Tabbah, MD, Cincinnati Children’s Fetal Care Center: “There are only a handful of centers that even have a delivery unit housed within the fetal center proper. This is definitely a unique place to be.”

Mounira Habli, MD, Cincinnati Children's Fetal Care Center: “It is a one-stop shop where everybody is taken care from the beginning to the end.”

Dr. Tabbah: “It really is the wave of the future whenever moms are looking for options for best care and best comprehensive care whenever they do experience a pregnancy with a wide variety of different complications.”

The six-bed delivery unit at Cincinnati Children's Fetal Care Center offers 24/7 services and is an option for some families based on both the health of the mother and the baby. Special Delivery Unit services are provided by TriHealth.

Madison: “Mila had a rough start to life. We almost lost her a couple times. We’ve had multiple surgeries since. We are finally in a pretty good spot so far. She has been developmentally hitting so many milestones. She has been doing phenomenal. To see her now is just mind-blowing. She’s such a miracle. It’s, it’s really awesome.”

Dr. Peiro: “The main satisfaction is about seeing babies and families happy at the end of the process. Every day I receive an email with some pictures of a family celebrating a birthday, whatever, that’s my best day.”

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