Innovative Surgery Saves Life of Baby with Rare Chest and Neck Growth in Colorado Mother

In a groundbreaking medical procedure at Children's Hospital Colorado, a Colorado mother underwent a rare and complex half-birth surgery to save her baby, who was diagnosed with a large growth obstructing her airway. The mother, Angelica Vance from Fort Collins, faced a critical situation during her pregnancy when ultrasound and MRI scans revealed a mass in her baby's chest and neck area. This growth threatened to prevent the infant, Chloe, from breathing after birth because it impeded her ability to swallow amniotic fluid and would obstruct her airway.

Throughout her pregnancy, Vance experienced symptoms such as increased abdominal size and pain, leading her medical team to monitor her closely. They drained excess amniotic fluid to reduce pressure but remained concerned about the baby’s airway, which was at risk of being obstructed by the growth. The doctors explained that, inside the womb, breathing isn't necessary as oxygen is supplied via the placenta through the umbilical cord. However, once Chloe was delivered, she would need to breathe independently.

To address this critical challenge, Dr. Chris Derderian, a pediatric and fetal surgeon at Children's Hospital Colorado, proposed an ex-utero intrapartum treatment (EXIT) procedure. This complex operation involves partially delivering the baby via cesarean while still connected to the placenta, giving the medical team time to secure the airway before the baby fully leaves the mother's body. Although the procedure carries risks—mainly bleeding due to uterus relaxation necessary to keep the placenta attached—it is performed only about once annually at the hospital, reserved for cases with promising chances of success.

On October 15, the surgery commenced after Vance was placed under general anesthesia. The medical team swiftly delivered Chloe's head and shoulders, then, within approximately 90 minutes, successfully inserted a breathing tube into her tiny airway, about the width of a pen tip. The process required precision and coordination from about 40 specialists, including a cardiac surgeon prepared to intervene if the growth caused severe lung pressure. The operation was a success; Chloe turned pink as oxygen was administered, and she was stabilized in the neonatal intensive care unit.

Post-surgery, Chloe remained on a ventilator for ten days and then gradually transitioned to less invasive oxygen support. Remarkably, her growth was not cancerous, and removal was straightforward. After six weeks in intensive care, Chloe was discharged home without the need for oxygen but with a feeding tube due to difficulty swallowing, a consequence of limited practice in utero. Today, she is relatively healthy, receiving therapy to strengthen her swallowing and neck muscles.

Vance shares her experience to raise awareness about rare fetal conditions and the lifesaving potential of advanced fetal surgeries. Her story highlights the importance of prompt diagnosis, specialized surgical interventions, and multidisciplinary teamwork in overcoming complex fetal health challenges.

This pioneering case underscores the critical role of fetal surgery techniques like EXIT in saving babies with life-threatening conditions and offers hope to families facing similar diagnoses.