With seven weeks left in pregnancy, Kristina DeCesare anticipated the birth of her third child. The healthy 32-year-old mother of boys ages five years and 18 months was not unduly anxious about the impending labor and delivery. Then one evening last January, she was struck suddenly by severe abdominal pain. The excruciating pain was caused by the rupture of a splenic artery aneurysm. An extremely rare condition sometimes associated with the third trimester of pregnancy, the condition would nearly kill Kristina and her baby.
As the pain intensified, her husband, Chris, called 911. Inside the ambulance, Kristina was barely hanging onto consciousness. When she arrived at Grand View, she recalls a flurry of activity and learned her baby was in fetal distress. “A nurse held my hand, and I was pleading, ‘Please help me,’” Kristina said. She was comforted by the voice of the nursing supervisor, who said calmly, “Don’t worry, we’ll help you.”
Kristina was extremely pale and barely had a pulse. The baby’s heartbeat was dangerously low. Dr. Adibi, an OB/GYN on-site at the time Kristina had arrived, assessed the situation and immediately determined both mother and baby were in grave danger. To save them, he needed to deliver the baby quickly. With the help of the Labor and Delivery staff, he performed an emergency C-section. As he lifted the infant from the uterus, however, he discovered blood was gushing into Kristina’s abdomen behind her uterus.
“Liters of blood came spilling out of me,” Kristina said. “I had an 80 percent blood loss.” General Surgeon John Pagan, MD, was called to the emergency and discovered Kristina had a ruptured splenic artery aneurysm. Along with his operating room team, he removed the injured spleen. Meanwhile, a team of nurses and physicians, led by Children’s Hospital of Philadelphia pediatricians at Grand View, fought to stabilize the infant, who had been born without a heartbeat.
Meanwhile, thinking that his wife had gone into premature labor, Chris expected a long night of labor and telephoned friends, telling them excitedly the baby was coming. After dropping off their young sons at the babysitter’s house, he arrived at Grand View and was shocked to learn his wife, newborn or both might die. “My husband sat in the waiting room thinking, ‘How can I raise these kids alone?’” Kristina continued, “He kept telling everyone, ‘Please save my wife.’”
Once stable, baby Kaia was transferred to a hospital with an intensive-care nursery. After surgery, Kristina was moved to the Grand View Intensive/Coronary Care Unit, where she woke up a few hours later attached to IV tubes and monitors with a ventilator tube down her throat. “All I cared about was the baby,” she said.
The removal of the spleen had been successful. As is often the case with patients who have lost a great deal of blood as a result of ruptured splenic artery aneurysm, a second surgery was necessary. Surgeon Gary S. Finklestein, MD, removed part of the pancreas. “Meanwhile, my husband knew our baby girl hung onto life by a thread. He doled out information about Kaia’s condition as he felt I could handle it.”
Throughout the ordeal, Kristina found the Grand View staff extremely supportive. “The nurses and unit assistants in the ICCU were fantastic, very compassionate. They made me as comfortable as possible.” Before long, Kristina was strong enough to move to the Maternity Unit to continue recovery. “Although I had my boys at other hospitals, I must say the Maternity Unit at Grand View is the best I’ve ever been in,” she said. “It was peaceful, and everyone was so caring and warm.”
|Describing her family as the “luckiest unlucky people,” Kristina later learned that only about 25 percent of women who have a ruptured splenic aneurysm during pregnancy survive, and only about 5 percent of their babies survive. “If Dr. Adibi hadn’t acted so quickly, Kaia wouldn’t be here. I wouldn’t be here. I would have lost my will to live if Kaia had died.”
Months later, Kristina has recovered fully. In August, she returned to work as a social worker. Kaia, who was later transferred to CHOP, is home and is receiving intensive therapies. “Kaia brings us such joy,” said Kristina. “We love her to pieces. We celebrate every small accomplishment. We don’t know what the future holds for Kaia, but we hope for the best. She’s our miracle. She makes our lives complete.”
source: Annual Report 2007