Multidisciplinary Team Joins Forces for Complex Pediatric Surgical Case
Theresa Delgado was 20 weeks pregnant when she found out the news: the baby boy growing within her had a large tumor originating at the base of his tailbone, a condition called sacrococcygeal teratoma that affects approximately 1 in 50,000 births. The news knocked the wind out of the expectant parents, Theresa and her wife of two years, Angela McCray.
“It was pretty overwhelming,” said Angela. “You don’t expect anything negative to happen to a child even before they’re born.”
Angela, as an emergency medical technician with the New York City Fire Department, was well-equipped to become the “question-asker,” and there were none better to ask questions of than Martin Chavez, MD, Chief of Maternal-Fetal Medicine and Fetal Surgery at NYU Winthrop Hospital.
“Dr. Chavez was amazing,” added Angela. “Being in the medical field, I loved the fact that he was straightforward. There was no sugar-coating. He said, ‘Here’s what it is, and here are your options.’”
As the weeks progressed, Dr. Chavez observed the tumor growing, and it began stealing blood from fetal circulation, causing the baby’s heart to work in overdrive and causing the fetus to go into cardiac failure. In a race against time, Dr. Chavez performed surgery in-utero at 30 weeks to close off as many blood vessels to the tumor as possible. This would reverse the cardiac failure and also allow the fetus to become bigger and stronger in the best place possible – the maternal uterine environment. A laser was used to seal off as many vessels in the tumor without harming the fetus inside the mother’s uterus. At that point, he also tapped the expertise of a colleague, Chief of Pediatric Surgery Brian Gilchrist, MD, who also happens to be an expert in the sacrococcygeal teratoma condition.