Every time Maria Elliott* looks into the smiling face
of her 13-month-old son Elijah, she is reminded of
what helped make it all possible – the extraordinary,
multidisciplinary care that she and her baby
received at Winthrop-University Hospital.
Martin Chavez, MD, Chief of the Division
of Maternal-Fetal Medicine and Director
of the Fetal Therapy and Surgery Program
at Winthrop.
Mrs. Elliott suffered from Rh
Disease during pregnancy – a
condition that results when Rhnegative
blood is exposed to
Rh-positive blood cells, leading
to the development of Rh antibodies.
During pregnancy, these
Rh antibodies travel through the
placenta and attack a baby’s red
blood cells, posing several complications
including severe
anemia leading to cardiac failure
and fetal death.
Though she was blessed with
a healthy child 10 years ago,
Mrs. Elliott’s immune response
was so intense that hope for any
future children was dismal.
Despondent in anticipation of the
difficult road ahead when she
learned that she was pregnant
in the fall of 2008, Mrs. Elliott
turned to obstetrician/gynecologist
Peyman Zandieh, MD, for
guidance. Dr. Zandieh works in close collaboration
with Winthrop’s Department of Obstetrics and
Gynecology and is committed to providing expectant
mothers with the best possible care.
“Understanding the severity of Mrs. Elliott’s
condition, I knew we needed to act quickly,” said
Dr. Zandieh. Confident in the expertise of a dedicated
team of Maternal-Fetal Medicine physicians at
Winthrop who specialize in the treatment of highrisk
pregnancies, Dr. Zandieh promptly referred
Mrs. Elliott to the Hospital’s advanced fetal treatment
and surgery program. The program offers
specialized surgical/treatment modalities to treat
a variety of complex fetal conditions.
“With its dedicated team of experts including
doctors and nurses who specialize in high risk
pregnancy, modern facilities
and equipment, and a Neonatal
Intensive Care Unit that can
support any complication,
Winthrop’s comprehensive
obstetrical program was the
perfect place for Mrs. Elliott,”
said Dr. Zandieh.
Upon an initial consultation
with Anthony Vintzileos, MD,
Chairman of Winthrop’s
Department of Obstetrics and
Gynecology, and Daniel Kiefer,
MD, Ob/Gyn Maternal-Fetal
Medicine Fellow, Mrs. Elliott
learned of an advanced treatment
plan – only available at
select hospitals nationwide –
that could offer hope for a successful
pregnancy. Without this
treatment, the chances for fetal
hydrops (a serious fetal condition)
and early in-utero fetal
death would be extremely high.
She was soon evaluated by Martin Chavez,
MD, Chief of the Division of Maternal-Fetal
Medicine and Director of the Fetal Therapy and
Surgery Program at Winthrop, who, with the help
of the team, proposed a unique plan of care involving
a series of intravenous medical treatments
(known as IVIG therapy) and in-utero blood transfusions
to treat the baby’s anemia prior to delivery.
“This novel approach enables our team to
address anemia problems and treat a fetus in-utero
so that the patient’s pregnancy can continue
with better outcomes,” said Dr.
Chavez, who specializes in high risk
pregnancies, ultrasound diagnosis,
ultrasound-guided procedures, and fetal
therapy, treatment and surgery.
Understanding the need for immediate
intervention, Mrs. Elliott began
IVIG therapy during the 10th week of
her pregnancy. This intravenous treatment
utilizes donor blood which
provides human-derived antibodies to
prevent the mother’s immune system
from recognizing a fetus as foreign and
attacking it. The first treatment was
administered at Winthrop and was a
success; subsequent treatments, which
averaged six hours in duration, followed
on a weekly basis in Mrs. Elliott’s home
until approximately the sixth month of
her pregnancy.
At 27 weeks, Mrs. Elliott began the
second phase of treatment – a series of
in-utero blood transfusions. This
advanced technique uses ultrasound
guided technology to replace fetal red
blood cells that are being destroyed by
the mother’s immune system. After
Mrs. Elliott was administered a medication
that would temporarily immobilize
her baby, Dr. Chavez used ultrasound
technology to guide a needle into the
baby’s umbilical cord to transfuse a
concentrated amount of healthy blood.
“Fetal umbilical cord transfusion
allows for accurate measurements of
fetal blood count and exact amounts
of blood to be delivered to the baby,”
said Dr. Chavez.
Each transfusion was performed
in the Hospital’s Labor & Delivery
Operating Room with the support of
a specially trained team of doctors,
nurses and anesthesiologists.
Also instrumental to Mrs. Elliott’s
course of treatment was the dedicated
efforts of Winthrop’s Blood Bank Team,
who worked diligently
to ensure the
availability and processing
of donor
blood and platelets
necessary for Mrs.
Elliott’s in-utero
transfusions.
Among the members of Maria Elliott and Elijah’s care team at
Winthrop were (l.-r.) Jane Chiusano, MT(ASCP), Blood Bank
Supervisor; CJ Catalano, RN, MSN, Nurse Manager, Labor & Delivery;
Martin Chavez, MD, Chief of the Division of Maternal-
Fetal Medicine and Director of the Fetal Therapy
and Surgery Program; Peyman Zandieh, MD;
Anthony Vintzileos, MD, Chairman of the
Department of Obstetrics and Gynecology;
and Nazeeh Hanna, MD, Chief of the
Division of Neonatal Medicine.
“We needed a
consistent supply of
O Rh-negative blood
and AB negative
platelets – the
rarest types of
blood and
platelets,”
said Jane
Chiusano,
MT (ASCP),
Winthrop’s
Blood Bank
Supervisor.
“Thanks to the
efforts of the Long
Island Blood Services and all of the
community members who stepped up
to donate, we were able to meet this
vital need.”
What’s more, members of the
Blood Bank Team received specialized
training in order to prepare specified
volumes of blood needed for each inutero
transfusion.
“It was truly remarkable to witness
multiple departments working
together to achieve one common goal
– helping this mother and baby,” said
Ms. Chiusano.
On July 26, 2009, Mrs. Elliott
happily welcomed Elijah into the
world, delivered by Dr. Zandieh, who
co-managed her care throughout the
entire pregnancy.
Elijah’s care continued in
Winthrop’s Neonatal Intensive Care
Unit (NICU), where he was monitored
by an outstanding team of neonatologists
and nurses for several days
before going home with his mom and
dad. Though he required some followup
treatment, today, Elijah is a vibrant
14-month-old who is making full
progress thanks to the extraordinary
care that he received at Winthrop.
“When I first found out I was pregnant,
I felt hopeless,” said Mrs. Elliott.
“Today, I am so thankful to have come
across such a wonderful team of specialists
at Winthrop, who have truly
restored my confidence in healthcare.”
Winthrop-University Hospital
offers a full range of comprehensive
obstetric and gynecological services.
Winthrop is a New York State Regional
Perinatal Center – a prestigious designation
that recognizes the Hospital’s
commitment to delivering the highest
level of obstetrical and perinatal care.
For more information about
obstetrical and gynecological services
at Winthrop, call 1-866-WINTHROP
*patient’s name has been
changed to respect her privacy.
|
Vol. 20, No. 2
Summer/Fall 2010
Back to Publications
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