Monday, August 26, 2019
A Mother and Her Newborn Are Saved by a Specialized Team Effort
Two lives at stake were rescued by exceptional skill, coordination and multidisciplinary medical care at Westchester Medical Center and Maria Fareri Children’s Hospital.
By Debra Bresnan
As seen in the Sepptember/October 2019 issue of Advancing Care
Even under the best of circumstances, delivering a premature baby via emergency C-section can be traumatic for both mother and child. But when the mother is gravely ill, the scenario demands exceptional skill, coordination and multidisciplinary medical care.
“Two lives were at stake, with the potential for 200 percent mortality. That rarely happens in medicine,” says Ramin Malekan, MD, cardiothoracic surgeon at Westchester Medical Center, the flagship of the Westchester Medical Center Health Network (WMCHealth).
It wasn’t ‘just the flu’
Pleasantville resident Cabiria Dougherty, 35, experienced a normal pregnancy until early January 2018, when Dougherty (who is an opera singer, as is her husband, Kirk) felt very sick. Her doctor prescribed Tamiflu for what was presumed to be the flu. But when her fever spiked above 104 degrees, she was transferred from another hospital to Westchester Medical Center. Blood tests revealed a blood-borne bacterial infection was affecting her heart. She also had an abnormal mitral valve in her heart, a hereditary condition, which had caused her no difficulties since she was originally diagnosed in her 20s. A few days after admission, she became confused, and her mental status changed: A brain scan confirmed she’d had a stroke.
Heart and Vascular Care
Westchester Medical Center . . . . . . 914.909.6900
Maria Fareri Children’s Hospital . . . 914.493.8372
MidHudson Regional Hospital . . . . . 845.483.5720
Good Samaritan Hospital . . . . . . . . . 845.368.5620
St. Anthony Community Hospital . . 845.987.5147
HealthAlliance Hospital . . . . . . . . . . 845.339.3663
WestchesterMedicalCenter.com/heart
“This was all extremely rare in a healthy, active woman,” says Tanya Dutta, MD, Director of Echocardiography at Westchester Medical Center. “When we did the original echogram of her heart, no one expected to see infection on a heart valve. Things became very complicated very quickly.”
On the evening of January 23, Dr. Malekan examined Dougherty, consulted with the Intensive Care Unit doctors and began coordinating surgical planning. “This was a complex case because of the mother’s infection, and it involved another person, the baby,” says Dr. Malekan. “We are one of very few specialized centers that could handle a case like this. And, because Cabiria had just had a small stroke, we sought to eliminate the occurrence of another stroke, which could have been disabling or fatal.”
The next morning, Dougherty, at 30 weeks pregnant, went to the operating room, where the OB-GYN and Neonatal ICU (NICU) teams were mobilized, and daughter Suleika was delivered. The cardiac team then performed open-heart surgery on Dougherty to remove the infected area and repair her mitral valve.
Following surgery, “her heart function was very good, and her valve worked perfectly. She did extremely well, post-operatively, and her prognosis overall is excellent,” says Dr. Malekan.
“People have the impression that heart surgery keeps you in the hospital for a very long time,” Dr. Dutta says, “but Cabiria was out of the hospital just nine days later.”
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Maria Fareri Children’s Hospital’s Donor Milk Bank
“I was one of the youngest patients in the cardiothoracic unit — and the only one with a baby,” recalls Dougherty of her time in surgical recovery. “Three days later, I started pumping milk for Suleika; the children’s hospital’s Donor Milk program supplied milk for her up until then.”
Cabiria and Kirk Dougherty are enjoying life with their growing daughter, pictured here taking a stroll through Kensico Dam Plaza.
Led by neonatologist Boriana Parvez, MD, the Preterm Donor Milk Bank at Maria Fareri Children’s Hospital, a member of WMCHealth, has provided 56,326 ounces of human donor milk to 367 very premature and critically ill infants since 2015. As a Level IV NICU, the hospital treats more than 600 critically ill babies each year. About 150 are as small and premature as Suleika.
Born 10 weeks early, Suleika only weighed 3 pounds, 10 ounces, and all her organ systems were immature. “The survival rate for preemies is about 90 percent, but, because of how sick her mom was, her mortality chances were much higher than 10 percent,” says Dr. Parvez. “Infections can be transmitted to a baby via breast milk. Our program is very proactive about providing human donor milk to eliminate that and other risks.”
Maria Fareri Children’s Hospital’s Donor Milk Program, one of the first in New York State, is one of the few in the United States that uses human milk. The milk is fortified with extra nutrients and leads to significant reduction of necrotizing enterocolitis (NEC), another risk for preemies fed with formula. Inspired by her own experience, Dougherty has become a certified lactation counselor.
Suleika required care in Maria Fareri Children’s Hospital’s Regional Neonatal Intensive Care Unit for 10 weeks before going home on March 31. During that time, Dougherty pumped milk for and nursed her daughter, and she and Kirk visited almost every day. Dougherty says, “The NICU nurses became my lifeline. Though the baby is their patient, they are really caring for the whole family. As a patient, the incredible warmth of the nursing staff really sticks with me, and the doctors were wonderful, too,” she says.
These days, mother and daughter enjoy walks in downtown Pleasantville, playdates with other moms and babies, and days at the playground when the weather is nice. Dougherty has also resumed her vocal training.
“I’m extremely grateful for the care we received,” says Dougherty. “Other families of preemies are going through much more than we are, and we count our blessings every day.”
Suleika required care in Maria Fareri Children’s Hospital’s Regional Neonatal Intensive Care Unit for 10 weeks before going home on March 31. During that time, Dougherty pumped milk for and nursed her daughter, and she and Kirk visited almost every day. Dougherty says, “The NICU nurses became my lifeline. Though the baby is their patient, they are really caring for the whole family. As a patient, the incredible warmth of the nursing staff really sticks with me, and the doctors were wonderful, too,” she says.
These days, mother and daughter enjoy walks in downtown Pleasantville, playdates with other moms and babies, and days at the playground when the weather is nice. Dougherty has also resumed her vocal training.
“I’m extremely grateful for the care we received,” says Dougherty. “Other families of preemies are going through much more than we are, and we count our blessings every day.”
Visit us at Westchester Medical Center, a member of Westchester Medical Center Health Network, to learn more. Advancing Care. Here.
Photos by John Halpern