April 14, 2015

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Dr. Wesley Lee, co-director of Texas Children’s Fetal Center and section chief for women’s and fetal imaging at Baylor College of Medicine, recently received the William J. Fry Memorial Lecture Award from the American Institute of Ultrasound in Medicine (AIUM).

The award recognizes a current or retired AIUM member who has significantly contributed in his or her particular field to the scientific progress of medical ultrasound.

Lee’s lecture titled, “Great Expectations: The Way Forward in Fetal Imaging,” was presented during the opening session of the 2015 AIUM/WFUMB Annual Convention in Lake Buena Vista, Florida.

Among his many accomplishments, Lee has authored 148 peer-reviewed articles and 20 book chapters pertaining to maternal-fetal medicine, prenatal detection of congenital anomalies, 3-/4-dimensional fetal sonography and fetal magnetic resonance imaging.

March 24, 2015

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Growing up can be tough, especially on girls, but there’s one way to make this journey through adolescence easier for moms and daughters – preparation.

“If you equip teens and preteens with the knowledge they need to navigate the changes and challenges that lie ahead, they’ll emerge stronger, healthier, more confident young women,” said Dr. Jennifer Dietrich, Texas Children’s chief of pediatric and adolescent gynecology.

Hosted by experts from Texas Children’s and Baylor College of Medicine Department of Obstetrics and Gynecology, Girls Elevated is an empowering, interactive one-day event that educates teens about their bodies and helps them cope with peer pressure and self-esteem issues that often occur during puberty.

Girls between the ages of 10 and 18, and their mothers or caregivers, are invited to attend separate, age-appropriate sessions to hear from physicians, law enforcement and other experts on topics girls want and need to know about, from physical development to personal safety to healthy relationships and more.

This year’s keynote speaker, Jamie Schanbaum, will deliver an inspirational talk about overcoming adversity, positive body image and self-esteem, after losing her legs and fingers to bacterial meningitis. Her mission is to prevent others from suffering from this vaccine preventable disease.

Since the event’s launch in 2014, 120 participants attended Girls Elevated. This year, organizers are expecting an even larger crowd of 240.

Girls Elevated will be held from 9:30 a.m. to 2:30 p.m. on Saturday, April 11, at the United Way Community Resource Center at 50 Waugh Drive, Houston, TX, 77007.

Click here to register online for Girls Elevated 2015! The deadline to register is Friday, April 10.

March 3, 2015

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I felt compelled to share the story of my late son, Anthony Jaxon Llanas, who was born at Texas Children’s Pavilion for Women on October 16, 2014. Alongside his two older siblings, he was my pride and joy. I only knew him for one month, but in those 29 days, we developed a strong, unbreakable bond.

Anthonyand MommyUnlike my previous pregnancies, this pregnancy was complicated. At 32 weeks, I was hospitalized at the Pavilion for Women. During my two-week stay, many of the nurses were wonderful and made me feel comfortable. Because of polyhydramnios (excessive amniotic fluid), I had an emergency C-section and delivered a handsome 4 pound, 7 ounce baby boy.

While still in my womb, I knew Anthony’s chances for survival would be uncertain. When I was 20 weeks pregnant, Anthony was diagnosed with esophageal atresia – a congenital defect where the upper esophagus does not connect with the lower esophagus and stomach – and tracheoesophageal fistula, an abnormal connection between the esophagus and the trachea. Two weeks later, doctors discovered he had coarctation or narrowing of the aorta. Anthony was also diagnosed with CHARGE syndrome which was not confirmed until after my son passed away peacefully in my arms.

Despite Anthony’s lengthy list of health problems, I was overjoyed to see his precious little face staring right at me, but at the same time, I was nervous about his prognosis. My Little Angel was wheeled away to the Neonatal Intensive Care Unit (NICU) at Texas Children’s Newborn Center where many of the NICU nurses took excellent care of him and answered all of my questions. He spent two weeks in the NICU before he was transferred to the Cardiovascular ICU, where a team of physicians and nurses closely monitored him.

As I struggled to stay positive while my baby was courageously fighting for his life, Anthony’s health problems quickly stacked up, one after another. Shortly after birth, Anthony was diagnosed with choanal atresia which prevented him from breathing through his nose. At 10 days old, doctors diagnosed him with severe immune system deficiency. His T-cells were lower than most normal babies at birth.

JuliaWhen Anthony was one week old, he had his first surgery to correct esophageal atresia, and two days later, he had surgery to treat choanal atresia. Anthony underwent bypass open heart surgery a few days later to repair the narrowing of his aorta, which eventually caused his heart rate to increase and be off rhythm. He was placed on an Extracorporeal Membrane Oxygenation (ECHMO) machine because his lungs and heart were too weak to function on their own. While he was on the ECHMO machine, his left lung collapsed. The day after his bypass, he was taken off the machine, but since his heart could not tolerate it, he was placed on the ECHMO machine for a second time. Sadly, Anthony’s extremely weak heart and lung were not cooperating.

On Wednesday, November 12, 2014, doctors told us Anthony’s heart rate was steadily dropping and that his body was not recovering from the multiple surgeries. He was getting sicker and they felt there was nothing more that could be done.

After hanging on for so long and enduring all of the surgeries to save his life, he passed away in my arms in a room full of people who loved him. He was by far the strongest and the most beautiful baby boy I’ve ever met. As all parents who’ve dealt with a loss of a child, I wish I could have done things differently to prevent his death, but with the support of Zoey’s Angels, they’ve helped me understand that I did as much as a parent could do and that his memory is not erased. If anything, it has just begun.

Four months after the tragic loss of my baby, I am back at work. While it’s been a difficult road for me and my family, my colleagues and manager, Lindi Stegeman, have been so supportive and I am so grateful to be working with such wonderful people.

February 24, 2015

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During the early morning hours of February 17, Elysse Mata sat holding her babies tightly, kissing them as tears ran down her face. She was saying goodbye to her girls, conjoined for the last time before undergoing a historical surgery that would offer them their first chance at separate lives.

“We’ve been waiting for this moment for a year,” Elysse said. “Ever since we found out the twins were conjoined, we’ve been praying and hoping this day would come.”

Conjoined twins Knatalye Hope and Adeline Faith Mata – known by their family simply as Hope and Faith – were born at Texas Children’s Pavilion for Women on April 11, 2014 via Caesarean-section at 31 weeks gestation after weeks of extensive prenatal imaging, multidisciplinary consultation and planning at Texas Children’s Fetal Center. The babies each weighed 3 pounds, 7 ounces.

Surgeons allowed the girls to grow and gain strength for 10 months before undertaking the difficult task of separating them. During that time our comprehensive team of surgeons, physicians, nurses and support staff prepared for the day that had finally arrived. The lead surgeons had met and thoughtfully examined every aspect of their procedure, the simulation staff prepared the team for complications, and Critical Care nurses were readying the PICU for the girls post-surgery.

Letting go

In those quiet, prayerful moments before the surgery, Elysse’s husband, John Eric, and their 5-year-old son, Azariah, were also near, kissing the girls’ foreheads and squeezing their tiny hands while they anxiously awaited the start of the surgery that would change the girls’ lives forever. A group of extended family, friends and a Texas Children’s Hospital chaplain joined the Matas for an emotional prayer.

Lead surgeon Dr. Darrell Cass entered the room, gave the family a hug, and with the help of supporting operating room staff, escorted the girls to Texas Children’s Operating Room 12. Members of the girls’ NICU care team, who had been by their sides for almost a year, lined the hallways in an emotional show of support.

Just after 7 a.m., Hope and Faith were wheeled into the operating room where a team of 12 surgeons from seven specialties, six anesthesiologists, eight highly trained nurses and support staff spent nearly 24 hours performing an operation that would eventually separate the twins.

Surgery begins

During the first few hours of the procedure, Anesthesiologist Dr. Helana Karlberg and Surgical Nurse Audra Rushing prepped the girls for surgery. At 1:10 p.m., Chief of Plastic Surgery Dr. Larry Hollier made the first incision. For the next 18 hours, the surgical team worked in shifts to separate the twins, who shared a chest wall, pericardial sac (the lining of the heart), diaphragm, liver, intestines, bladder, uterus and pelvis.

As the surgeons continued the difficult task, family and friends gathered in a large, room praying and supporting the parents while they waited for updates from the surgical team.

“This is the (most difficult) feeling ever,” said John Eric Mata as he and Elysse waited for their first in-person update. “It’s giving me too much time to think. I’ll be a lot more comfortable when they say they are separated. I’m ready for that.”

At one point, the family was told there had been a rocky part in the procedure when the twin’s livers were being operated on. During that process, surgeons explained there was quite a bit of blood loss and that the anesthesiologists and cardiologist in the room had to keep up with that and maintain the girls’ blood pressure.

“At times it was difficult,” Hollier said. “But it was controlled very rapidly, allowing us to move on with the procedure.”

Hours later, Eric and Elysse heard the answer to months of prayers when Pediatric Surgeon Dr. Oluyinka Olutoye met them in a private consult room and delivered the good news – the twins had been successfully separated.

“This is the farthest they’ve been from each other,” Olutoye said when we greeted the family around 1 a.m. “They’re about 30 feet apart right now.”

They are two

Separate for the first time, the twins were taken to different operating rooms where surgeons continued to work on the girls’ critical organs. Just before 10 a.m., the surgery was complete, and the family visited their girls, apart for the first time in rooms next to each other in the PICU, where they are being cared for by a team of their NICU primary nurses and their new PICU nurses.

Elysse said she and her family are extremely grateful for the team that separated her babies, and the countless hours they put into understanding the girls’ condition, and how best to treat and care for them.

Cass and several of the other surgeons, including plastic surgeon Dr. Ed Buchanan, met the family in Adeline’s room to share in the family’s joy and relief. They gave the family a summary of the monumental procedure and explained what they should expect in the next few days.

“Thank you for your trust,” Cass said to the Mata family. “We are going to keep doing everything we can to get them through this. So far, so good.”

Hollier said that to the best we know this is the first time a case of this magnitude – conjoined twins connected at the chest, abdomen and pelvis – has ever been done.

“It could not have gone better,” he said. “It was phenomenal team work and great preparation on the part of the institution.”

Click on the photo to view a gallery showing the Mata’s journey to separation.
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A dream realized

By late morning Wednesday, February 19, Elysse and John Eric were again with their babies, watching over their girls, now in two beds, in adjoining PICU rooms. It was a moment they had been waiting for since more than a year ago when a routine ultrasound revealed that Elysse was carrying conjoined twins. They traveled from their hometown of Lubbock to Texas Children’s Fetal Center, where the next chapter of their journey began.

Today, their family has a promising new chapter, thanks to the compassionate expertise of our physicians, nurses and countless staff and employees.

“We love them,” Elysse said of the girls’ medical team. “They mean the world to us, and they will forever hold a special place in our hearts.”

Conjoined Twins Separation Surgical Team

  • Plastic Surgeon Dr. Ed Buchanan
  • Lead Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Darrell Cass
  • Chief of Pediatric Gynecology Dr. Jennifer Dietrich
  • Pediatric Urologist Dr. Patricio Gargollo
  • Transplant Services Surgeon Dr. John Goss
  • Anesthesiologist Dr. Kalyani Govindan
  • Chief of Plastic Surgery Dr. Larry Hollier
  • Lead Anesthesiologist Dr. Helena Karlberg
  • Plastic Surgeon Dr. David Khechoyan
  • Pediatric Urologist Dr. Chester Koh
  • Cardiovascular Surgeon Dr. Dean McKenzie
  • Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Oluyinka Olutoye
  • Anesthesiologist Dr. Olutoyin Olutoye
  • Chief of Orthopedics Dr. William Phillips
  • Lead Surgical Nurse Audra Rushing
  • Anesthesiologist Dr. Steve Stayer

Learn more about the Mata twins and the preparation Texas Children’s team took on to care for the girls:
Mata conjoined twins born at Texas Children’s
Tissue expander surgery allows twins to prepare for separation surgery
Mata twins’ care team helps create swing for baby girls
Radiology team helps prepare surgeons for separation surgery with 3D model

February 17, 2015

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Due to our success in treating the most severe cases of morbidly adherent placenta, Texas Children’s Pavilion for Women continues to attract numerous patients from across the country. With the rise of caesarean births in the U.S., this potentially life-threatening condition is becoming more common among pregnant women.

Morbidly adherent placenta – known as placenta accreta, increta or percreta, depending on the depth of uterine invasion – occurs when the placenta and its blood vessels grow deeply into the wall of the uterus and is unable to detach after childbirth. Women who have had prior caesarean sections (C-sections) or other uterine surgeries are more at risk for this pregnancy complication since the placenta latches on to the surgical scar too firmly. About 5 to 7 percent of women die due to massive hemorrhage.

“The number of women with morbidly adherent placenta that we care for is rapidly escalating as our outcomes continue to attract a growing number of referrals,” said Texas Children’s OB-GYN Chief Dr. Michael Belfort, a world-renowned placenta accreta expert and founder of the Morbidly Adherent Placenta Program at Baylor College of Medicine. “Our success is rooted in our ability to work as a team.”

Women with morbidly adherent placenta receive multidisciplinary care from a diverse group of specialists representing maternal-fetal medicine, gynecologic oncology, anesthesiology, urology, neonatology, radiology and blood bank services.

“Our multidisciplinary team works closely with the hospital’s blood bank to ensure adequate supply of blood products is available for surgery and to help manage transfusions,” said Texas Children’s Maternal-Fetal Medicine specialist Dr. Karin Fox. “We rely on our anesthesiology team to administer blood and draw labs to ensure electrolytes remain stable in addition to keeping the patient comfortable. Urologists provide expertise when the placenta embeds itself into the urinary system.”

The approach that gynecologic oncology surgeons use to remove uterine cancer inspired the technique used to treat placenta percreta since the abnormal placenta acts like a cancer invading the outside of where it is supposed to be growing.

“We take a wider approach when we perform a hysterectomy to reduce the potential for blood loss,” said Texas Children’s gynecologic oncologist and surgeon Dr. Concepcion Diaz-Arrastia. “We remove the uterus and cervix in a modified radical hysterectomy along with a small amount of the tissue that attaches the uterus to the pelvis as if it were cancerous.”

Khadajah Winchester credits the Pavilion for Women’s highly skilled team of physicians who meticulously prepared and planned for her emergency surgery. She was airlifted from a hospital in Alexandria, Louisiana to the Pavilion for Women.

Winchester – who had two previous caesarean deliveries – had placenta percreta where the placenta invaded part of her bladder. Physicians made an incision high on Winchester’s uterus to avoid touching her placenta. Despite minimal bleeding during the actual delivery of her 6-pound 7-ounce baby girl Brooklyn, Winchester began bleeding profusely from the numerous vessels that had fed her invasive placenta and required a 25-pint massive blood transfusion.

“I hardly had blood pumping through my veins and if I had not gone to the Pavilion for Women, I would have died,” Winchester said. “Hospitals in smaller communities don’t carry the large volume of blood that I needed to survive.”

The Pavilion for Women – world renowned for its comprehensive, multidisciplinary care and focus on high-risk pregnancies – has treated 27 cases of placenta accreta in the last 12 months.

“Patients with risk factors for placenta accreta should consult with specialists early – ideally by 24 to 28 weeks of pregnancy,” said Texas Children’s Maternal-Fetal specialist Dr. Alireza Shamshirsaz. “Early diagnosis prior to delivery is crucial to allow time for planning and preparation to enhance the best possible outcomes for mother and baby.”

Click here for more information about Baylor’s Morbidly Adherent Placenta Program at the Pavilion for Women.

February 10, 2015

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Living with pelvic health issues isn’t easy. Many women are too embarrassed to talk about it. Some simply don’t know where to turn, while others struggle to find a physician who will listen to them.

Texas Children’s Pavilion for Women is changing that, and the lives of our patients.

In partnership with Baylor College of Medicine Department of Obstetrics and Gynecology, Texas Children’s Pavilion for Women recently launched the Pelvic Health and Wellness Program to improve the quality of life for women suffering from pelvic disorders and sexual dysfunction.

While incontinence, overactive bladder, pelvic organ prolapse and low libido are more common in women over 50, these conditions affect women of all ages. Studies estimate more than 40 percent of women will experience symptoms related to incontinence, prolapse, or pain with intercourse in their lifetime.

“We understand the toll these disorders can take on a woman’s physical and emotional well-being,” said Dr. Anuja Vyas, a Texas Children’s gynecologist and obstetrician who specializes in the diagnosis and treatment of vulvovaginal disorders. “Our team takes the time to listen to our patients’ needs and tailor a customized treatment plan for every patient to achieve the best possible outcomes.”

Many patients who are referred to the Pavilion for Women have already seen countless physicians who have unsuccessfully treated their condition. When they come to our facility, they receive comprehensive care from a multidisciplinary team of specialists representing diverse areas of expertise:

  • Urogynecology
  • Vulvovaginal health
  • Menopause health care
  • Reproductive psychiatry
  • Obstetrics and gynecology
  • Physical therapy
  • Surgery (cutting-edge technology)

The Pelvic Health and Wellness team also includes nurse practitioners, licensed biofeedback therapists, massage therapists and sexual counselors, all collaborating to improve the health of women during every stage of their reproductive lives.

From diagnosis to treatment – whether it is physical therapy, mental health, or minimally invasive surgery – women receive the full complement of services in one centralized location.

“We know what our patients are going through and we want to help them,” said Texas Children’s surgeon Dr. Francisco Orejuela, a urogynecologist who is board certified in female pelvic medicine and reproductive surgery, and specializes in treating women with pelvic floor disorders. “The sooner they come to us, the greater our success in treating them, and the faster they can return to their normal lifestyle.”

For more information about the Pelvic Health and Wellness program, click here.

Click here to watch a video spotlighting the world-class, gynecologic care provided to women of all ages at the Pavilion for Women.

September 3, 2014

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On April 11, identical conjoined twin girls were born at Texas Children’s Pavilion for Women, each weighing about 3 pounds, 7 ounces. Born via Caesarean-section at 31 weeks gestation, Knatalye Hope and Adeline Faith share a liver, diaphragm, pericardial sac (the lining of the heart) and intestines. They were welcomed by their parents, Elysse and John Mata and their older brother Azariah.

Now estimated to weigh 10 pounds, 4 ounces each, the girls are being cared for by a team of specialists at Texas Children’s Newborn Center.

“The twins still require some respiratory support but they are doing well, and we don’t expect them to have any significant setbacks,” said Chief of Neonatology Dr. Stephen Welty.

Plans for surgical separation are being discussed among a team of multidisciplinary specialists. The Mata family and the care team’s goal right now is for the babies to continue to grow and gain weight.

“I expect it to go well,” Welty said in an interview with KHOU on Tuesday. “Will it be easy? No. The best thing to do is to do the safest thing, which is grow them up, get them bigger and healthier with great nutrition and great developmental care and then separate them at a time which is as safe as possible.”

Waiting a few months after the babies’ birth before proceeding with separation helps optimize the lung and organ function, which can minimize the risk of complications.

“Although other facilities have reported early separations, each case is different with regard to the number of organs that needs to be separated,” said Dr. Darrell Cass, co-director of Texas Children’s Fetal Center. “Also, in some instances those cases have experienced complications due to the early separation, which I believe can be avoided.”

Doctors anticipate beginning the twins’ separation process between the ages of 6 months and 8 months. First, our plastic surgery team will place tissue expanders to help induce the growth of additional skin that will be needed once the two babies are separated. The process of tissue expansion is six to eight weeks. Afterward, a multidisciplinary team of specialists will proceed with separation of the twins. The separation will involve many surgeons, including those from Pediatric General Surgery, Urology, Plastic Surgery, Orthopedic Surgery, Cardiac Surgery and Gynecology.

“There will be two surgical teams,” Cass said. “One team will start, and then once the babies are separated, the teams will separate to work on each infant and finish the reconstruction.”

The surgical teams include:

  • Anesthesiology: Dr. Helena Karlberg and Dr. Steve Stayer
  • Pediatric General Surgery: Dr. Darrell Cass (team lead) and Dr. Oluyinka Olutoye
  • Pediatric Urology: Dr. Patricio Gargollo and Dr. Chester Koh
  • Pediatric Plastic Surgery: Dr. Ed Buchanan and Dr. Larry Hollier
  • Pediatric Orthopedic Surgery: Dr. David Antekeir and Dr. Frank Gerow
  • Pediatric Gynecology surgery: Dr. Jennifer Dietrich

Cass said the surgery is risky, as there always is the risk of death for one or both children. However, he believes the risk is small and the team is anticipating an excellent outcome.