Newswise — LOS ANGELES (June 3, 2024) -- Vita Rose Carletti made her grand entry into the world on Jan. 7, 2024, after her mother, Krista Hazelwood, went through an arduous 36-hour labor that ended in an emergency cesarean section.
During labor, doctors alerted Hazelwood and her husband, Matteo Carletti, about the presence of meconium—a newborn’s first bowel movement—in the amniotic fluid in the uterus. However, the passing of meconium before birth is a fairly common issue that occurs in up to 22% of deliveries and is typically easy to manage.
But Vita Rose’s birth wasn’t typical.
Moments after Vita Rose’s debut, physicians and nurses rushed the newborn to the Neonatal Intensive Care Unit (NICU) at Cedars-Sinai Guerin Children’s. Soon, she was diagnosed with a severe case of meconium aspiration syndrome.
Unlike regular stool, meconium is a black, tarry and sticky substance. Typically, most babies pass meconium a few hours after birth. However, if ingested in utero or during birth, the viscous fluid could potentially coat the air sacs (alveoli) inside the lungs and block the airways, causing lung and heart problems.
“In a lot of cases, meconium aspiration is very mild because there's maybe not very much that gets deposited into the lungs. But in Vita Rose’s case, there was a significant amount, to the point that it caused significant lung damage,” said David Epstein, MD, director of Pediatric and Congenital Cardiac Intensive Care at Cedars-Sinai Guerin Children’s.
By next morning, Vita Rose’s complications had snowballed quickly, and her health had taken a turn for the worse.
ECMO to the Rescue
Vita Rose was in respiratory lung and heart failure. With her life in jeopardy, the newborn was placed on a ventilator to help her breathe, and Guerin Children's physicians consulted with experts in the Smidt Heart Institute to devise a plan to strengthen the baby's heart and lungs.
“In the initial chest X-rays that were taken within one hour [of birth], her lungs were already very opaque, which tells us that her lungs didn't have the ability to oxygenate her blood or to remove some of the carbon dioxide that all babies have,” said Richard W. Kim, MD, director of Pediatric and Congenital Heart Surgery and surgical director of the Guerin Family Congenital Heart Program in the Smidt Heart Institute and Cedars-Sinai Guerin Children’s.
“Gradually over the course of the next few hours, it became apparent that even our typical forms of invasive support, like a ventilator or a machine that can breathe for her, weren't going to be sufficient,” Kim said.
Time was of the essence. So, in addition to the ventilator, the doctors decided to put her on extracorporeal membrane oxygenation (ECMO). ECMO is a dual bypass life support machine that performs the function of the heart and lungs.
Generally, patients are on ECMO for only three to five days to reduce the risk of blood clots, neurological issues, seizures and potential infections.
But Vita Rose’s condition was extremely critical. In order to keep her stable, doctors kept her on ECMO support for nearly a month and monitored her condition closely.
So did Vita Rose’s parents. The lifesaving machine and complex web of cords and tubes prevented the parents from touching or holding their baby girl. All they could do was show up, pull up a chair next to the machine and talk to her.
“We just prayed and showed up and showed up, and it was like really early on in the situation that we had to ask ourselves … is our kid going to live?” Hazelwood said.
It Takes a Village
Vita Rose was in the Guerin Children’s Pediatric Intensive Care Unit for more than 100 days, including nearly a month on ECMO.
Over the course of her stay in Guerin Children’s, Vita Rose required round-the-clock care and underwent multiple medical procedures to get her heart and lungs functioning without machines. Healthcare workers from numerous departments and specialties pitched in to meet Vita Rose’s changing needs.
“I think she's met every unit at the hospital except maybe dermatology,” Hazelwood said.
Epstein credits the hospital-wide team. “It's really like this cadre of individuals from all areas who are working with her to get her through this. So, it was a huge team effort, and it was one that I was just proud to be a part of because everybody just worked so well together,” Epstein said.
Kim agrees. “There were many dark days, but I think we never gave up. We were always very optimistic for her. And sure enough, that's the way it worked out in the end,” he said.
While the recovery was slow and steady, Vita Rose is already thriving, babbling and fixating on her favorite stuffed toys hanging over her crib, just like any other child her age.
“She's come a very, very long way,” Hazelwood said. “She is the strongest, most joyous, bravest little fighter we know. And we're just so, so grateful that God said she can stay.”
Read more on the Cedars-Sinai Blog: A High-Risk Pregnancy Lifeline
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