special feature
EXIT Procedure Saves Baby with Rare Tumor Diagnosis Giving birth under normal circumstances can often be incredibly stressful. Giving birth to a baby with an unusual prenatal diagnosis at 27 weeks in the midst of a global pandemic, though, comes with its own unique challenges. That was the reality one family was facing. But the care team at the Colorado Fetal Care Center — the only team in the region able to perform the procedure their baby needed to survive — was there to help them through it. Fetal tumor diagnosis and treatment plan When rural Colorado couple Lyndsy Tobler and her husband, Aaron, found out they were pregnant with their third child, Ella, they were excited. Lyndsy’s other pregnancies had gone smoothly, and this one was too. At Lyndsy’s 20-week ultrasound, doctors found a large mass on Ella’s tailbone. Using telehealth, doctors connected with maternal-fetal medicine specialist and Medical Director of the Colorado Fetal Care Center, Michael Zaretsky, MD, who confirmed Ella had a particularly aggressive sacrococcygeal teratoma. Also known as SCT, it’s an extremely rare fetal tumor that occurs in approximately 1 in every 40,000 live births. “I automatically started researching the diagnosis,” Lyndsy says, “but because the condition is so rare, there was hardly any information on it. It was extremely frustrating.” At 22 weeks, Lyndsy and Aaron traveled to Denver for a comprehensive appointment at the Colorado Fetal Care Center.
After several in-depth fetal diagnostic tests, including a fetal MRI, ultrasound and echocardiogram, they were finally able to get concrete answers and treatment options. Dr. Zaretsky and the care team explained the associated risks and outcomes possibilities of each. Importantly, some treatment options would increase the risk for early delivery, which meant Ella would have a higher risk of complications, even death. “I had tons of questions over the next few weeks,” Lyndsy says. “But every time I’d call Dr. Zaretsky or any of the Colorado Fetal Care Center doctors, they’d call me back that same day. That really helped me and my husband through the process so we could make a decision that was right for us.” Lyndsy and Aaron decided to let doctors continue monitoring Ella to see if she could make it to 28 weeks. That way, she could grow as much as possible before doctors had to intervene.
