Located in the Midwest, a 1,059-bed adult tertiary hospital and a pediatric tertiary hospital with 1600 neonatal admissions each year, teamed together for the first-ever planned delivery at a pediatric hospital.

This unusual collaborative arrangement between two hospitals was made necessary when a perinatologist diagnosed the fetus to have a congenital condition known as hypoplastic left heart syndrome. Left untreated this condition is often fatal.  In addition, this fetus also had a Restrictive Atrial Septum; the critical causeway between the hearts upper chambers was fused shut, preventing the circulation of any oxygenated blood back to the baby’s body.  It was this rare combination of congenital heart defects and the need for specialized treatment immediately after birth that led to the first-ever planned delivery at a pediatric tertiary hospital. Delivering the baby in the pediatric hospital allowed for immediate cardiac intervention which meant the difference in life and death for this neonate.

More than three months of intense planning took place between more than 70 healthcare professionals.  These healthcare professionals included physician specialists in Obstetrics, Maternal-Fetal Medicine, Neonatal Intensive Care, Intensive Care, Anesthesia, Pediatric Cardiology, Pediatric Interventional Cardiology, Pediatric Cardiothoracic Surgery; nurses; scrub technicians; Pharmacy; Ethics and Compliance; Legal; Communications; Transportation and more.

Every aspect needed to be considered and evaluated for safety of the mother and baby. As part of our planning, a mock delivery was scheduled. In addition, meetings were arranged with the Quality and Improvement Department to discuss the possible scenarios regarding neonatal and obstetrical complications. There were back up plans in order to prevent such complications. Arrangements were made for adult medications and equipment to be available at the pediatric hospital.

With nearly 20 healthcare professionals in attendance, the success of our labors resulted in a delivery of a beautiful baby girl.  After stabilization, she was transferred from the Congenital Cardiac Hybrid Operating Suite across the hall to the Hybrid Cardiac Catheterization Suite where she underwent an emergent catheterization procedure. These suites accommodate any cardiac surgical case, catheterization or collaborative hybrid procedure in which cardiothoracic surgeons and interventional cardiologists work together to reduce the amount of time required to correct a heart problem and the amount of emotional and physical stress placed on a patient or their family.

After more than five weeks in the hospital, and after surpassing her birth weight, the baby was discharged home to her family. She is scheduled for two more procedures, one at 6 months of age and another at 3 years of age, to ensure proper blood flow. Delivering a baby at a free-standing children’s hospital is a rare occurrence nationwide and one that could only happen with the remarkable collaboration between these two institutions.
Lessons learned included the need for representatives from each discipline to be part of the planning as well as representatives from each hospital. Planning for emergency situations, premature delivery and home births must also be addressed. Patient participation is also important. Emphasis is on communication