A miracle baby

Savannah Perry kisses her daughter, Lake Annabella Hall

What happened during the EXIT procedure?

On the day of delivery, the baby was pulled halfway out of her mother's uterus. The baby stayed connected to the umbilical cord during the procedure, allowing placental support.

A right thoracotomy was performed to remove the bronchogenic cyst and then a bronchoscopy to treat sufficient deficiency in the left lung to exclude damage to trachea and left mainstem bronchus. The umbilical cord was cut upon completion of the EXIT procedure. The baby was fully delivered and handled by Dr. Crombleholme and the neonatal team, who were able to help the baby breathe.

According to Dr. Crombleholme, an international leader in the field of fetal surgery, the EXIT procedure with a bronchogenic cyst removal was the first documented procedure of its type.

In its new Children's
Colorado East Tower facility,
the Colorado Fetal
Care Center has:

Separate entrance/exit

12 labor, delivery, recovery and
postpartum (LDRP) rooms equipped
for full maternal and neonatal care

1 maternal operating room for
Cesarean section deliveries

1 fetal surgical suite
specifically designed to
perform a full range of
fetal surgical interventions

2 infant
stabilization rooms

When Savannah Perry, a nurse who lives in Boulder, was 20 weeks pregnant, she received a shocking phone call.

An anomaly was found in her baby's lung, so the family was referred to the Colorado Institute for Maternal and Fetal Health (CIMFH) for further imaging. There, doctors found a congenital pulmonary adenomatoid malformation (CPAM) on the baby's left lung and a bronchogenic cyst.

At 34 weeks, careful monitoring by the team revealed that growth of the bronchogenic cyst blocked the trachea and left mainstem bronchus, causing extreme hyperinflation of the left lung. This was a life-threatening condition, as there would be no way for the lungs to function after delivery.

Timothy Crombleholme, M.D., Children's Colorado's surgeon-in-chief and Director of the Colorado Fetal Care Center (CFCC) and CIMFH, met with Perry and her fiancé, Erik Hall, to discuss all options. Dr. Crombleholme recommended an EXIT* to-resection procedure to remove the bronchogenic cyst during delivery at 36 weeks.

"We didn't see another choice; this would give her the best chance," Perry said.

Dr. Crombleholme, Henry Galan, M.D., a maternal fetal medicine specialist, Stig Somme, M.D., pediatric general surgeon, and a team of 36 specialists, performed the procedure on Nov. 6, the same day the CFCC opened at Children's Colorado. This is the first time the EXIT strategy has been used to treat this problem and without it, the baby, Lake Annabella Hall, would not have had an airway at birth.

After an 18-day stay in Children's Colorado's Neonatal Intensive Care Unit, Lake was well enough to go home. She receives regular follow-up at Children's Colorado to ensure no further surgeries will be needed.

"We had the greatest experience with the entire medical team," Perry said. "She's our little miracle baby. Looking at her, you'd never know what she's been through."

*ex utero intrapartum treatment