Zoey Life: Initial Email to Friends and Family (4-10-09)

Tuesday, May 19, 2009

Initial Email to Friends and Family (4-10-09)

Hi everyone!

I'm sorry to send out a "mass" email like this but wanted to get the word out without making a ton of phone calls. I know you all will understand.

We found out yesterday during a routine ultrasound with our perinatologist, that our little girl has a rare birth "defect" - I hate that word because I refuse to believe there's anything "defective" about our baby - called an omphalocele. What this means is that there is a portion of her internal organs that are growing outside of her body, at the umbilical cord.

We are unsure, at this point, what the size of the omphalocele is and/or what organs are involved. We will be meeting with pediatric surgeons from Cook Children's Hospital on Tuesday and will hopefully have some more information then. Her prognosis depends on the size of the omphalocele and what organs are involved, as well as whether she has any other underlying genetic problems. Apparently, it is common for children with this type of rare problem to have other genetic problems, as well. However, our doctor said that our girl's brain, heart and spine look great so he's optimistic that the only problem is the omphalocele itself.

I will continue to see Dr. Froeschke every two weeks for routine OB care and I will see Dr. Howard, our perinatologist, weekly for ultraounds and bio-physical profiles. Together they will keep a very close eye on our girl.

This is all still sinking in for us and Randy and I are, of course, worried about what this all means for a little girl. No matter what, it sounds like she's in for a pretty rough "ride", at least in the beginning. No one wants or expects to welcome their child to the world in this way. Come what may, we are committed to loving her with our whole hearts and doing anything and everything that we can to ensure she has the best possible start to her life come June. We feel very blessed to be under the care of such wonderful doctors and to live in an area that is surrounded by some of the best children's hospitals, doctors and surgeons in the country.

Please keep us all in your prayers (and feel free to put us on your prayers lists at church or email...we believe in the power of prayer!) While we want a miracle and complete healing in the womb for our girl, we are prayerful that her omphalocele is small and can be repaired at birth; that she has no other underlying conditions that could hinder her surgery and recovery; that my blood pressure stays under control so that I can deliver her as close to term as possible so that she will be strong enough and developed enough to endure a surgery immediately following delivery; and for strength for Randy and I.

If anyone wants to know more about omphaloceles, this website has good information:

http://www.chw.org/display/PPF/DocID/34370/Nav/1/router.asp

We will keep you all posted, of course, as we know more.

Oh, I will say this...this girl is fiesty! She was kicking away at the ultrasound wand. I know she'll be a fighter! She's also BIG, too, just like Sam was. At 29 weeks, she already weights 3.5 pounds! She also has the same big chubby cheeks and lips that her big brother had, too.

We think she's beautiful and are so in love with her!

Love,

Alicia, Randy, Sam and Baby S

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OMPHALOCELE

What is an omphalocele?

An omphalocele is a birth defect, which is an abnormality that occurs before birth as a fetus is forming in its mother's uterus. Some of the abdominal organs protrude through an opening in the abdominal muscles in the area of the umbilical cord. A translucent membrane covers the protruding organs.
The omphalocele may be small, with only a portion of the intestine protruding outside the abdominal cavity, or large, with most of the abdominal organs (including intestine, liver, and spleen) present outside the abdominal cavity. Further, the abdominal cavity itself may be small due to underdevelopment during pregnancy.

What causes an omphalocele?

As a fetus is growing in the mother's uterus before birth, different organ systems are developing and maturing. Between the 6th and the 10th weeks of pregnancy, the intestines actually project into the umbilical cord as they are growing. By the 11th week of development, the intestines should return to the abdomen. When the fetus is growing and developing during pregnancy, there is a small opening in the abdominal muscles that the umbilical cord can pass through, connecting the mother to the fetus. As the fetus matures, the abdominal muscles should meet in the middle and grow together, closing off this opening. An omphalocele occurs when the abdominal organs do not return to the abdominal cavity as they should.

It is not known what causes omphalocele. Steps that normally happen in the development of the abdominal organs and muscles simply did not happen properly. It is not known to be caused by anything the mother did during pregnancy.

Who is at risk for developing an omphalocele?

When an omphalocele is isolated (no other birth defects are present), the risk for it to happen in a future pregnancy is one percent or one in 100. There are some families that have been reported to have an omphalocele inherited as an autosomal dominant or X-linked recessive trait. In these cases, the chance for reoccurrence would be higher.

Many babies born with an omphalocele also have other abnormalities. The chance for reoccurrence depends upon the underlying disorder:

Thirty percent have a chromosomal (genetic) abnormality, most commonly Trisomy 13, Trisomy 18, Trisomy 21, Turner syndrome, or triploidy.

Some infants with omphalocele have a syndrome known as Beckwith-Wiedemann syndrome.

More than half of babies with omphalocele have abnormalities of other organs or body parts, most commonly the spine, digestive system, heart, urinary system, and limbs.

How often does an omphalocele occur?

A "small" type omphalocele (involving protrusion of a small portion of the intestine only) occurs in one out of every 5,000 live births.

A "large" type omphalocele (involving protrusion of the intestines, liver, and other organs) occurs in one out of every 10,000 live births.

More boys than girls are affected with omphalocele.

Why is an omphalocele a concern?

Since some or all of the abdominal organs are outside the body, infection is a concern, especially if the protective membrane around the organs breaks. Also, an organ may lose its blood supply if it becomes pinched or twisted. A loss of blood flow can damage the affected organ.

How is an omphalocele diagnosed?

Omphalocele can often be detected on fetal ultrasound in the second and third trimesters of pregnancy. A fetal echocardiogram (ultrasound of the heart) may also be done to check for heart abnormalities before the baby is born.

After birth, the omphalocele can be noted by the physician during the physical examination. X-rays (diagnostic tests which use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film) may also be done after birth to evaluate abnormalities of other organs or body parts.

Treatment for an omphalocele:

Specific treatment for an omphalocele will be determined by your baby's physician based on the following:

your baby's gestational age, overall health, and medical history
the extent of the condition

your baby's tolerance for specific medications, procedures, or therapies

expectations for the course of the condition

your opinion and preference

For a "small" omphalocele (only a portion of the intestine protruding outside the abdominal cavity), shortly after birth, an operation is done to return the organs to the abdomen and close the opening in the abdominal wall.

For a "large" omphalocele (most of the abdominal organs, including intestine, liver, and spleen are present outside the abdominal cavity), the repair is done in "stages" and may include the following:

Initially, sterile, protective sheeting is placed over the abdominal organs.

Because the abdomen may be small and underdeveloped, it may not be able to hold all of the organs at once. Therefore, the exposed organs are gradually moved back into the abdomen over several days or weeks.

The abdominal wall is closed surgically once the organs have been returned to the abdominal cavity.

Because the abdominal cavity may be small and underdeveloped, and the organs may be swollen, a baby with an omphalocele may have breathing difficulties as the organs are returned to the abdomen. Your baby may need help from a breathing machine called a mechanical ventilator while the swelling is decreasing and the size of the abdominal cavity is increasing.

What is the long-term outlook for a baby born with an omphalocele?

Problems in the future often depend on:

the size of the omphalocele.

if there was a loss of blood flow to part of the intestine or other organs.

the extent of other abnormalities.

Babies who have damage to the intestines or other abdominal organs may have long-term problems with digestion, elimination, and infection.

Tuesday, May 19, 2009

Initial Email to Friends and Family (4-10-09)

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