UAB Medicine News


Mending Tiny Hearts

Kristin Nelson and her husband were excited to find out whether they were having a boy or a girl when they visited their obstetrician the Monday before Thanksgiving in 2010. The Nelsons found out they’d be adding another boy to their brood, but also learned there were some complications with their son—whom they named Reid.

“They told us that they found several abnormalities in the ultrasound, the main one being that they couldn’t see the left side of his heart,” Kristin says. “It was so under-developed, and just from the regular ultrasound they were extremely concerned that he might have Down syndrome and other problems too. In the beginning, they actually talked to us about the possibility of the baby not making it through the pregnancy. In that moment, we just kind-of felt sheer panic. We didn’t really know what to expect.”

The Nelsons were immediately referred to UAB to better assess Reid’s condition. That Wednesday, they met with Joseph Biggio, MD, director of Maternal-Fetal Medicine at UAB, and Kristin underwent an amniocentesis. It was determined that Reid likely had hypoplastic left heart syndrome, a condition in which the left side of the heart does not develop correctly. Luckily, the amniocentesis showed no other complications. After the amniocentesis, the Nelsons and Biggio were joined by their entire treatment team of pediatric heart and high-risk obstetrics specialists, including their pediatric cardiologist Robb L. Romp, MD, to discuss a plan for baby Reid.

Over the next several months, the Nelsons made regular trips to UAB from their home in Lanett, Alabama. With each visit, things began to look up for Reid.

“Every time we came to Birmingham, it seemed like things were getting a little bit better,” Kristen says.“The left side of Reid’s heart was starting to develop more and more. By the time Reid was born, they were still diagnosing him with hypoplastic left heart, but they were expecting something better. Dr. Romp and Dr. Biggio were both very involved from the beginning to the delivery point.”

Upon delivery, it was determined that Reid's aorta was severely narrowed in several areas, and would require surgery. At five days old, Reid underwent surgery and spent a day in CICU. He was then moved to a post-op floor for four days before being released.

“The NICU at the Women and Infant’s Center was amazing in caring for our baby, keeping us informed, and helping us with anything we could possibly need.”

Today, Reid is a happy, healthy, and rambunctious two-year-old, who earlier this year was told he doesn’t need to come back for another heart checkup for one year. “We just couldn’t praise UAB enough, all parts: delivery, post-partum care, Dr. Biggio, Dr. Romp, Dr. Kirklin,” Kristin says. “They have all been amazing.”

Reid is just one of hundreds of babies with congenital heart conditions treated at UAB Medicine and Children’s Hospital of Alabama each year. UAB Maternal-Fetal Medicine and the Joseph S. Bruno Heart Center at Children’s combine their resources and expertise to create the UAB Fetal Diagnosis and Care Center. The Fetal Diagnosis and Care Center is the only clinic of its kind in Alabama and brings together experts in the fields of Maternal-Fetal Medicine and Pediatric Cardiology, as well as Genetics, Cardiothoracic Surgery, Neonatology, and more.

Most of the center’s patients face structural congenital heart abnormalities and rhythm disturbances in the heart. If a heart abnormality is suspected, a UAB Maternal-Fetal Medicine specialist performs a thorough evaluation of the mother and baby, including a focused assessment of the baby’s heart. From there, a multidisciplinary meeting is held with the team of experts that will be working with the family along the way.

Each family’s care is coordinated by a clinical nurse, from team meetings and follow-up appointments to tours of the Women & Infants Center and Joseph S. Bruno Heart Center. UAB sees 100 fetal congenital heart cases on average each year, and according to Biggio, is the only place in the state that can offer this level of comprehensive multidisciplinary care together.

“We have a team of all the experts that you could need, and your baby is not going to have to go somewhere else to have someone that is appropriate to treat them,” says Biggio.

And though a fetal heart abnormality is a frightening diagnosis, UAB pediatric heart surgeon Robert J. Dabal, MD, says that treatments are curative for the vast majority of children. The most important thing for patients to know, says Dabal, is that surgery for congenital heart disease is a team-based approach to care and is the best way to get good results.

“As soon as a patient is diagnosed, they have access to all of the resources from cardiologists, high-risk OBs, the surgeons, the intensivists, so there are a lot of people that can help them through this,” says Dabal. “Every member of our team works together to make sure that every baby gets the very best care.”