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(September 24, 2013) – For 24 weeks, Janet Stopa had enjoyed a blissfully smooth pregnancy. After trying to start a family for three years, she and her husband, Chris, were now joyfully anticipating the arrival of their first-born son, Nathaniel. Graced with an abundance of energy, Janet was able to maintain her fast-paced career as an emergency room nurse at Inova, where she has worked for more than a decade.

But one August evening in 2010, things changed quickly and without warning. While the couple was socializing with neighbors, Janet suddenly experienced nausea and severe chest pain that wouldn’t go away. In the middle of the night she and her husband rushed to the Inova Fair Oaks Hospital Emergency Department, where a thorough evaluation revealed that Janet’s blood pressure had skyrocketed and her blood cells were rapidly breaking down.

Janet’s obstetrician, who was on call at the hospital, recognized the classic signs of HELLP syndrome, a life-threatening complication of the pregnancy disorder preeclampsia. Given that the only cure for HELLP syndrome is delivery, Janet was transported by ambulance to the Inova Women’s Hospital, where she had an emergency C-section. Having her baby in a hospital with a Level IV neonatal intensive care unit (NICU), Janet knew Nathaniel would receive the highest level of care and have an increased chance of survival.

“We’re a very high-volume NICU offering an advanced and continually refined approach to neonatal medicine,” says Robin Baker, MD, a neonatologist at Inova Children’s Hospital, who took care of Nathaniel during his stay in the NICU. “We provide a team approach with well thought out and tested protocols that set these kids up for a very positive outcome.”

There to Help
When Nathaniel was born he weighed barely more than a pound. He spent the first four months of his life in the NICU undergoing multiple procedures, including heart surgery for a patent ductus arteriosus (PDA). In addition, Nathaniel had retinopathy of prematurity (ROP), a vision disorder affecting premature infants, and a small intraventricular hemorrhage (IVH), or bleeding inside the brain. Fortunately, both conditions resolved on their own in the NICU.

When Janet and Chris weren’t at work, they stayed close by Nathaniel’s side.

“The NICU staff was very good about wanting us to be there and they encouraged us to hold Nathaniel and even do simple things like nap time, feeding, kangaroo care, bathing and changing diapers,” says Janet.

With the help and encouragement of the NICU’s board-certified lactation consultants, Janet pumped breast milk for Nathaniel to give him the best possible start.

“Breast milk is the best formula for newborns,” says Dr. Baker. “It’s laden with antibodies that have a positive influence on the newborn. It’s better absorbed, it’s better nutrition and easier to digest, and the incidence of a devastating disease called necrotizing enterocolitis is markedly decreased if you use breast milk.”

While Janet was at work, she found solace in the fact that the multidisciplinary NICU staff, including board-certified neonatologists, neonatal nurse practitioners and respiratory therapists, were there around the clock to watch over Nathaniel.
She also felt reassured by the fact that Nathaniel was being cared for by the same team of nurses throughout his NICU stay.

“We have primary team nursing where a core group of nurses takes care of a baby,” says Katherine Herold, RN, who took care of Nathaniel while he was in the NICU. “It’s great for consistency, and primary care nurses sometimes pick up faster that there’s an issue because they really know the baby.”

Baby on the Way
parents and two kids pose behind a fence Just three months into Nathaniel’s NICU stay, another remarkable event occurred: Janet was pregnant. She was ecstatic about having a second child after years of trying. But when she learned that having a baby so soon after an emergent C-section could lead to a ruptured uterus, she had concerns about her baby’s outcome. She was also apprehensive about a recurrence of HELLP syndrome.

Fortunately, the pregnancy went extremely well. Janet’s uterus remained intact and she was prescribed medications to prevent HELLP syndrome from returning. When Janet found out that nurse Katherine Herold had made arrangements to be in the delivery room for Matthew’s arrival, she felt confident and overjoyed. “Having Katie take care of Nathaniel during the most critical and scary time in our lives and then taking the time to make sure she was there for Matthew’s delivery once again made a scary situation more calming,” she says.

Matthew was born at 37 weeks, weighing a healthy 7 pounds and 9 ounces.

Today, Nathaniel, 3, and Matthew, 2 — only 11 months apart — are active toddlers who keep their parents busy. Nathaniel just finished his first year of preschool and he loves to talk and sing and play with his brother. For Janet and Chris, each milestone is a moment to be cherished.

“This has been a life-changing experience,” says Janet. “To look at Nathaniel you wouldn’t be able to tell he had such a rough start.”

HELLP syndrome

HELLP syndrome is a severe complication of preeclampsia that can be life-threatening for both mom and baby. HELLP syndrome, which stands for Hemolysis (destruction of red blood cells), Elevated Liver enzymes (signaling liver damage) and Low Platelet count, occurs in 10 to 20 percent of women with severe preeclampsia.

The symptoms of HELLP syndrome include headache, nausea and vomiting, vision problems and pain in the upper right abdomen. They can strike at any time, even before the classic symptoms of preeclampsia appear. Although HELLP syndrome can only be resolved with delivery, medication may be used to prevent seizures, control high blood pressure and to help the baby’s lungs develop.

Because HELLP syndrome may recur in 1 out of 4 future pregnancies, it is important for expectant moms who’ve experienced the condition to seek early and regular prenatal care in subsequent pregnancies.

Highest Level of Care
Parents can rest at ease knowing that Inova Children’s Hospital (on the Inova Fairfax Medical Campus on Gallows Road in Falls Church, VA) is home to Northern Virginia’s only Level IV NICU. Recently named 35th in the nation in Neonatology by U.S. News & World Report, the 75-bed, level IV NICU provides comprehensive services for premature and sick infants. Staffed with neonatologists and a full complement of pediatric sub-specialists, the NICU is the first in the nation to receive The Joint Commission’s Gold Seal of Approval for Prematurity, representing the highest level of care for infants born prematurely.

“In neonatology what we do sets these babies up for how they’re going to do for the rest of their lives,” says Robin Baker, MD. “At the Inova Children’s Hospital NICU, we’re trying to optimize the future for these tiny, fragile infants.”

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Click to see more news and articles from Inova Fairfax Hospital in the Summer / Fall 2013 issue of INhealth magazine:  Read more arrow