Heidi's Remarkable Journey: Thriving After Omphalocele Surgery in the NICU
The dream of starting a family is often met with eager anticipation and excitement. For Jennifer and Alexis Canela, this dream became a reality when they learned they were expecting their first child.
“I remember noticing changes in my body,” Jennifer recalled. “Things I used to enjoy, like chicken, suddenly became intolerable during my pregnancy due to the smell. These subtle changes led me to take a home pregnancy test, and to my surprise, it came back positive. We were happy when we found out.”
Subchorionic Hemorrhage Sparks Fear of Miscarriage
However, the couple’s excitement was quickly met with concern when Jennifer began experiencing heavy bleeding the day after receiving the positive test. Worried for her well-being, Jennifer rushed to an emergency center, seeking immediate medical attention.
“In the ER, doctors ran an ultrasound and determined despite the alarming bleeding, the baby was in stable condition,” said Jennifer. “They explained the bleeding was due to a subchorionic hemorrhage.”
A subchorionic hemorrhage is bleeding between the uterine wall and the chorionic membrane during pregnancy, potentially forming a blood clot. It can lead to light spotting or heavy bleeding, and is often accompanied by abdominal pain or cramping. While many resolve without harm, some may increase the risk of complications such as miscarriage or preterm labor, requiring immediate medical attention.
Despite this initial scare, the pregnancy continued smoothly. Jennifer continued to have regular check-ups with her OB-GYN in Austin, where they lived at the time, confirming Heidi’s healthy growth and development.
Ultrasound Reveals Omphalocele
During the early stages of her pregnancy, everything appeared to be progressing smoothly, despite occasional episodes of bleeding. However, by the third month, the situation began to stabilize, and the pregnancy was proceeding as expected.
At 20 weeks, her OB-GYN detected an unusual bubble on the baby's abdomen during the anatomical ultrasound followed by a full ultrasound which raised concerns about a potential abdominal wall defect. That’s when Jennifer learned about Heidi’s diagnosis of omphalocele, a congenital birth defect in which an infant’s abdomen does not properly close during development in the womb. This can cause certain abdominal organs (such as the intestines, liver and other organs) to protrude through the belly button. Omphalocele can vary in size and severity, from small defects to large ones involving multiple organs.
"When she told me, I was in shock," Jennifer remembers. “In addition to seeing my OB-GYN in Austin, I began seeing a maternal fetal medicine specialist every month to monitor my baby’s condition. They told me that after she was born, she would possibly need to undergo surgery to correct the omphalocele.”
In November 2023, when Jennifer was 29 weeks pregnant, she and her husband relocated from Austin to San Antonio. There, she began her prenatal care with her new OB-GYN, Dr. George Cajas, and consulted with Dr. Emma Rodriguez, a maternal fetal medicine specialist, both affiliated with CHRISTUS Children’s.
Upon evaluation, Dr. Rodriguez ordered another ultrasound, which revealed the bubble previously observed still persisted. She explained to Jennifer that the bubble contained her baby’s liver. Considering the situation, Dr. Rodriguez presented Jennifer with various options regarding the delivery of her baby.
"She mentioned the possibility of a vaginal delivery, but considering that 80 percent of the liver was contained within the bubble, she cautioned against it," Jennifer explained. "Instead, she strongly advised a C-section, emphasizing its safety for both me and the baby."
NICU Journey Begins
On February 7, 2024, Jennifer and Alexis welcomed their beautiful daughter, Heidi, at 39 weeks. Born at CHRISTUS Children’s, Heidi weighed 7 pounds. After delivery, she was immediately transferred to the neonatal intensive care unit (NICU) to assess whether she would require immediate surgery.
“When I saw her in the NICU later that day, I had a mix of emotions," said Jennifer. “Seeing her hooked up to IVs and oxygen, surrounded by cords, filled me with sadness and worry. But amidst those feelings, seeing the compassionate care provided by the NICU staff brought me comfort. Their patience and love for the babies eased my concerns. Yet, seeing Heidi in that condition still weighed heavily on my heart.”
Surgeon Creates Plan to Insert Baby’s Liver in Abdomen
Heidi’s medical team decided that the best course of action was to proceed with surgery to repair her omphalocele a few hours after her birth. In the weeks leading up to the surgery, Jennifer met with Dr. Jonathan Greenfeld, an abdominal and thoracic pediatric surgeon, who provided detailed explanations of the procedure, discussed its potential benefits and risks, and helped set expectations for Heidi's care.
"I placed my trust in Heidi’s surgical team and prayed for the best outcome,” said Jennifer “Hearing from the doctors in Austin that we were at one of the top children’s hospitals in the country eased my worries. I knew our daughter, Heidi, was in good hands. I remained hopeful for a positive outcome for our baby."
On February 7, Dr. Greenfeld and his team successfully repaired Heidi's omphalocele, which involved gently guiding her protruding liver back into her abdominal cavity. Dr. Greenfeld carefully released the liver from the adherent omphalocele sac, which had firmly adhered to the entire surface of the sac. Fortunately, despite the delicate nature of the neonatal liver, which is very prone to bleeding, minimal blood loss occurred, about a teaspoon. Dr. Greenfeld then proceeded to close the small opening in Heidi's abdominal wall, ensuring a secure and stable closure to protect her organs.
Heidi spent 12 days recovering in the NICU. Jennifer recalls the day when Heidi was finally discharged.
“We were excited but also nervous,” said Jennifer. “I was like what if something happened to her when I take her home? What if I am not fully prepared? But I knew that I could reach out to her doctors if I had any questions or concerns. I could reach out to the lactation consultant if I had trouble feeding her. Having such a supportive team by our side made bringing Heidi home a comforting experience."
Heidi’s Developmental Milestones
At three months old, Heidi is a happy baby. She loves making eye contact and thriving in interactions. She cherishes the attention she gets from her parents and family. Mealtime is a delight for her as well. Heidi maintains regular visits with her pediatrician, Dr. Lisa Vargas, and a developmental specialist to monitor her milestones, which is typical for babies following NICU discharge to ensure they are developing normally.
“I love being a mom,” said Jennifer. “It’s definitely an unpredictable adventure. We are so happy to have Heidi and grateful to Dr. Greenfeld and the CHRISTUS NICU team for taking wonderful care of her.”
Learn more about the CHRISTUS Children's NICU here.
