Press releases

Released July 15, 1996
Yale-New Haven Hospital news release

Physicians perform rare life-saving surgery on newborn

First such procedure in U.S.

On July 1, 1996, pediatric surgeons at the Yale-New Haven Children's Hospital performed surgery on a newborn, before it was totally delivered from its mother, for a condition that previously had not been successfully corrected with surgery.

Nineteen weeks earlier, the baby was diagnosed by ultrasound in utero with a rare condition called congenital high airway obstruction syndrome (CHAOS). The baby had laryngeal atresia, an absence of the opening of the larynx, the portion of the air passage that connects the pharynx with the trachea. In utero, the baby had received oxygen through the umbilical cord, but once delivered, the baby was not structurally able to support breathing and an emergency procedure needed to be performed.

The infant, Aaron Spencer of Hamden, was delivered by cesarean section with pediatric surgeons standing by. Aaron needed an immediate surgical procedure known as an Ex Utero Intrapartum Treatment (EXIT). Once the head and chest were delivered, an upper airway bronchoscopy was performed to confirm the diagnosis and verify the need for the EXIT procedure. While the lower portion of the baby was still inside his mother, pediatric surgeons performed a tracheostomy, an opening through the neck into the trachea through which a tube is inserted for breathing. This was the first time this life-saving procedure was done at the Children's Hospital and the first time it was performed successfully in the United States for a baby with this diagnosis.

Following the procedure, the delivery was completed and the baby was transferred to the Newborn Special Care Unit (NBSCU) for follow up treatment and care. The mother was under general anesthesia during the entire procedure, and at no time was her health compromised.

Perinatologists at YNHH diagnosed this condition. Physicians responsible for diagnosis and treatment of both mother and baby described the fetal diagnosis and the life-saving procedure at a news conference July 15. The perinatologist showed fetal ultrasound images of how the diagnosis was made and the pediatric surgeons used slides to explain the delivery room procedure.

Physicians describe the baby's prognosis as excellent. The need for more follow up surgery has yet to be determined. The baby is presently on a respirator in the NBSCU.

Perinatologists

David Jones, MD

Obstetrician/Perinatologist, Maternal/Fetal Medicine-YNHH Perinatal Unit, Assistant Professor of OB/GYN at Yale University School of Medicine

Andre Rebarber, MD

Obstetrician/Perinatologist, Maternal/Fetal Medicine-YNHH Perinatal Unit, Instructor in OB/GYN at Yale University School of Medicine

Pediatric Surgeons

Robert Touloukian, MD

Chief, Pediatric Surgery, Yale-New Haven Children's Hospital and the Yale University School of Medicine

James Decou, MD

Pediatric Surgeon, Yale-New Haven Children's Hospital, Pediatric Surgical Fellow at Yale University School of Medicine

Neonatologist

Harris Jacobs, MD

Attending Physician, Newborn Special Care Unit, Yale-New Haven Children's Hospital

Family information
Aaron Spencer, born to Jerry & Sylvonia Spencer on July 1, 1996, weighed 8 1/2 lbs. at birth. The family lives in Hamden, Conn., and this is their first child.

* Many other members of the medical staff--anesthesiologists, nurses and various technicians--were involved in caring for the Spencer family.

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