Physicians at Methodist Sugar Land Hospital (MSLH) call little Elayna Nigrelli a “miracle baby,” and with good reason.
Elayna was born via post-mortem Cesarean section following a medical emergency that caused her pregnant mother Erica’s heart to stop beating for more than 20 minutes. But thanks to the intervention of coworkers, emergency medical personnel and the staff at Methodist Sugar Land Hospital, Elayna and Erica are alive and doing well.
“This is a situation that most doctors would maybe only see once in a career, if that,” says Dr. Brian Heaps, the Sugar Land obstetrician who delivered Elayna. “Generally speaking, the prognosis for mom and baby following a cardiac incident isn’t very good. This really is a miracle.”
One morning in February, Erica – a teacher at Elkins High School began feeling ill at work. She was 36 weeks pregnant and assumed that her symptoms were typical.
But in an instant, Erica collapsed in front of a coworker. Her husband Nathan, who also teaches at the school, was in a nearby classroom and heard the commotion. He arrived to find his wife on the floor, not breathing and with no pulse. He quickly called 911, and the school’s two nurses and a coach trained in first aid jumped in to help. The coach began cardio-pulmonary resuscitation while the nurses administered an automatic external defibrillator, or AED, until the ambulance arrived.
At Methodist Sugar Land Hospital, Emergency Department physician Dr. Shawn Baichoo was going about routine duties when he heard a quick mention on the scanner radio about “CPR” and “eight months.” The report said the patient was headed to MSLH.
“At the time, I didn’t know if the emergency medical technician was referring to an eight-month-old baby or a woman who was eight months pregnant,” Dr. Baichoo says. “But I knew either way it was a very serious situation.”
Dr. Baichoo and his staff prepared for Erica’s arrival, which was imminent. “We pulled together the nurses that needed to be involved and we paged for assistance from any physicians who were in the hospital at that moment,” he said.
Dr. Heaps was in his office next door to the hospital that morning, seeing a patient, when he received an emergent call from the Emergency Department informing him that a pregnant woman in cardiac arrest was en route – and his services were needed.
Shortly after, EMS personnel wheeled Erica into the hospital, and Drs. Heaps and Baichoo learned that she had been unconscious – without a pulse and without breathing on her own – for approximately 25 minutes.
The window of opportunity for a successful medical intervention in a post-mortem C-section is typically seconds to minutes. “So we didn’t waste any time,” says Dr. Heaps. Dr. Baichoo and the Emergency Department staff continued to resuscitate the mother as Dr. Heaps and fellow obstetrician Dr. Patricia Mitchell, performed a C-section right there in the examining room.
“We were ready to go,” Dr. Heaps says. “It only took about 20 seconds to deliver the baby.”
Once Elayna was born, Dr. Baichoo and Dr. Bracken Kolle – an anesthesiologist who came down from the operating rooms to assist – continued their efforts to revive Erica. In addition to continuing chest compressions, Erica was administered epinephrine, a drug which helps regulate heart rate, along with other medications. Dr. Kolle also replaced a temporary airway installed by the EMS crew with an endotracheal tube to allow Erica to be attached to a ventilator.
Within a few minutes, Erica’s heart began pumping again. “It was God’s plan,” says Dr. Baichoo.
Once she was resuscitated, Erica’s breathing and blood flow began to improve rapidly, in part because the baby was no longer in utero and requiring oxygen.
Cardiologist Dr. Yassir Sonbol later determined that Erica’s emergency was caused by an undetected heart condition called hypertrophic cardiomyopathy. This thickening of the heart muscle often leads to abnormal heart rhythms and is a frequent cause of death for young athletes – which is why Elkins High School had the AED on campus and staff trained in its use.
“The most important part of this story is that the baby and mother were kept alive by the actions of those nurses and staff at the high school and the emergency responders,” says Dr. Heaps. “They are the heroes. But the presence of so many trained personnel here at Methodist Sugar Land Hospital – people with the knowledge and experience to deal with these types of unusual situations – made a difference.”