The complex procedure is known as EXIT-to-airway. To ensure that she would survive delivery, Shelia’s baby would need a breathing tube to be placed into her airway before her umbilical cord was cut. Because it can cause the lower jaw to grow more slowly than the upper, an anatomical domino effect can result in a narrow airway, and babies with PRS are sometimes unable to breathe on their own once they are born. Subsequent tests showed that the baby had a condition called Pierre Robin sequence (PRS). Five months into her pregnancy, a sonogram had revealed that the baby’s airway was pinched and dangerously narrow. They were all assembling for a complex, multistage procedure that would usher Shelia’s baby safely into the world. Hintz and her colleagues had been meticulously coordinating and planning for this day. Earlier that afternoon, when Susan Hintz, MD, medical director of the Fetal and Pregnancy Health Program, received word that the care team’s patient Shelia had gone into labor three weeks early, it triggered a phone tree alerting about 40 different health care providers in 12 different subspecialties from around Lucile Packard Children’s Hospital Stanford and Stanford Hospital, all of whom were on call for the delivery and neonatal operation. She sped to the hospital in record time, then jogged into the operating room and, still in her heels, scrubbed up. Kara Meister, MD, an ear, nose, and throat (ENT) surgeon specializing in pediatric airway surgery, was in her Los Gatos clinic when she got the call.
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