Two Tiny Miralces, Born Seven Months Apart

Two years ago, newlyweds Valentina and Anthony Holguin were excited when they learned that Valentina was expecting a little girl. In just a few short months, it seemed like everything they had ever wished for was coming true.

But after a smooth and uneventful pregnancy, Valentina began experiencing extreme pain at the beginning of her third trimester.

“All of a sudden, I had these awful symptoms,” Valentina recalled. “My ribs felt like they were going to break and I had difficulty breathing. I was in so much pain.”

Valentina brought her concerns to her OB-GYN, but she was told that what she was experiencing was normal, especially toward the end of a pregnancy. Valentina decided to push through the pain and do her best to enjoy the time she had left before her daughter was born. At 32 weeks pregnant, she and her husband planned a trip over Memorial Day Weekend to attend her little sister’s high school graduation.

“We drove five and a half hours to get there and we had to stop every hour because I was in such excruciating pain,” Valentina said. “I didn’t know it at the time, but I was experiencing labor pains.”

The morning after they arrived, Valentina proudly watched as her little sister walked across the stage to accept her diploma. She bent down to take a picture to commemorate the moment, and just then, her water broke.

“I didn’t know what happened at first because it wasn’t a huge gush, but I could tell something was off,” Valentina said. “I went into the bathroom and saw that I had some bleeding, so I called my OB-GYN and they told me to go straight to the ER.”

There, the doctors confirmed that Valentina was in labor. Because she was only 32 weeks along, however, they did everything they could to stop her from delivering that day.

“They wanted me to hold out as long as possible to give my baby more time to grow,” Valentina said. “They admitted me to the hospital and I spent the weekend there on bedrest.”

That following Tuesday, a Maternal-Fetal Medicine specialist took Valentina for an ultrasound to check on the baby’s progress.

“I remember that the specialist was concerned because I was so swollen,” Valentina said. “I had so much amniotic fluid in my womb that the specialist said it must have felt like I was carrying twins.”

After the ultrasound, the specialist sat down with Valentina and told her some devastating news. Her baby girl had a condition called hydrops fetalis, also known as hydrops, which is characterized by a large amount of fluid build-up in the tissues and organs. The condition causes swelling and has a poor prognosis, with less than 50 percent of unborn babies surviving birth. In Valentina’s case, her baby’s lungs were filled with fluid.

“She was very straightforward with us and prepared us for the worst, saying that there was a very real chance that our baby may not make it,” Valentina said. “I tried to remain as positive as possible and my husband and I just hoped and prayed she would make it. I knew that my daughter needed me to be strong, and so I was only going to emit positive energy to her.”

The specialist told Valentina that she would need to be transferred to a hospital with a Level IV NICU before delivery, since her daughter would need specialized surgery immediately after birth. With the clock ticking, Valentina was airlifted to The Children’s Hospital of San Antonio (CHofSA).

The day after she arrived, Valentina went into active labor, and she was placed under the care of OB-GYN Dr. Jacqueline Battistelli, MD.

“Dr. Battistelli was an angel sent from heaven above,” Valentina said. “She really helped guide me through the process of labor.”

Before the delivery, Valentina was also paid a visit by neonatologist Dr. Sowmya Mohan, MD.

“Dr. Mohan gave me such reassurance. She told me her name, introduced me to her team, and told me that they were going to take care of me and my baby,” Valentina said. “She also explained how, after the delivery, they were going to try to let me see her for a moment, if possible, but that they would then have to take her into surgery immediately and put a shunt in her lungs to release the fluid. She gave me such clarity as to what was going to happen, which I really appreciated.”

Neonatologist Dr. Sowmya Mohan helped Valentina understand exactly what to expect when her baby was delivered at The Children’s Hospital of San Antonio.

Shortly thereafter, Dr. Battistelli delivered a baby girl, whom Valentina and her husband named Elena Diana.

“It was a beautiful delivery,” Valentina said. “We played worship music and after just an hour of pushing, my beautiful daughter was born.”

Valentina was able to see Elena for just a few seconds before she was rushed into surgery. About an hour after the delivery, Dr. Mohan walked into the room and told Valentina that her little girl was OK.

“They were able to put the shunt in and drain the fluid, and she told us that Elena was in the NICU and ready for us to see her,” Valentina said.

Valentina and Anthony were relieved beyond belief. Elena stayed in the NICU for 47 days until she went home with her parents. During that time, Valentina and her husband stayed in the hospital at the Ronald McDonald House, located just one floor above the NICU.

“I hardly left her bedside,” Valentina said. “I couldn’t hold her for the first 12 days of her life because of all the tubing and how fragile she was, but I made sure to give her all the love she needed.”

Baby Elena was finally in her mother Valentina’s arms. The baby girl needed surgery immediately following her birth to have a shunt placed in her lungs.

Although the experience was difficult and at times exhausting, Valentina said she was so grateful for everyone at The Children’s Hospital who supported her and took care of her daughter.

“Every single morning our resident, Dr. Shawnee Wallace, would come by Elena’s room and answer all of my questions,” Valentina said. “I am so grateful for doctors like her that listened to all of my concerns and allowed me to advocate for my daughter. We had such an amazing experience with everyone, and I felt like I was just surrounded by such good people.”

During Elena’s NICU stay, Valentina was especially impressed with first year resident Dr. Shawnee Wallace who eased her concerns by thoroughly answering all her questions.

Valentina and Anthony were thrilled to finally bring their daughter home. But then, something unexpected happened.

“A month later, I found out I was pregnant again,” Valentina said. “We were shocked but also so excited. And we thought everything was going to be so different this time. What happened with Elena was so rare.”

For a while, Valentina’s pregnancy progressed as expected. She was monitored closely by a Maternal-Fetal Medicine specialist because of her previous experience, and so far, there were no signs of any complications. But then, at just 25 weeks, Valentina went into labor.

“I started work that morning at 8:00 a.m., and then by 9:08 a.m., I was on the floor with insane contractions—I thought it was Braxton Hicks,” Valentina said. “I was working from home so I got into the bathtub and filled it with some warm water just trying to soothe myself, but I was in miserable pain. Then I went to the bathroom and that’s when I could feel my amniotic sac.”

Valentina was fully dilated.

“I called my husband to come home and he rushed me to the nearest hospital, we didn’t have time to go anywhere else,” Valentina said.

Because her baby was breech, doctors performed an emergency C-section within an hour of her arrival at the hospital, and her second baby girl, due April 27, was born on January 13, 2022.

“She was so tiny, a micro-preemie, weighing just 1 pound, 13 ounces,” Valentina said.

Her daughter, Lucia Valentina, would need the highest level of NICU care, so Valentina asked for her to be transferred to The Children’s Hospital of San Antonio.

“It was so scary because of how tiny she was,” Valentina said. “At that point, I had already lived a NICU experience and I had made friends with other parents who had shared their experiences with me, both the good and also the really tragic and sad. So, this time it just felt more real.”

At CHofSA, Valentina learned that her daughter had a grade three bilateral brain bleed, as well as a patent ductus arteriosus (PDA) which is an opening between the two major blood vessels leading from the heart. Lucia was monitored closely by her primary doctor, Dr. Maria Pierce, a board-certified Perinatal-Neonatal Medicine physician at CHofSA. Both conditions, common among babies born as early as Lucia, were monitored closely and, thankfully, resolved with time.

Valentina wanted to make sure her daughter Lucia had the same level of care that Elena had. Again, she turned to The Children’s Hospital of San Antonio. This time Dr. Maria Pierce, Medical Director of the NICU, provided outstanding care to Lucia for more than 100 days.

“The doctors were so communicative with me and always let me know what was going on with her every single day,” Valentina said. “Dr. Mohan, who we had grown close to on our first NICU stay, never failed to come by and ask how we were doing, as well as answer any questions we had. She had a special way of explaining everything to us.”

The Holguins found themselves back in the NICU at The Children’s Hospital of San Antonio with their second daughter Lucia who was born prematurely. They returned only a few months after Elena was discharged from the NICU. The baby girls were born just seven months apart.

Lucia stayed in the NICU for 101 days. “This time was harder because I couldn’t live with her in the hospital since we had another baby at home,” Valentina said. “But it was comforting to know that she was in good hands with her nurses. It was a whole process learning to let go and trust others to look after her, but I know the staff there loved her so much. She had a couple of nurses that I got to know well during our NICU stay, and when Lucia was in their care, I could sleep peacefully at night. Amy Parker, Jesse Battleson, Dayzee Treiber, Coral Nolan and Kristin Joyner are some of those amazing nurses that I was confident would look after her with such genuine love and care.”

Despite two high-risk pregnancies, the Holguins welcomed two baby girls into their family during a short span of seven months. Here the couple is shown with daughters Lucia and Elena.

Today, both girls are home, surrounded by their loving parents and doting extended family. Although Lucia still has some hurdles in her growth and development—she is being treated for retinopathy of prematurity, an eye abnormality common in premature infants—she is making strides with a bright future ahead.

“We are just so in love with these amazing little babies,” Valentina said. “I still can’t believe I have two little miracles, and I am eternally grateful to The Children’s Hospital of San Antonio and its outstanding staff for taking care of my girls so well.”

To learn more about the Level IV NICU at The Children’s Hospital of San Antonio, visit https://www.christushealth.org/get-care/services-specialties/womens-services/neonatal-intensive-care.

A Rainbow After Many Storms

Every time Stephanie Rodriguez and her husband, JC, lay eyes on their 6-month-old daughter, Vida Rose, they can’t help but call her their miracle rainbow baby. The couple never imagined having another child would be a struggle filled with lots of heartache. After two miscarriages and a chemical pregnancy,* Stephanie wasn’t sure if a viable pregnancy was even possible for her.

“When I had my son, he was a total surprise,” said Stephanie. “I didn’t have any complications carrying him to term. Then, when he turned 4, my husband and I wanted to have a second baby so our son could have a sibling. It took me nine months to get pregnant. At our baby’s 24-week anatomy scan, I found out our daughter, Ruby Rose, had passed at 18 weeks. It was when COVID first started. My appointments were spaced out because my doctor reduced our visits during COVID. When I heard the words, ‘There is no heartbeat,’ I never thought that this would happen to me. Because literally, no one in my family that I know of – my mother, grandma, my aunts, the women in my family – had a miscarriage. I hadn’t felt the baby move because I was overweight. I thought maybe I’m just too big to feel her move. The loss was so painful for me.”

Dr. Emma Rodriguez provided preconception counseling to help Stephanie have a healthy pregnancy.

After her miscarriage, Stephanie began seeing Dr. Emma Rodriguez, a high-risk maternal fetal medicine physician at The Children’s Hospital of San Antonio and Dr. Mary Stokes, an OB-GYN with CHRISTUS Trinity Clinic. Because she had a prior history of miscarriage, Stephanie had preconception counseling with Drs. Rodriguez and Stokes to plan for a future pregnancy. Struggling with the devastating loss of her daughter, Stephanie wanted to get pregnant right away because she felt a nagging feeling inside of her – she had a baby one day and the next day it was taken away from her. In July 2020, Stephanie was pregnant again.

Dr. Mary Stokes with CHRISTUS Trinity Clinic, was Stephanie’s OB-GYN as she continued to try and have for a second baby.

“I was happy to be pregnant, but I was nervous at the same time,” said Stephanie. “I didn’t want this pregnancy to be like the last one. So, my husband and I were cautiously optimistic. When I came in for a six-week ultrasound, my doctor saw a fetal pole (first visible sign of a developing embryo) but there wasn’t a heartbeat. We went week by week to see – maybe the baby is too small. Every week when we went in for an ultrasound, there was no heartbeat. When I was nine weeks along, I had a D&C.** A few months later, I had a chemical pregnancy in February 2021. As much as I wanted another baby, I cried because I just felt like a failure over and over again.”

Stephanie was cautiously optimistic about being pregnant again after several miscarriages. She is grateful to the doctors at The Children’s Hospital of San Antonio who were there for her every step of the way.

Then, in April 2021, Stephanie found out she was pregnant with Vida Rose. But this time, she didn’t tell her husband the baby news just yet. She waited until she had her blood drawn at her OB-GYN’s office to confirm the faint pink lines she saw on her pregnancy test were indeed true.

“When the time came for me to share the baby news with my husband, I wanted to make it extra special for him,” said Stephanie. “I had a box that I made, and I ordered a onesie with a rainbow on it. I bought some little baby shoes and put them in the box along with the positive pregnancy test. When he opened the box, he was happy because he knew how sad I was with our losses. My mom was thrilled to hear the news. The rest of our family was hoping for the best for us.”

Due to her history of recurrent pregnancy loss and testing indicating she was at increased risk for clotting, Dr. Rodriguez prescribed Lovenox, a blood thinning medication which was taken throughout her pregnancy. When Stephanie was six weeks pregnant, she had her first ultrasound. Baby Vida Rose’s measurements were spot on. As her first and second trimesters passed by, everything was going smoothly. Stephanie and her baby were doing well.

“Every time I went in for an ultrasound, I could see my baby’s heartbeat,” said Stephanie. “When I could see her on the doppler at home and see her heartbeat, it made me feel less nervous. I’d check on her heartbeat often. Is she still alive? Is there a heartbeat? I kept thinking those things throughout my pregnancy. I could not stand to go through the loss of another baby. I wasn’t able to relax until Vida Rose was in my arms. As the days got closer to my induction, I started getting more nervous. I was like, I am going to have two babies now, a 4-year-old and now a newborn.”

The Rodriguez family was thrilled to welcome Vida Rose when she arrived in early January.

On January 3, 2022, when Stephanie was 39 weeks along, she and her husband, JC, welcomed their daughter, Vida Rose, at The Children’s Hospital. She weighed 7 pounds, 3 ounces. Stephanie was excited to finally see her baby’s face because every time she had a 3-D ultrasound, Vida would always hide her face. She thought maybe her daughter wanted her debut to be a big surprise.

“When the nurses put Vida in my arms for the first time, it was just like we were meant for each other,” said Stephanie. “Vida is my miracle baby for sure. She is now a happy, healthy 6-month-old who loves to eat. She doesn’t want me to put her down. She’s like a little koala holding on to me. I wouldn’t have it any other way. While this was a difficult journey, I had a wonderful support system that helped me through it. My husband was definitely my rock, and my entire family was supportive. I am also thankful to Dr. Rodriguez and Dr. Stokes for being with me on this journey. They were rooting for me and were always there to answer my questions and concerns. They both knew my history so they did everything they could to ensure a successful pregnancy.”

The Rodriguez family considers Vida Rose a miracle baby after they experienced multiple miscarriages.

The Children’s Hospital of San Antonio has an entire team of maternal fetal medicine specialists caring for women experiencing high-risk pregnancies. For more information about the Centers for Maternal and Fetal Medicine, visit our website:

Maternal Fetal Medicine | San Antonio, TX | Children’s Hospital (christushealth.org)

*A chemical pregnancy is an early miscarriage that happens in the first five weeks of pregnancy.

**D&C stands for dilation and curettage, a procedure in which a doctor uses a spoon-shaped instrument to scrape the lining of the uterus to remove tissue.

Our little heart warrior: Our story of hope and perseverance

Just before Valentine’s Day 2021, Jennifer and Alejandro Cantu, already parents to 3-year-old Camila and 2-year-old Lyla, were thrilled when they found out their family would be growing once again.

“I was surprised and excited,” said Jennifer. “I waited the following day to tell my husband in a cute little way. I bought a bunch of Valentine’s Day knickknacks – five gum balls, five little hearts, 5 little bubbles – five of everything, and put it in a basket along with a bundle of wrapped up positive pregnancy tests. I wrote on the heart, “What do you think of the number five?” My husband was puzzled at first and then he finally got it. We were thrilled to find out that we were having another baby sooner than expected.”

Unlike her first two pregnancies, Jennifer was extremely sick during this one – the constant morning sickness just wouldn’t go away. She felt nauseated all the time and super tired. As much as she loved chocolate, she couldn’t eat sweets because it would make her feel sick, which was strange to her.

Jennifer and Alejandro excitedly awaited the arrival of their third child they would name Jax. Jennifer was diagnosed with gestational diabetes and she soon learned her son would be born with a heart defect.

“I knew something was off,” said Jennifer. “I could tell my body wasn’t responding normally. Every time I would eat something sweet, I would get sick. It wasn’t like pregnancy sick. It was more jittery, like I was going to pass out because my sugar was off. So, my maternal fetal medicine (MFM) physician in Georgetown, north of Austin, gave me a two-hour gestational diabetes test and I failed it. Since I was diagnosed with gestational diabetes, I had to adjust to a strict diet. I wasn’t allowed to eat sweets. I couldn’t drink any juice, just water. I ate a lot of chicken, vegetables and eggs, and I had to check my sugars three times a day after every meal. That was challenging as well because pricking your finger hurts when you do it wrong.”

As Jennifer was dealing with pregnancy challenges of her own, it wasn’t until she was 28 weeks along that she found out her baby boy had a ventricular septal defect (VSD), a type of congenital heart defect where a hole forms in the wall between the ventricles, the main pumping chambers of the heart. Her MFM physician wasn’t too concerned about it at the time, and told Jennifer that after her son’s birth, he would need another echocardiogram to check on his heart condition to see if he needed interventions.

“After we relocated our family to San Antonio, I began seeing Dr. Angela Akonye, an OB-GYN at the Women’s Center in Westover Hills,” said Jennifer. “I updated her on my gestational diabetes diagnosis and that my son had a small hole in his heart. Dr. Akonye referred me to Dr. James Hill,  an Maternal Fetal Medicine physician at The Children’s Hospital of San Antonio (CHofSA). I was about 30 weeks when my husband and I saw Dr. Hill for the first time. He gave us such a warm welcome. He was knowledgeable and made us feel comfortable. He just gave off a really good vibe. No question was a dumb question for him. He gave us that platform to talk and he just listened to us and answered any questions or concerns that we had.”

Jennifer and Alejandro were impressed by the care and attention they received from Maternal Fetal Medicine Specialist Dr. James Hill. “He just listened to us and answered any questions or concerns we had,” Jennifer said.

Then, Dr. Hill referred Jennifer to The Children’s Hospital to have a fetal echocardiogram. He wanted to make sure nothing else was wrong with her baby’s heart. After the echocardiogram, she met with Dr. Chetan Sharma, who would become her son’s pediatric cardiologist. At the time, Dr. Sharma noticed a small hole in his heart and was concerned about a possible narrowing of the aortic arch so he suggested Jennifer deliver at CHofSA.

“I met with Dr. Hill and told him everything about my son’s echocardiogram,” said Jennifer. “Even though the test showed my son had a hole in his heart, Dr. Hill was adamant about us delivering at Children’s Hospital because they had a great team in place. I will never forget what he told me that still resonates with me today. He said, ‘After you deliver, make sure you get an echo done ASAP to rule out any other problems. Do not leave the hospital until you get it. Your baby needs that test.’”

A few days leading up to the birth of their son, Jennifer embraced the last couple of days being pregnant and spent quality time with her husband and their two girls. She soaked in that little bit of time she had before their newest addition joined their family. This third pregnancy was bittersweet for the couple since this was their final pregnancy. This would be the last time Jennifer would experience giving birth to another baby and the emotions that come along with meeting that precious newborn for the first time.  

“I was already 3 centimeters dilated by the time I got to the hospital for my induction around 9 p.m.,” said Jennifer. “I didn’t get Pitocin until the next morning because they wanted to wait to see if my body would progress on its own. An hour or two after I got an epidural, I was ready to push. I pushed for about two minutes, and not long after that, my husband and I welcomed our beautiful son, Jax, on October 5, 2021. He was almost 8 pounds and he cried immediately when he was born. It was a surreal moment for us. This was my last baby, so I experienced a mixture of emotions that day. I was also very anxious too. I knew Jax had a hole in his heart and that he needed to get an echocardiogram right away. I recalled what Dr. Hill told me over and over again – do not leave the hospital until he gets that test.”

Jennifer experienced a range of emotions when she gave birth to her son Jax, knowing he would need additional tests to determine the extent of his heart defect.

The next morning, the cardiology team entered Jennifer’s room to perform an echocardiogram, or an ultrasound of Jax’s heart.  They started the echocardiogram, and when Jennifer woke up from her nap, she noticed they were still in the room. When they finally left, Jennifer and her husband grew concerned that the echo took longer than usual. They began wondering if something else was wrong with their son’s heart. Moments later, a swarm of doctors came in the room. The cardiologist on call told them Jax had a hole in his heart called a PDA, or Patent Ductus Arteriosus, which would mostly likely close on its own. A PDA is diagnosed when the ductus arteriosus, or the opening between the aorta (the artery that carries oxygen-rich blood to the body) and the pulmonary artery (the artery that carries oxygen-poor blood to the lungs) does not close as it should. Jax also had two other heart defects, a bicuspid valve and a Coarctation of the aorta. The last diagnosis is what concerned the doctors the most.

“The doctor drew us a diagram of Jax’s heart,” said Jennifer. “He said he had a narrowing of the aorta, which forces the heart to pump harder to get blood through the aorta and to the rest of the body. He said Jax had a PDA that was open. If that closes, he wasn’t going to have enough blood pumping to his lower organs. So, his organs were going to start to fail – his liver, kidneys, everything would shut down. It was less than 24 hours that I had my baby in my arms and all this stuff started to hit me – one thing after another. I started to bawl my eyes out. I was in shock and was terrified. The cardiologist told me this wasn’t an affirmative diagnosis because they were still waiting for the PDA to close to see what would happen to the narrowing of the aorta. They did another echo later that day. The PDA closed, and it revealed that he had coarcation of the aorta. When the doctors left, I just kept thinking about Dr. Hill and what he told me early on in my pregnancy – and I am glad I listened to him. If my baby didn’t get that test at that point in time, he would have died. My son is literally here today because of Dr. Hill.”

Jax needed heart surgery. But until he had his surgery, his cardiology team wanted to keep the PDA open for a few more days. They wanted Jax to be at least a week old before he had surgery. While his nurses took care of him in the NICU, Jax was given medication to keep the PDA open to allow blood flow to his body beyond the coarctation. Jennifer and her husband met with Dr. Victor Bautista-Hernandez, a cardiothoracic surgeon at The Children’s Hospital, who explained how he would repair Jax’s defect.

Dr. Victor Bautista-Hernandez, a cardiothoracic surgery, helped explain Jax’s condition to Jennifer and Alejandro. Dr. Bautista eventually performed three separate operations to help Jax’s heart function normally.

“Newborns who have extensive narrowing in the aorta usually need surgery soon after birth,” said Dr. Bautista. “To repair coarctation surgically, clamps are placed on the aorta to quickly interrupt blood flow to downstream areas. In Jax’s case, we performed a resection with anastomosis where we removed the narrowed segment of the aorta and reconnected the two ends together. When we did the first repair, I didn’t like what I was seeing after we closed him up and did an echocardiogram. We had to redo the repair twice before I was satisfied with the repair surgery. Jax did well during the procedure. With this repair, we were able to open the narrowed aorta to allow enough blood to flow throughout his body.”

Dr. Chetan Sharma, a pediatric cardiologist at The Children’s Hospital of San Antonio, continues to monitor Jax’s condition to ensure his heart keeps working as it should.

After his surgery, Jax was swollen, heavily sedated and hooked up to many different machines, as he spent one week in the PICU recovering before he could go home. Now, 9 months old, Jax is doing great. Jennifer says everything is checking out well for him developmental wise. While he has a very slight narrowing in his aorta, his blood pressure medication is maintaining it, so it doesn’t close. He sees his cardiologist, Dr. Sharma, every month for follow-up visits. He won’t need another surgery, but he may need a ballooning or a stent procedure to expand his artery down the road if the narrowing returns. He still has a bicuspid valve, but his doctors are monitoring it closely. He doesn’t need additional surgery at this time.

Jennifer believes Dr. James Hills’ advice regarding an immediate ultrasound of Jax’s heart may have saved her baby’s life.

“I am so grateful to all of the doctors who took great care of our son,” said Jennifer. “I had a wonderful experience at Children’s Hospital.  First of all, I want to thank my MFM physician, Dr. Hill. I owe my son’s life to this man. If my son didn’t get that echocardiogram soon after he was born, the situation would have been much different. Dr. Bautista was an amazing surgeon. It’s hard working with little patients. You don’t know what to expect. They are very small and vulnerable, but he was the miracle worker. His nurse practitioner, Amanda, was awesome and updated me on everything going on in the OR. She was reassuring us and providing us with detailed information and was always there when we needed her. We are just happy to have Jax with us. He is a living and breathing miracle. He completes our family.”

The Heart Center at The Children’s Hospital of San Antonio provides comprehensive care to children with rare to complex heart problems. To learn more about our Heart Center, please visit:

Pediatric Cardiology & Heart Care | CHRISTUS Health

To learn more about diagnosing and treating gestational diabetes, please read: https://chofsablog.org/2021/09/29/youve-been-diagnosed-with-gestational-diabetes-now-what/

Heart to Heart: The Gift of Motherhood

For Tierany Narro, there’s nothing quite like celebrating motherhood for the first time. Two months ago, she welcomed her beautiful daughter, Paityn, into the world. From the moment their eyes met, Tierany fell in love with her instantly. Just as she imagined, their mother-daughter bond grew stronger than ever.

“My first day as a mother was everything I could have wanted and more,” said Tierany. “My fiancé, Byron, and I celebrated this special milestone as we bonded with our new baby. To be able to care for another life other than my own, and to love this cute little human that we created together, is such an amazing and indescribable feeling. Our daughter is the most precious gift that we could have ever asked for.”

For the longest time, Tierany wasn’t sure if she could have a baby. When she was 11 years old, she was diagnosed with Long QT syndrome (LQTS), a rare heart rhythm disorder. Her heart’s electrical system took longer to recharge causing her to have rapid and chaotic heartbeats. Even the slightest physical activity or emotional excitement could trigger an episode. LQTS causes fainting and seizures, and if left untreated, it can lead to sudden cardiac arrest. Tierany didn’t know she had it until her first episode.

“I was racing my brother and cousin on the trail,” recalled Tierany. “The only thing that I remember was I could only breathe in. I could not breathe out. I was rushed to the hospital and when doctors did an EKG on me, I found out that I had LQTS. It was a crazy experience. As a kid, you want to ride rollercoasters, get spooked at haunted houses, play sports and I wasn’t allowed to do any of those things. The only sport I was allowed to play was golf. I had to avoid anything that raised my blood pressure and heart rate. I was put on beta blockers to slow my heart rate down which I still take today. When I found out I was pregnant, my doctors treated my pregnancy as if it was high risk due to my heart issue. They were concerned how my heart would handle the delivery.”

Tierany wasn’t sure she could even get pregnancy and have a baby. Once she found out she was goign to have a baby, her OB-GYN referred her to Dr. James Hill, a maternal-fetal medicine specialist, to closely monitor her high-risk pregnancy.

Throughout her pregnancy, Tierany began seeing OB-GYN Dr. George Cajas, who referred her to Dr. James Hill, a high-risk maternal-fetal medicine specialist at The Children’s Hospital of San Antonio. She saw Dr. Hill once a month for the first trimester. Then, halfway through her second trimester, she had weekly visits with Dr. Hill since she resumed taking her medication for LQTS. Since beta blockers can impact the growth of the baby, Dr. Hill checked Paityn’s growth curve every three weeks. Paityn was growing at a normal pace, but her growth lagged during the third trimester. Her growth would be a few days behind and then a week behind – but it was only in certain parts of her body. Her little belly was measuring the furthest behind. Paityn was doing fine. She was just on her own little growth curve.

Maternal and Fetal Medicine Specialist Dr. James Hill helps expectant moms manage their high-risk pregnancies. Dr. Hill ran a number of tests during Tierany’s high-risk pregnancy to make sure her heart could withstand the stress of labor.

“My excitement grew as I neared the end of my pregnancy,” said Tierany. “During my last trimester, Dr. Hill performed nonstress tests on my daughter to monitor her heart rate and to see if I had contractions at the same time. If I had contractions, the nonstress test would let Dr. Hill know how well Paityn was tolerating those contractions. When I started having Braxton Hicks, I met every week with Dr. Cajas and Dr. Hill. They did nonstress tests on my baby twice a week. They wanted to space them apart so if I was having contractions, they could see it. At every appointment, they talked to me about my birth plan.”

The plan was to deliver Paityn at 40 weeks. Dr. Hill explained to Tierany the risks and benefits with trying to deliver naturally versus a Cesarean section due to her heart condition. The goal was to put the least amount of stress on her heart, but it was up to Tierany to make that final decision. A few days before Tierany was admitted to the hospital, Dr. Hill compiled detailed notes on what Tierany could and couldn’t do. As much as possible, he did not want her to feel any contractions or do anything that would increase her blood pressure and accelerate her heart rate especially leading up to the birth of her daughter.

When Tierany arrived at CHRISTUS Santa Rosa Hospital – Westover Hills on March 27, 2022, the nurses started her on a Foley balloon, a catheter-like device that helps the cervix dilate when labor needs to be induced. Her cervix dilated to 3.5 centimeters before she began feeling light cramping and contractions. The next morning, Tierany had an epidural to help speed up her progress. She was on a continuous slow and light drip of Pitocin to avoid hyperstimulation because of her heart condition. Her nurses did not want her to feel the contractions. Later that evening, when Tierany had not progressed, Dr. Cajas broke her water.

“The slow drip of Pitocin helped me dilate but it wasn’t doing too much,” said Tierany. “I didn’t realize that once my water broke, my contractions got very serious. I had an IV in my left arm that had Pitocin, magnesium and other fluids. The magnesium helped with my heart. My doctors also gave me potassium pills for my heart, and I was still taking my beta blocker medications. Then, around four in the morning, I started feeling intense contractions. I clicked the epidural button to draw more medicine, but it was almost empty. I called my nurse, and she stepped in to help. Later that morning when Dr. Cajas checked on me to see my progress, he could feel my baby’s head. I was super excited and so ready to finally meet her.”

Since Tierany’s pregnancy was high risk, her doctors planned everything out in case something happened during delivery. Tierany was hooked up to an EKG telemonitor to monitor her heart rate throughout the birth process. They also had a crash cart ready just in case she had to be resuscitated. Luckily, there were no complications. On March 29, 2022, at 10:09 a.m., after three pushes, Tierany and her fiancé, Byron, welcomed their precious baby daughter, Paityn, into the world. She weighed 6 pounds and 15 ounces.

“I got so emotional when I saw Paityn for the first time,” Tierany. “I got to see her little face looking right at me. We didn’t see her face but one time during my pregnancy because she always covered herself. Our daughter is two months old now, and she is nothing short of a miracle. She has a such a little attitude and a big personality. She is a happy baby, but she will give you mean faces when she demands something. She loves to be held all the time. She loves to eat. She eats four ounces every two hours. And she just started sleeping through the night. When she wakes up, she’ll scream at the top of her lungs like mommy, please feed me. She’s the cutest thing ever. While there were risks involved with me being pregnant, I was blessed with wonderful, caring doctors. Dr. Cajas and Dr. Hill were both amazing and followed my pregnancy closely. The nurses were great. They understood me and validated my concerns. They were always there whenever I needed them. They cared for me not just as a patient, but as a human being.”

Tierany says 2-month-old Paityn has a big personality. She’s grateful to the doctors who cared for her and for those who will monitor Paityn’s condition throughout her childhood.

After her daughter’s birth, Tierany had Paityn tested for LQTS since this heart problem can be genetically passed on. Tierany got the LQTS chromosome from her father. After taking a buccal swab test, the results came back two weeks later. Just like Tierany, Paityn also has the same heart condition. She’ll have regular visits with her cardiologist at The Children’s Hospital of San Antonio, Dr. Arpit Agrawal, throughout her life – but just like her mother, she can still enjoy life to the fullest.

Because Paityn was diagnosed with LQTS through genetic testing, Pediatric Cardiologist Dr. Arpit Agrawal will now monitor her heart as she grows.

“I am glad we did the buccal swab test and caught it when she was a newborn,” said Tierany. “Most kids find out they have it much later when they get their first episode, since there are no symptoms early on. While I didn’t want her to have LQTS, I know my baby can still live a healthy, vivacious life just like me.” To learn more about the Centers for Maternal and Fetal Care at The Children’s Hospital of San Antonio and how we care for high-risk pregnancies, please visit:  Maternal Fetal Medicine | San Antonio, TX | Children’s Hospital (christushealth.org)

Blessed Beyond Measure

When Amarachi Ogu found out she was pregnant, she was overjoyed about becoming a mother again. She and her husband, David, are parents to 2-year-old Adaeze who keeps them quite busy. But the couple always wanted a little sibling for their daughter. This time, they were expecting a baby boy.

“We were excited to become parents again,” said Amarachi. “I remember the day when I found out I was pregnant. I was feeling a little dizzy but that wasn’t unusual because I felt the same way when I was pregnant with my daughter. Since I had been bleeding, I thought the chances of being pregnant were slim, but I decided to buy a few home pregnancy tests anyway. When I took the first test, it came back positive. Then I took a second test, and it was positive again. I was surprised and confused. When I saw my OB-GYN, she confirmed I was six weeks pregnant. She told me I was spotting, and it wasn’t a period.”

Amarachi and David were excited to welcome a baby boy to their family and give 2-year-old Adaeze a sibling.

Since Amarachi had a history of placenta previa with her first pregnancy, and she was spotting, her OB-GYN, Dr. Angela Akonye, suggested she take a small dose of aspirin daily throughout her pregnancy. Since she was 40 years old – pregnant women over the age of 35 are considered high risk due to their advanced maternal age – Dr. Akonye referred Amarachi to Dr. James Hill, a Maternal-Fetal Medicine physician with The Children’s Hospital of San Antonio who monitored her pregnancy and her baby closely.

Dr. James Hill specializes in maternal-fetal medicine. He closely monitored Amarachi’s high-risk pregnancy.

“My pregnancy was extremely difficult, especially during the first 14 weeks,” said Amarachi. “I had so many unpleasant symptoms happening all at once – I had nausea, vomiting, dizziness and extreme fatigue. I was tired all the time. I had to miss two weeks of work because I was feeling sick. The biggest challenge was keeping food down. The only thing I was able to eat was white rice and crackers. For some reason, whenever I am pregnant, I have a hard time drinking water. The whole relationship with water was tough for me at the time. My OB-GYN prescribed nausea pills, which helped me a little bit.”

Despite the symptoms that came with her pregnancy, the couple’s son was doing well. His weekly ultrasounds showed that he was growing and developing like he should. Then, when Amarachi was 20 weeks along, she had incompetent cervix (also known as cervical insufficiency), where the cervix begins to thin out too early in pregnancy, which can lead to miscarriage, preterm labor and premature birth.

Amarachi Ogu turned to Dr. James Hill to help manage her high-risk pregnancy. At 20-weeks into her pregnancy, she was diagnosed as having an incompetent cervix.

“When I met with Dr. Hill, he was concerned about my cervix, and he told me we had to do something quickly before it complicated the pregnancy,” said Amarachi. “He said there were two treatment options to consider. He could put a stitch in my cervix to reinforce it or he could give me vaginal progesterone to reduce the risk of pregnancy loss or premature labor. I was concerned, but I told him please give me a week. I am a person of faith. Let me go home, talk to my husband, and pray on it. He said, “I’ll give you a week but if you come back and it is still there, we need to do something to avoid any complications. When I came back a week later, Dr. Hill did another test on my cervix – and my cervix returned back to normal. Dr. Hill asked me, “What happened? What did you do? And I said, God did it. I felt a big sense of relief.”

As Amarachi’s pregnancy progressed, she continued to see Dr. Hill for her baby’s weekly anatomy scans. She and her baby checked out well. Thankfully, Amarachi didn’t show signs of placenta previa like she did with her first pregnancy, a condition where the placenta covers parts of the cervix which can lead to severe bleeding and preterm birth. She had no major complications other than the physical discomfort of being pregnant. Since the baby sat lower, she had a lot of back pain and wasn’t able to exercise like she did when she was pregnant with her daughter. Once the baby was full term, Amarachi had a scheduled induction for April 12, 2022. But it turns out her son had other plans on when he’d make his debut. 

“I remember doing my regular chores at home and running a few errands,” said Amarachi. “Ten days before my scheduled induction, I started to feel intense pressure. I didn’t know I was going into labor because with my daughter, I was induced. I started to feel pressure in my lower back. The feeling was coming every 10 minutes or so. When I got home, I told my husband that I think I was going into labor. I was having excruciating pain. By the time we got to the hospital, I was already nine centimeters dilated. My labor progressed rather quickly. In less than an hour and with one big push, our baby boy was here.”

On April 2, Amarachi and David welcomed their son, Peter, at CHRISTUS Santa Rosa Hospital – Westover Hills. He weighed 6 pounds, 7 ounces. From the moment they laid eyes on him, he stole their heart.

“I was so emotional when I first saw him and cradled him in my arms,” said Amarachi. “It was just an amazing feeling to meet our beautiful son. He was healthy and perfect in every way. I had a wonderful experience with Dr. Hill and his team. That is why I asked to go back to Dr. Hill for my second pregnancy. If I had to be seen again by a specialist, I wanted to be seen by Dr. Hill. He and his staff are very caring, pleasant and professional. They know you by name – and don’t treat you like you are just a patient. Thankfully, I didn’t have complications this time around. From my experiences with my first and second pregnancies, I’ve learned that it really helps when you trust and feel comfortable with your doctor. That’s how I have always felt with Dr. Hill. He has your best interests and your baby’s interest at heart.”

The Ogus welcomed Peter into their family and feel blessed that they had the care and support they needed at the Center for Maternal and Fetal Care.

The Ogus say 2-month-old Peter is doing well and is the perfect addition to their family of four. Their daughter loves her little brother and is getting used to not always being the center of attention. While the Ogus are adjusting to taking care of a newborn and toddler, they thank God for their blessings.

“This pregnancy was such a blessing. The reason my husband and I named our son Peter (meaning the rock) is because God was and continues to be our rock,” said Amarachi. “I unfortunately suffered a miscarriage prior to becoming pregnant with Peter. We were so devastated, but we trusted God to help us heal and restore us, which He did! When I was 10 weeks pregnant with Peter, my husband became very ill and was hospitalized for one week. This was a very difficult time because I was dealing with severe morning sickness and taking care of my husband. Through it all God was faithful and again was our rock through it all.” At the Center for Maternal and Fetal Care, our team of dedicated specialists delivers peace of mind to women and their families through coordinated, comprehensive and compassionate care. To learn more about The Center for Maternal and Fetal Care, please visit: https://www.christushealth.org/childrens/services-treatments/womens-services/maternal-fetal-medicine

You’ve Been Diagnosed with Preeclampsia: Now What?

Q&A with Dr. Emma Rodriguez, maternal fetal medicine specialist

Preeclampsia is a serious health problem for pregnant women around the world. It is one of the more common pregnancy complications, affecting about 5 to 8 percent of pregnant women in the U.S. It is also the leading cause of premature birth, contributing to 15 percent of all premature deliveries in the U.S.

The disease is sometimes referred to as a silent killer because most pregnant women can’t “feel” their blood pressure going up. As a result, patient awareness of the early warning signs is one of the most important tools around to successfully help pregnant women receive the immediate care they need.

So, what exactly is preeclampsia, and how can it be managed effectively? We recently sat down with Dr. Emma Rodriguez to talk about preeclampsia and what women need to know.

Dr. Emma Rodriguez is a maternal fetal medicine specialist with The Children’s Hospital of San Antonio. She helps her patients manage high-risk pregnancies when they develop conditions like preeclampsia.

What is preeclampsia? What symptoms should I be looking out for?
Preeclampsia is a serious medical condition characterized by high blood pressure that can happen after the 20^th week of pregnancy or after giving birth (called postpartum preeclampsia). Symptoms include high blood pressure, protein in urine, swelling, headaches and blurred vision. This condition needs to be treated by a health-care provider. If left untreated, preeclampsia can endanger the health of the mom and her unborn baby. In the most severe cases, preeclampsia can cause organ failure and even death.

How is preeclampsia diagnosed?
Preeclampsia is diagnosed by measuring a woman’s blood pressure and conducting routine urine tests during prenatal visits. The purpose of the urine test is to see if there is protein in the urine, which can indicate a kidney problem. If the blood pressure reading is high (more than 140/90), especially after the 20^th week of pregnancy, and there is protein in the urine, a diagnosis of preeclampsia is made. To determine the severity of the diagnosis, more extensive lab tests may be ordered, including blood tests to evaluate the level of platelets in the blood and to test for abnormally high levels of serum creatinine and liver enzymes in the blood that may suggest impaired kidney and liver function.

Pulmonary edema (excess fluid in the lungs) is another symptom of severe preeclampsia that may present as shortness of breath.

What is the typical medication/treatment for a pregnant woman with preeclampsia?
Treatment during pregnancy will depend on the severity of a patient’s high blood pressure and the health of her and her unborn baby. In general, prenatal care may include frequent prenatal visits, close monitoring of blood pressure, adjustments to blood pressure medications as needed, and regular maternal blood testing to check for signs of the condition worsening. In mild cases, patients are monitored more closely as previously mentioned.  In severe cases of preeclampsia, treatment may include giving anticonvulsant medications to prevent seizures, corticosteroids to speed up the baby’s lung development and early delivery may be indicated.

What are some common risk factors associated with preeclampsia?
There are certain risk factors that predispose a woman to develop preeclampsia. First, if you had it before with another pregnancy, the likelihood of you developing it again is greater. Also, if you have chronic (pre-existing) hypertension, are pregnant with more than one baby, or have underlying health conditions like type 1 or type 2 diabetes, kidney disease or certain autoimmune diseases, you may be at higher-than-average risk for preeclampsia during pregnancy. Other risk factors include being African American, having a family history of preeclampsia, or having a body mass index (BMI) of 30 or higher.

How can you prevent and/or reduce your risk of developing this condition?
As with most pregnancy-related complications, the best way to prevent preeclampsia is to keep up on all your prenatal appointments, and let your doctor know if you are experiencing any unusual symptoms that need attention. Other ways to decrease your preeclampsia risk is to eat healthy, exercise, and maintain a healthy weight. That means staying away from sugary and processed foods and eating more nutrient dense foods including high-fiber fruits and vegetables, lean proteins, whole grains and dairy. Also, incorporating exercise into your daily routine, like taking a 30-minute walk during the day, will also help. You should consult your doctor about how much exercise you should be getting. For high-risk women, taking a low-dose aspirin (81 mg) daily after 12 weeks of pregnancy may reduce their risk of preeclampsia. Before taking any medications during your pregnancy, check with your doctor first.

What causes preeclampsia?
No one knows for sure what causes preeclampsia, although experts believe it begins in the placenta as your body amps up your blood production to support your growing baby. A decreased blood supply to the placenta in some women may lead to preeclampsia. The genetic makeup of a fetus could predispose a pregnancy to preeclampsia. Because a family history also increases the risk, your own genetics may play a role as well. 

How can you manage preeclampsia during pregnancy?
If a woman has been diagnosed with preeclampsia, it is important for them to get plenty of rest and to take prescribed medications to manage their blood pressure. It’s also important to go to regular prenatal visits for close blood pressure monitoring and weekly labs to make sure the preeclampsia hasn’t gotten any worse. Frequent ultrasounds to monitor amniotic fluid and baby’s growth are also very important. Slow fetal growth is often associated with preeclampsia.  

How does preeclampsia affect pregnancy and the baby?
Preeclampsia is one of the most common causes of premature births. Unmanaged preeclampsia can prevent a developing fetus from getting enough blood and oxygen and damage a mother’s liver and kidneys. In rare cases, untreated preeclampsia can progress to eclampsia, a much more serious condition involving seizures, or HELLP syndrome, another serious condition that can lead to liver damage and other complications. Additionally, if the condition is not monitored closely and treated promptly, it can also cause the placenta to suddenly separate from the uterus (called placental abruption), which can lead to serious pregnancy complications and death.

If you have preeclampsia, can you carry your baby to full term?
It depends. Your doctor will determine when to deliver based on how far along your baby is, how well your baby is doing in your womb, and the severity of your preeclampsia. If your baby has developed well and preeclampsia is mild, delivery at 37 weeks is recommended.  In severe cases of preeclampsia, or if there is evidence of worsening disease, preterm delivery may be indicated. Your doctor may want to induce labor or do a cesarean section to keep preeclampsia from getting worse. The only cure for preeclampsia is to give birth.

Do preeclampsia symptoms go away after your baby is born?
The symptoms of preeclampsia usually go away within six weeks after delivery. In some women, the symptoms stop almost immediately after birth. However, in others, high blood pressure sometimes gets worse the first few days after delivery. Even if you were not diagnosed with preeclampsia before delivery, you are still at risk for preeclampsia for up to six weeks after delivery.

In a previous blog, expectant mom Vanessa shared her experience with preeclampsia that led to the premature birth of her daughter Luna.

Xochitl Scott developed preeclampsia during her pregnancy. She and her husband leaned on their faith and the expertise of doctors at The Children’s Hospital of San Antonio. Xochitl shared her story with us in January 2022.

If you have received a diagnosis of preeclampsia and would like to make an appointment with one of our high-risk pregnancy experts, please visit: Center for Maternal and Fetal Care.

Recognizing Black Maternal Health Week

According to the Centers for Disease Control and Prevention, approximately 700 women die each year in the United States because of pregnancy or delivery complications. In 2020, Black women were by far the most disproportionately affected with a mortality rate of 55.3 deaths per 100,000 live births, compared to 19.1 deaths per 100,000 live births, and 18.2 deaths per 100,000 live births for White and Hispanic women, respectively.

Black women in the U.S. are more likely to die from pregnancy related complications. The team at The Children’s Hospital of San Antonio trains other medical teams around the state to help them be prepared for emergencies during labor and delivery.

We hope you will join us as we celebrate the fifth anniversary of Black Maternal Health Week and the movement to change the state of black maternal health. Founded and led by the Black Mamas Matter Alliance is an exciting week of activism, awareness, and community-building.

At The Children’s Hospital of San Antonio (CHofSA), we emphasize innovative programs to make sure our Black patients have a safe and healthy pregnancy, delivery and postpartum recovery. It starts with education and the team at CHofSA is taking the lead to train hospitals across Texas through hands-on simulation programs where our physicians, nurses and the entire care team can practice for critical obstetric emergencies together on their own labor and delivery units. In collaboration with the Texas Alliance for Innovation on Maternal Health (AIM) initiative we have helped to train hospitals across all of Texas on how to run simulation drills on their units. 

These learning sessions pair the multi-disciplinary improvement teams from each participating hospital and expert faculty to exchange ideas about challenges facing our black mothers. The learning sessions include time for each hospital’s team to work together to integrate learning and plan for how to immediately incorporate simulation into their improvement processes.

Currently, 98% of the medical staff at CHofSA and 100% of the nursing staff have participated in both a post-partum hemorrhage and a hypertension emergency simulation. This has greatly decreased the team’s reaction time and increased the team’s performance in responding to these emergencies. Through conducting debriefs after actual events, the staff works to continuously improve and decrease the number of severe morbidity and mortality events.

To learn more about how the simulation program is improving maternal outcomes for our moms, please see: https://www.aha.org/system/files/media/file/2022/03/members-in-action-childrens-hospital-of-san-antonio-case-study.pdf

A Story of Faith, Hope and Survival

Last August, Cynthia and Isaac Torres from Eagle Pass, Texas, were excited when they found out they were expecting another baby. The couple has a 13-year-old son, but they always wanted to have more children. After several miscarriages, they were unsure if another baby was possible. As they clung to their faith, God doubled their blessings in ways they never imagined.

“Early in my pregnancy, my ultrasounds showed I was carrying one baby,” said Cynthia. “When I was 13 weeks pregnant, I had another ultrasound, and I will never forget that day. Just like any other prenatal appointment, I went in for an anatomy scan to see how my baby was developing and I remember the technician telling me, ‘I see two babies. You are pregnant with twins.’ My immediate reaction was, ‘Are you serious?’ When she turned the monitor towards me, sure enough, I saw two tiny hearts beating in unison. My husband and I were beyond excited.”

Cynthia began seeing two OB-GYN specialists – Dr. Carlos Hernandez in Eagle Pass and Dr. James Hill, her high-risk maternal fetal medicine physician at The Children’s Hospital of San Antonio. Since Cynthia was pregnant with twins and she had a previous history of miscarriages, she and her babies were monitored closely. Cynthia had to take daily injections of Enoxaparin, a blood-thinning medication to prevent recurrent miscarriages. She gave herself these injections throughout her entire pregnancy. During her first and second trimesters, her pregnancy was going smoothly, and the babies were developing normally.

When Cynthia was 31-weeks pregnant, she went on a family vacation to Mazatlan, Mexico, with her husband, their 13-year-old son, and her mother in December 2021. They enjoyed the beach and wanted to have one last family vacation before the babies were due on March 1, 2022. After spending nearly a week in Mexico, the unexpected happened on the last day of their vacation.

“My family was packing our luggage since we were heading home the next day,” said Cynthia. “I was laying on the couch in our hotel room, and I remember screaming. My mom asked me what was wrong. I told her I didn’t know. I just got this bad pain. And when I got up, my water broke. Since I was considered high risk, I went to the hospital which was a short drive from our hotel. I was hoping that I could still make it back home the next day, but that wasn’t the case. When I arrived in the ER at Mazatlan, I had an ultrasound to see if my babies were OK. Then, the gynecologist who examined me performed another ultrasound. He told me there was not enough amniotic fluid in the sac, and it was dangerous for the babies to remain in my womb.”

On January 2, 2022, Cynthia and Isaac welcomed their fraternal twins – Isaac and Israel – who were delivered via emergency cesarean section in Mexico. They were born at 31 weeks and weighed just three pounds each. Isaac was born first, and was smaller than his younger brother, Israel. Soon after their births, Isaac and Israel were sent to the neonatal intensive care unit where they were monitored.

“It was a big sigh of relief when I heard my babies cry for the first time,” said Cynthia. “As much as I wanted to hold them closely, I couldn’t because I tested positive for COVID-19. This was my second time having COVID, but in both cases, I had mild symptoms. I was quarantined at the hospital and nobody in my family could see me. I remember crying and feeling so alone. I had my cell phone with me so my husband could text me pictures of Israel and Isaac in the NICU.”

Since the twins were born premature, Israel and Isaac were having trouble breathing. They were both hooked up to oxygen, but Israel’s lung condition seemed to be getting worse. The NICU doctors in Mazatlan told the Torres’ that it would be best for Israel and Isaac to be transferred to The Children’s Hospital of San Antonio since they have a Level IV NICU that provides the highest level of care for premature and critically ill newborns. Once the babies arrived, they would be placed under the care of Dr. Maria Pierce, a perinatal-neonatal medicine physician and medical director of the hospital’s NICU.

A transport team loads the Torres twins onto an airplane in Mazatlan, Mexico, to bring the twins to The Children’s Hospital of San Antonio’s Level IV NICU.

“Dr. Pierce was an angel sent from above,” said Cynthia. “My husband called her from Mexico, and she told us there was space for our boys in the NICU. As nervous as we were, my husband got the paperwork completed for the air transport of our twins. He accompanied our sons on the two-hour airplane ride to San Antonio. They arrived at Children’s Hospital on January 5 at 2:00 a.m. Dr. Pierce and the rest of the team were already waiting for Israel and Isaac to get to the NICU.”

When the babies arrived at Children’s, they both needed oxygen. Israel, the weaker twin,went into cardiac arrest as they arrived to the NICU. The NICU team performed CPR on Israel, and they were able to resuscitate him within minutes. Both babies were stable, but they were not out of the woods. Dr. Pierce and the NICU nurses monitored them closely and updated the family on their progress.

Isaac Torres flew with the twins to San Antonio and stayed with them during their first two weeks in the NICU while his wife recovered from COVID.

“Dr. Pierce called me in Mexico to let me know how my twins were doing,” said Cynthia. “I spent two nights in the hospital in Mexico before I could go back to Texas. My son, mom and I made the 12-hour drive to Eagle Pass. It was a long ride for me as I was still recovering from my C-section. Since I had COVID and had to be quarantined at home, my husband stayed with our twins for the first 10 days in the NICU. When I finally held Isaac and Israel for the first time, I cried. It was a beautiful thing to be reunited with my sons. It was the best feeling in the world.”

Cynthia cried tears of joy when she was finally able to hold her babies for the first time since they were born.

While in the NICU, Israel and Isaac were monitored and tested daily. They underwent many different screening tests including MRIs on their brains and lungs to make sure everything was functioning normally. Although they had low iron levels, which is not uncommon in premature babies, they were given vitamins twice a day. While they had feeding tubes, they were receiving bottle feeds as well, and they gained weight in the NICU. Isaac and Israel were getting stronger day by day and were able to breathe on their own. Once they were completely stable, they were ready to go home on February 12, 2022, after spending a month and a half in the NICU.

Isaac and Israel spent six weeks in the NICU at The Children’s Hospital of San Antonio. Their parents are happy to be back home in Eagle Pass now where the twins are thriving and mom enjoys dressing them up in matching outfits!

“Our 2-month-old sons are doing amazingly well,” said Cynthia. “Their little personalities are beginning to show. While Isaac loves to command attention – he thinks he’s the center of the world – his younger brother Israel loves to be held all the time. He is more patient than his older brother. As I look at our sons today, I can’t help but think about their journey of survival, and the amazing doctors and nurses in the NICU who took great care of them. Dr. Pierce and the NICU nurses were amazing. They answered all of our questions and concerns, and they were always there to comfort and support us especially during those unstable moments when I wasn’t sure what the outcome would be. There were a lot of ups and downs on our journey, but our family and faith kept us strong. I’d go to the chapel at the hospital and pray for our boys every day. I can’t wait to tell my boys the story about their birth when they get older. It was a wild ride – but in the end, I am grateful God blessed us with these two miracle babies that we love so much.”

The Children’s Hospital of San Antonio provides the highest level of specialized care for premature and critically ill infants. Click here to learn more about our Level IV NICU.

An unexpected miracle

For as long as she can remember, Rebekah Jowers knew it would be difficult to get pregnant. In 2017, she was diagnosed with Polycystic Ovary Syndrome (PCOS), a hormone imbalance disorder that causes small cysts to form on the ovaries. It was normal for Rebekah to skip her periods for several months or even years. If she was pregnant, a missed period wouldn’t be a clear indicator.

While Rebekah and her fiancé, Logan, were eager to start a family, they knew their dream may not happen, but they clung to hope even though they were hanging by a thread. Rebekah’s biggest dream was becoming a mom. Little did she know, things happen when least expected.

“A few days after my fiancé and I went out for dinner, I started feeling very ill,” said Rebekah. “I couldn’t keep anything down. At first, I thought I had food poisoning. When my symptoms persisted for several days, I went to the emergency room. They gave me IV fluids and a pregnancy test which I didn’t think much about. To my surprise, the nurse told me my test came back positive! I was like, ‘What? Are you sure this is right?’ And she said, ‘Yes, you are pregnant. Congratulations!’ It took me a few minutes to process what I just heard. It was a jaw dropping moment for me because I thought I could never conceive a baby. I have PCOS and the chances of me getting pregnant were slim to none. When I told Logan the news, he was as surprised as I was! It was an amazing moment for us.”

Rebekah and Logan were surprised to learn she was pregnant, but happily anticipated their baby’s arrival.

While Rebekah had frequent bouts of morning sickness during the first three months, her baby was growing and developing normally. Her obstetrician, Dr. George Cajas at the Women’s Center at Westover Hills, requested weekly ultrasound visits and her baby was very active and loved to stand up and dance in her belly.

“I love dancing so my baby picked up on that,” said Rebekah. “During my second trimester, Logan and I found out we were expecting a girl. As my pregnancy progressed, I noticed she wasn’t as active, so I went to the ER to make sure she was still breathing.  And sure enough, when we saw and heard her heartbeat on the ultrasound monitor, we knew our baby was fine. Since I’m a physically active person, the doctors told me I basically rocked my baby to sleep in my belly. I put her in a deep sleep and that is why she wasn’t moving as much. They told me to lay down in a dark room and drink lots of cold water to wake her up. Sure enough, it worked. She started moving again.”

When Rebekah was 37 weeks pregnant, she began having Braxton Hicks contractions. She was doing everything possible to alleviate the contractions. She’d walk, perform breathing exercises, and move back and forth on a bouncing ball. While it seemed to calm down the contractions, she began having more frequent contractions several days later. At 39 weeks, she was put into the hospital and labor was induced. Her nurses evaluated her progress and noticed the baby’s heart rate was dropping. Whenever Rebekah rolled over to her left side, the baby’s heart rate would go down and so would Rebekah’s blood pressure. But, when Rebekah rolled over to her right side, the baby’s heart rate would go up again, and Rebekah’s blood pressure would return to normal. Her nurses were a bit concerned and monitored Rebekah and her baby more frequently.

“My labor wasn’t progressing well,” said Rebekah. “At that point, I was given medicine to speed up my contractions. As I was going through labor, my nurses checked the ultrasound monitor and they noticed that my baby had ingested meconium (her first stool) which can lead to serious breathing problems after birth.  As a result, my obstetrician determined it was best to deliver my baby right away.  As I was being prepped for an emergency C-section, my fiancé and I were so nervous. Up until this point, I had an uneventful pregnancy. We tried to stay positive and basically roll with the punches.”

On November 12, the couple welcomed their daughter, Paisleigh, who was born at 39 weeks, and weighed 8 pounds, 4 ounces. Immediately after she was born, Paisleigh was transferred to The Children’s Hospital of San Antonio (CHofSA) since they had a level IV neonatal intensive care unit (NICU).

“As a new mother, it was heart-breaking to see my baby in an incubator hooked up to everything you could imagine,” said Rebekah. “She was on oxygen and connected to different machines. My daughter wasn’t moving, and it was hard to see her in this condition. I was glad she made it here.”

When Paisleigh arrived, she was put under the care of neonatologist Dr. Cheryl Motta and Dr. Maria Pierce, a neonatal medicine physician who provides care for infants with persistent pulmonary hypertension and those in need of extracorporeal membrane oxygenation (ECMO). CHofSA is one of the only children’s hospitals in the region providing this advanced life-saving treatment for infants.

Paisleigh was treated for meconium aspiration, which occurs when a baby ingests amniotic fluid containing meconium (baby’s first stool) into their lungs. When these particles stick to the lungs, it can prevent a baby from breathing properly resulting in respiratory distress. In Paisleigh’s case, she developed persistent pulmonary hypertension, or high blood pressure in her lungs, due to the meconium build-up which restricted the flow of blood into her lungs where it normally picks up oxygen.

Paisley was transferred to The Children’s Hospital of San Antonio Level IV NICU to receive expert care including ECMO treatment.

“When treating pulmonary hypertension, our primary goal is to increase oxygen flow to the baby’s organs to prevent further complications,” said Pierce. “Severe meconium aspiration and pulmonary hypertension can be fatal. Our team responded quickly and gave Paisleigh the care she needed. To help her lungs recover and heal, we placed her on ECMO for several days, which is a heart-lung bypass machine that takes over the baby’s heart and lung functions and delivers oxygen to the brain and other parts of the body. ECMO is the highest form of life support that can be provided to a critically ill infant. We are fortunate to have the resources available to be able to offer it here at CHofSA.”

Paisleigh spent 18 days in the NICU under the care of Drs. Maria Pierce and Cheryl Motta.

After 18 days in the NICU, Paisleigh was discharged on November 30, just weeks before Christmas, which is what Rebekah and Logan had hoped for. Rebekah says if it weren’t for the wonderful doctors and nurses who took such great care of her baby, her outcome could have been completely different.

“I had the greatest team of doctors and nurses,” said Rebekah. “They were amazing since the first day my daughter was transported to the NICU. If I had a question or concern, it was never hard to reach them. As a first-time mother, I had so many questions to ask them. I credit the NICU care team, including Dr. Pierce and Dr. Motta who were Pasleigh’s primary physicians, for saving my daughter’s life. Despite everything we’ve been through, I am grateful my baby is alive and with us.”

Today, 2-month-old Paisleigh is doing remarkably well. She can breathe on her own and acts like any other healthy baby. She is a miracle to her parents, and her personality is beginning to show.

Rebekah is grateful for the life-saving care Paisleigh received in the NICU at The Children’s Hospital of San Antonio.

Rebekah credits the ECMO program at The Children’s Hospital of San Antonio for helping her daughter survive during a critical period. The ECMO program at CHofSA is the most active, comprehensive, and experienced neonatal, pediatric, and cardiac ECMO center in South-Central Texas since 1989, providing ECMO treatment to critically ill infants and pediatric patients. Additionally, the program has been internationally recognized as an Extracorporeal Life Support Organization designated “Center of Excellence.” Click here for more information about the ECMO program at our children’s hospital.

A smile to treasure

Emily Garcia and her husband were surprised and excited about adding a fourth child to their growing family. They wanted to pick a unique name for this child and decided to name him River upon learning they would be having a boy.

“One day, I was going through a list of names and stumbled upon ‘River,'” said Emily. “I thought it was different, and it just stuck.”

No stranger to high-risk pregnancies due to her high blood pressure and gestational diabetes, Emily made an appointment with her obstetrician, Dr. Tracy Lyon at CHRISTUS Women’s Health associated with The Children’s Hospital of San Antonio (CHofSA). When Emily was about 12 weeks along, Dr. Lyon detected on the ultrasound that River’s chin was tiny and pushed back. And at the 20-week mark, they also discovered that River had a clubfoot, a birth defect that affects muscles and bones in a baby’s feet, making their foot (or both feet) point down and in.

Dr. Tracy Lyon, an OB-GYN with CHRISTUS Women’s Health, helped Emily manage her high-risk pregnancy.

“I was super emotional because I had never dealt with anything like that with my previous pregnancies,” said Emily. “But my husband and I decided to take it one day at a time and deal with whatever came our way.”

Doctors recommended that Emily undergo an amniocentesis, a procedure where a small sample of amniotic fluid is taken to be tested for any abnormalities that might have caused River’s small chin and clubfoot. Everything came back negative.

Doctors wanted to keep a close eye on River and scheduled weekly ultrasounds for Emily to check on his progress.

The remainder of Emily’s pregnancy was uneventful until she hit 35 weeks and started feeling a little “off” and suspected that her blood pressure was high. She decided to take it, and sure enough, it was. She waited an hour or so to see if her medicine made a difference and when it didn’t, she called her doctor.

After doctors put her on a different medication and placed an IV, Emily’s blood pressure was still elevated. So, the doctors prepared her for a C-section.  

Once they delivered River, doctors discovered that in addition to the small chin and clubfoot, he also had a cleft palate, a condition where the roof of the mouth does not fuse completely during pregnancy.

“The doctors attending River’s delivery were super concerned about him, so they took him to the neonatal intensive care unit (NICU) immediately after he was born,” said Emily.

Because Emily was given magnesium to help her recover from her C-section, she could not see River right away.

When she finally did get to see River, he was doing well. He could breathe on his own, which was a good sign. Dr. Maria Pierce, River’s primary physician in the NICU, told Emily that as he grew, River’s need for supplemental oxygen may increase, which it eventually did.

When Emily finally got to see River in the NICU, he was receiving oxygen and breathing on his own.

As with most NICU babies, River’s journey in the NICU was somewhat of a rollercoaster, but through it all, the team at CHofSA kept Emily, and her husband updated every step of the way.

“I had a lot of communication with Dr. Pierce and some of the other physicians. They were always so helpful and understanding. It was a constant ‘two steps forward, one step backward’ scenario,” said Emily.

River was having some issues eating and, as a result, had trouble gaining weight. When he would try to eat, his heart rate would drop, which was somewhat concerning. After the speech pathologist conducting a swallow test, together with River’s doctors they pinpointed precisely what he needed to help him eat.

When he was about six weeks old and after he had gained some weight, River reached the point where he could have his jaw distraction surgery. Dr. Alejandra Garcia de Mitchell, his plastic surgeon, and her team carefully positioned plates in his jaw and little pins behind his ears. Every day, the doctors would turn the pins to help push his jaw forward.

“In a side-by-side comparison of what River looked like before surgery and what he looked like afterward, it was an amazing transformation,” said Emily. “He looks like a completely different baby.”

River spent 70 days in the NICU and enjoyed visits with his mom and dad.

In total, River spent 70 days in the NICU at CHofSA.

As for his clubfoot, Dr. Elizabeth Magnabosco, an orthopedic surgeon with Baylor College of Medicine at CHofSA, is treating it with ‘casting’ and his foot has slowly started to turn in the correct position.  Dr. Magnabosco is also using the “boots and bars” mechanism, where boots and bars are used to stabilize the muscles and ligaments and prevent them from tightening up.

Born with a club foot, doctors at The Children’s Hospital fitted River with the “boots and bars” mechanism that will gradually correct the position of his foot as he grows.

When River finally was able to go home, Emily and her husband were excited but also a bit overwhelmed. Before they left the hospital, they needed to know everything necessary to care for River at home. And they needed to be prepared to keep track of his many doctor’s appointments, including setting up physical therapy for his foot and face. He also needed to have the distractors removed, a procedure he recently had done.

Emily and her family are immensely grateful to the team at CHofSA for taking such great care of River, especially the plastic surgery team.

“The plastic surgery team made my life 10 times better. He’s able to do so much more than I ever thought he’d be able to do because of them,” said Emily. “They brightened the outlook for my son and increased his quality of life.”

The nursing team also made a significant impact on River and his family. There are two in particular that come to mind – Kim and Alison.

“Kim went above and beyond for us as far as River was concerned. She always took care of us and made sure we always knew what was going on,” said Emily. “And Alison took care of River during the night and was super helpful in making sure he was always fed, which could be complicated at times.”

The only surgery ahead of him is the procedures to correct his cleft palate. When he is a little older, Dr. Garcia de Mitchell will perform the surgery to repair his cleft palate in two stages. The first stage will be to correct his soft palate when he is about a year old, and the second phase to correct his hard palate will occur when he’s between 15 and 18 months old.

In the meantime, River is reaching some key milestones. He loves to be held, enjoys his swing, and has started to smile and even talk a little.

“There were times when I wasn’t sure we would ever see him smile,” said Emily. “Now, when he does, it means the world to me.”  

Services mentioned in this blog: Orthopedics, NICU, CHRISTUS Women’s Health, Plastic Surgery