Perinatal center

Medical technology is always improving. Even in the area of pregnancy, science has come a long way in just the last 10 years so that doctors can learn more about the unborn and act to save them.

"Ninety-nine percent of the time, we can tell the pregnant woman that everything is going to be fine," Dr. Joseph Bruner of the Regional Perinatal Center of West Texas said of the tests they do.

But that 1 percent of the time that something is wrong, Bruner and the other maternal fetal medicine specialists have the ability to go in and change the course of a pregnancy, saving lives that otherwise might have no hope.

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In February of 2009, Brianna Lisenbe found out she was pregnant. With twins.

Normally this would be good news, if a handful for a first-time mother, but in March her OB/GYN noticed something was wrong and sent Lisenbe to Dr. Jorge D. Blanco at Odessa Regional Medical Center’s perinatal center. Blanco diagnosed one of the boys, Camden, with acrania, or absence of part of the skull. The condition is fatal, and Blanco told her so. But he also made her a promise.

" ‘I’m not going to let you lose the other baby,’ " Lisenbe remembered Blanco saying. "And that’s what he did."

Creighton, the other twin, was generally healthy. But other tests were performed to be sure. Bruner performed an amniocentesis, sticking a needle into the mother’s stomach to take a sample of amniotic fluid to detect genetic disorders.

Sonograms were, among other things, used to monitor the heartbeats of the twins, both because Creighton appeared to have a heart condition and because Camden’s deterioration while in the womb could jeopardize his brother. However, the longer he could stay to grow in the womb, the better Creighton’s chances were.

Creighton also had one umbilical artery instead of two, which meant Bruner had to go in to see if there were any dangerous complications from that. There weren’t, and after all the tests and procedures, Lisenbe said Bruner was able to assure her that Creighton would be OK.

At first Lisenbe went to the center once a month to be monitored. Then about halfway through the pregnancy, she started having to go twice a month. Toward the end, it was once a week or more often, so she got to know a lot of the workers and other patients.

"It was like they were invested as much as we were," Lisenbe said of the perinatal center and its staff.

Her due date was Oct. 9, but in early September, the doctors told her that she’d have to deliver right away for Creighton’s sake, and for a chance to spend any time with Camden while he was alive.

Lisenbe needed one more day—for her family to get into town, she said then.

But, she admitted, "It was more so that I could have time to prepare myself."

So in the morning of Sept. 3, she went in and delivered her boys, one after another.

Creighton was 4 pounds, 3 ounces, and, after eight days of antibiotics running through him, with the right medication prescribed for his heart, was on the track to growing into the healthy kid of normal size and life expectancy he is now.

Camden was 3 pounds, 6 ounces and lived for 45 minutes.

"We probably had 26 people in the room holding him," Lisenbe said.

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Creighton, and dozens of other children, are alive now because of the testing and procedures performed by the perinatal center, which opened as a separate unit in 2000 in the third floor of what was then Odessa Regional Hospital’s west campus. After the arrival of Dr. Blanco in 2001, the push became to provide more of the latest and greatest in technology and expertise in order, Blanco said, to serve an area reaching all the way to Van Horn and Carlsbad.

Mothers can’t go to the perinatal center without recommendation, so when OB/GYNs in the surrounding community think something’s amiss, they send expectant mothers to the center for special treatment.

That includes tests with really unwieldy names like amniocentesis, nuchal translucency and chorionic villus sampling, which detect genetic abnormalities with ever-increasing accuracy and timeliness, Blanco said. Or some fetuses become anemic in the womb due to differences in the blood of the mother and baby, and percutaneous umbilical blood sampling (PUBS) can detect that so it can be treated.

Although some fetuses have conditions incompatible with life, the center has no involvement in terminating pregnancies, or even suggesting it. The focus is more on providing knowledge and connections to support groups so that parents are prepared to raise a child with particular needs.

"We’ve had mothers come in and find out their baby has dwarfism," Regional Perinatal Center Director Lori Newman said. "The questions they have are sometimes as mundane as, ‘How am I going to dress my child?’ "

The term Dr. Blanco stressed is "nondirective genetic counseling," which means Jamie Chance, the center’s genetic counselor, doesn’t go further than explaining the information to the parents so they can decide for themselves what to do.

And there’s a lot that can be done.

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In 2009 the perinatal center expanded to a new building, and in 2010 it opened an office in Midland, headed by Dr. Joseph Bruner, who moved down from Tennessee last year and specializes in the area of fetal surgery.

"There was simply a need for more manpower," said Bruner, who was asked by Dr. Blanco to come down to the area.

If his name sounds familiar, you may have read it in a chain e-mail circulating in the early ’00s in a photo showing him operating on a fetus in the womb with the fetus "grasping" his finger. Although the description was inaccurate, the picture was real and reveals open fetal surgery as practiced in 1999 when he was at the forefront of treating spina bifida.

He doesn’t do that anymore, although he can still save pregnancies with minimally invasive surgeries on fetuses such as installing catheters to fix defective urethras and drains that keep their lungs clear.

"The greatest service we provide is knowledge. Experience," Bruner said of the center.

Opening the Midland office didn’t provide any new services Bruner couldn’t do while in Odessa, where he still splits time, and some procedures that need hospital care still have to be done at the Odessa location, but it provides those high-risk services at a more convenient location, for the city of Midland as well as surrounding areas like Big Spring.

"Now we sort of bridge the gap between the communities," Bruner said.

* * *

Without the ORMC perinatal center, Brianna Lisenbe’s son Creighton would almost certainly be dead. She certainly wouldn’t have had any time with Creighton’s brother. With it, and now with the Midland office, she and many other mothers in the Permian Basin can understand much more about their pregnancies, prepare themselves for being parents of children with special needs and sometimes keep babies that would have died in virtually any other place or time.

"If you can get in to see Bruner and Blanco, do it," Lisenbe said. "Because they’re the best."

Services offered by ORMC’s Regional Perinatal Center

>> Consultations for high-risk or complicated pregnancies

>> Genetic Services

>> Amniocentesis

>> Targeted ultrasound studies

>> Fetal echo studies

>> Fetal therapy

>> Biophysical profiles

>> 4-D Ultrasounds

>> Nuchal translucency

>> Chorionic villus sampling