Despite cardiac tumors and hydrops, baby beats the odds

After five years of trying to get pregnant and then a miscarriage, Tabitha Downs and her husband received the good news they had hoped for: She was pregnant.

Everything seemed fine, until a routine ultrasound at 19 weeks revealed a very slow fetal heartbeat on the fetal Doppler monitor. A normal fetal heart rate is between 110 and 160 beats per minute. Her baby’s was in the 90s.

Tabitha returned the next week and her baby’s heart rate was in the 200s. Her obstetrician in Marysville referred her to the UC Davis Fetal Care and Treatment Center, inland Northern California’s first comprehensive fetal diagnosis and therapy center.

On Tabitha’s first visit to UC Davis, they performed an ultrasound. It was there that she discovered that her baby had hydrops, a condition in which large amounts of fluid build up in the baby’s tissues and organs, causing swelling. She had fluid in her stomach, her skin and around her heart and lungs. This condition is typically fatal when experienced this early in pregnancy. Tabitha then had a fetal echocardiogram, an ultrasound of the fetal heart, where it was found that her baby had multiple cardiac tumors.

“I [emotionally] lost it. I never expected that news,” said Tabitha. “We were told that it was very unlikely that she was going to survive. They explained that she was very sick. They would continue to monitor her.”

Tabitha returned for weekly ultrasounds and echocardiograms to check her baby’s heart’s rhythm and function. She required multiple hospitalizations for days at a time to manage her baby’s fast heart rate and hydrops. UC Davis fetal cardiologist Sherzana Sunderji was able to eventually control the baby’s heart rate with two different cardiac anti-arrhythmic medications. Sunderji also identified a medication used in kidney transplant patients, sirolimus, that was found to shrink cardiac tumors.

Tabitha Downs and her daughter Savannah with pediatric cardiologist Sherzana Sunderji at a recent appointment.

“Tabitha began taking the medication and within three weeks, her tumors started to regress and the hydrops improved. Unfortunately, her triglycerides were also rising with this medication, so she had to stop,” Sunderji said.

Sunderji, along with the UC Davis Maternal-Fetal Medicine team, devised a plan of care and monitoring.  Within a month, the hydrops resolved on its own, apart from the fluid that her baby had in her heart until she was born.

“The good news is that the tumors didn’t grow larger after that. And then it was just a waiting game,” Tabitha said. “I remember making it to 32 weeks, which was her best chance for survival. And then we tried for 34 weeks and we made it. We kept trying for the next goal.”

Baby Savannah was born in September, when Tabitha was 39 weeks, 2 days. Savannah spent three weeks in the UC Davis Neonatal Intensive Care Unit (NICU) and then was sent home. She continues to have regular appointments with Sunderji to monitor her tumors.

“I am so grateful to Dr. Sunderji and her team. I truly feel without them I wouldn’t be sitting here holding my baby girl. I’ve always wanted to be a mom and Dr. Sunderji and the weekly fetal echocardiograms we went to helped save my daughter’s life. She forever has a special place in my heart,” Tabitha said.