Specialized Pregnancy Care Helps Create a Safe Delivery
Jake Algerio’s life became difficult two months before he came into the world. A routine ultrasound conducted on his mother uncovered a serious bladder obstruction that significantly limited his amniotic fluid, which is crucial to a child’s growth and development in the uterus. Left untreated, the obstruction could cause renal failure, underdeveloped lungs or limbs – or worst of all – death.
“I was terrified,” says Jake’s mom, Brianne Algerio, 35, of Hawley, Wayne County, who was 20 weeks pregnant when she learned of Jake’s problem. So Brianne turned to ‘Team Jake’ – the caregivers who helped her eventually deliver a healthy baby. Through the Montage Center for Specialized Medicine in Moosic, Lackawanna County (about 45 minutes from Hawley), Brianne was able to consult with LVHN maternal fetal medicine (high-risk pregnancy) specialist Meredith Rochon, MD.
In turn, Rochon worked together with neonatologist Wendy Kowalski, MD, from Children’s Hospital at Lehigh Valley Hospital’s neonatal intensive care unit (NICU). Together they helped Brianne through her pregnancy, all while safeguarding the health of mom and baby.
Watch a video to learn more about her.
Meredith Rochon, MD
Maternal fetal medicine
Wendy Kowalski, MD
At 20 weeks, after learning of the bladder obstruction, Brianne relied on that team. “We weighed all the options, which included terminating the pregnancy,” she says. “But I wanted to see it through.”
The best option – inserting bladder shunts, a minimally invasive surgery where catheters are inserted through the mother’s belly and into the fetus’s bladder. This allows urine to drain properly into the amniotic cavity. “Without such a procedure, the prognosis for survival is very poor,” Rochon says. Brianne had the surgery at LVHN, and that procedure went well. Then, at 32 weeks came another challenge. From inside his mother’s womb, Jake wiggled enough to displace one of the shunts. A second surgery replaced the shunt, but when a blockage developed two weeks later, Brianne and “Team Jake” had one more crucial conversation.
“We discussed what would happen if Jake had to be delivered prematurely,” Kowalski says. “We met with Brianne and discussed what she could expect in the NICU and what Jake may face after delivery, such as the possibility of ongoing kidney problems and other issues related to prematurity.”
On Sept. 21, Jake was born via Cesarean section at Lehigh Valley Hospital–Cedar Crest. His shunts were removed the next day. Then, on Sept. 24, Jake got help from pediatric urologist Michele Clement, MD, who was just joining LVHN at the time.
“When I first saw Jake, there was no way for his bladder to drain. Our first step was to create a temporary path for the urine to drain,” Clement says. “Once this was done, we could let Jake grow until he was large enough for us to fix the problem that kept his bladder from emptying naturally. He’s done very well through it all, but will need close follow-up care in the years to come.” Jake spent two months in the NICU, and then came home to Hawley in late November. While Jake’s kidney issues may continue throughout his life, Brianne is confident in the team that has helped her and her newborn son thus far.
“Jake has come through it all and hasn’t shown any signs of ailments after five months,” she says. “All his wonderful doctors are happy with his progress. No matter what happens from here, I know he’s a blessing.”