NICU

With a Level IV NICU, St. David's Medical Center is uniquely equipped to provide advanced care. Neonatal specialists at this hospital perform a wide range of surgeries, including procedures related to the following specialties:

• Cardiology
• Dermatology
• Gastroenterology
• General surgery
• Hematology
• Infectiology (infectious disease care)
• Nephrology
• Neurology
• Neurosurgery
• Ophthalmology
• Orthopedic surgery
• Otolaryngology (head and neck care)
• Pulmonology
• Radiology
• Urology

We build treatment plans for a wide range of conditions, including:

Congenital lung malformations

Congenital cystic adenomatoid malformation (CCAM) is a benign lung lesion that appears before birth as a cyst or mass in the chest. It is made up of abnormal lung tissue that does not function properly but continues to grow. CCAM is also frequently referred to as a congenital pulmonary airway malformation (CPAM). The vast majority of CCAM/CPAM lesions are small enough that they will not cause any problems to your baby during pregnancy, and the CCAM/CPAM can be removed after birth. However, some large lesions can cause serious and even fatal complications, including fetal heart failure (also called fetal hydrops). These cases may require treatment before birth.

Congenital diaphragmatic hernias

A congenital diaphragmatic hernia is an abnormality in the formation of the diaphragm, the muscle separating the chest cavity from the abdomen. The diaphragm helps in breathing, so it is critical to the respiratory system. In a diaphragmatic hernia, the diaphragm does not completely form, leaving a gap between the chest and the abdominal cavities.

Esophageal atresia

A congenital condition where your baby's esophagus develops improperly. The esophagus carries food and water from the mouth to the stomach. The esophagus normally develops in two parts, a top and bottom part, that grow together during development. In the case of esophageal atresia, the esophagus fails to connect in the middle resulting in a top (proximal) and bottom (distal) esophageal pouch. These two pouches are eventually brought together surgically to create a complete esophagus.

Fetal gastroschisis

A congenital abnormality or opening in your baby's abdominal wall next to the umbilical cord, allowing the intestines to protrude out into the amniotic fluid, causing them to cease their normal movement.

Fetal hernia/hydrocele

During fetal development, a sac that surrounds normally descending sexual organs does not close, allowing the intestine to bulge through the opening, or fluid to build up.

Fetal intestinal atresia

A congenital abnormality in which a part of the intestines fails to form properly, resulting in an obstruction or blockage. Examples are duodenal atresia, jejunal atresia and ileal atresia.

Fetal omphalocele

A congenital abnormality or opening of the central abdominal wall, allowing abdominal organs to protrude through it. A translucent membrane or sac covers the protruding organs.

Gastrostomy tube

Some kids have medical problems that make it hard for them to get enough nutrition by mouth. A gastrostomy tube (also called a G-tube) is a tube inserted through the belly. It brings nutrition directly to the stomach and is one way that doctors can ensure kids who have trouble eating get the fluid and calories they need. A surgeon inserts a G-tube during a short procedure called a gastrostomy. The G-tube can stay in place for as long as your child needs it.

Babies need G-tubes for different kinds of health problems, including congenital (present at birth) problems of the mouth, esophagus, stomach or intestines, sucking and swallowing disorders (due to premature birth, injury, a developmental delay, or another condition) and failure to thrive (when a child can't gain weight and grow normally).

Hernia

A protrusion of tissue or organs through an opening or weakness in the muscle wall that usually contains it. Infants can be born with them or can develop them if born prematurely. Examples include inguinal hernia or umbilical hernia.

Hirschsprung disease

A condition that occurs when the intestinal wall is missing the nerve cells which signal the muscles in the large intestine to push stool towards the anus, causing an intestinal blockage.

Hydrocephalus

A baby with hydrocephalus has extra fluid in and around the brain. This fluid is called cerebrospinal fluid (CSF). Most CSF is found in fluid-filled areas (ventricles) inside the brain. Its purpose is to cushion and protect the brain and the spinal cord. Too much CSF can increase the pressure in your baby's head. This causes the bones in your baby's skull to expand and separate. Babies can be born with hydrocephalus or develop hydrocephalus if born extremely premature and experience severe intraventricular hemorrhage.

Hypertrophic pyloric stenosis

A narrowing of the lower portion of the stomach that leads into the small intestine, resulting in food not moving easily into the intestine for digestion.

Imperforate anus

This birth abnormality caused by improper development of the rectum and anus during pregnancy, causing the opening at the rectum/anus to be absent so stool cannot leave the body.

Intestinal malrotation and volvulus

A birth abnormality involving a malformation of the intestinal tract; occurs while a fetus is forming in its mother's uterus.

Necrotizing enterocolitis

A serious intestinal illness in babies, typically born premature, involving damage to intestinal tissues, which can lead to a perforation (hole) in the intestines, allowing bacteria in the intestine to leak into the abdomen (belly). This can lead to a serious infection known as peritonitis (inflammation of the abdomen lining).

Spontaneous intestinal perforation

Spontaneous intestinal perforation (SIP) is a hole in a premature baby's intestine. Though uncommon, SIP typically occurs in the first week of life. The hole can cause the intestine contents to leak into the abdomen (belly), which can lead to a serious infection known as peritonitis (inflammation of the abdomen lining). SIP is a surgical emergency and once diagnosed, it is treated as soon as possible.

Ovarian cysts or mass

An accumulation of fluid in the ovary encapsulated inside a thin wall of tissue. It is very common and usually harmless, but it may require surgical removal depending on the size of the mass.

Posterior urethral valves (PUV)

Posterior urethral valves (PUV), a cause for bladder outlet obstruction (BOO), are obstructive membranes that develop in the urethra (the tube that drains urine from the bladder), close to the bladder. The valve can obstruct or block the outflow of urine through the urethra. When this occurs, the bladder, ureters and kidneys become progressively dilated, which can lead to damage.

Sacrococcygeal teratoma

A congenital condition where rare tumors form at the bottom of the spine by the tailbone.

Spina bifida or myelomeningocele

Spina bifida (Latin for "split spine") is a type of neural tube abnormality, a problem with the spinal cord or the structures covering it. The neural tube normally closes during the early weeks of embryo development, and can occur at any point along the spine ("backbone"). The spine normally protects the spinal cord. Spina bifida occurs because of the neural tube not closing completely during an unborn baby's development, causing a hole in some of the bones of the spine (vertebrae). This may result in spinal cord and nerve damage, which may cause mild to severe disabilities.

Tracheoesophageal fistula

A congenital condition in which an abnormal connection exists between the trachea (windpipe) and the esophagus (the tube that carries food and water from the mouth to the stomach).

Tracheostomy

A tracheostomy is an opening surgically created through the neck into the trachea (windpipe) to allow direct access to a breathing tube that may be required for babies with severe lung disease needing long-term mechanical ventilation (breathing machine) or significant upper airway obstruction.