Marita Graham was 19 weeks into her first pregnancy when she and her husband, Clayton, went in for a routine ultrasound. They were excited to find out their baby’s sex and to celebrate this new milestone along their journey toward parenthood.
However, as the ultrasound technician did the scan, Marita and Clayton could tell something was off.
“He couldn’t move, or he wouldn’t move,” said Clayton.
“We didn’t realize the severity of what was happening,” added Marita.
That is until they sat down with Marita’s gynecologist, who said the words no parent-to-be wants to hear: “This isn’t good.”
Marita learned that her water had broken around 16 weeks gestation, but she hadn’t realized it. At 19 weeks, she had almost no amniotic fluid left, putting her baby at severe risk for infection and preterm birth.
“[There was] lots of just immediate uncertainty and fear,” Marita said. “Just complete fear.”
Marita’s gynecologist’s office is in the Medical City Dallas complex, meaning Fetal Care Center was only an elevator ride away. The couple was whisked downstairs and met with Dr. Nicole Yost, who performed a detailed ultrasound evaluation of their child.
Dr. Yost confirmed that the baby’s heartbeat was strong, and all the structures typical for 19 weeks gestation were in place. There just wasn’t any fluid around him.
It had been a long and emotionally draining day. As the couple returned home — Marita under strict bed-rest orders — they both felt numb. But there was hope.
“[Dr. Yost] was comforting,” Marita said. “She couldn’t say, ‘We’re going to save your child,’ but when I was crying, she grabbed my arm and [said], ‘We caught this at a really good time.’ That’s what she kept saying, ‘We caught this at a really good time.’ ”
Finding Hope at Fetal Care Dallas
Marita would learn later that what happened to her has a name: preterm premature rupture of membranes, or PPROM. That’s when the amniotic sac, which surrounds and protects the baby during pregnancy, ruptures before 37 weeks.
According to the PPROM foundation, the condition is responsible for 30% to 40% of preterm births and impacts 150,000 women in the U.S. annually. PPROM can happen in any trimester of a woman’s pregnancy and comes with significant risks for the mother and baby, such as infection, developmental complications and preterm labor.
Because Marita was only 16 weeks along when her water broke, her baby’s chance of survival outside the womb was minuscule. However, Marita hadn’t gone into preterm labor, so her job — along with support from the Fetal Care Dallas team — was to keep Damian inside as long as possible.
Dr. Yost asked the patient return to the office in the morning to be evaluated by Dr. Magee for possible amnioinfusions. When PROM happens this early in pregnancy, the child’s lungs are not able to develop because of the lack of fluid around the child. Amnioinfusion is a procedure that involves using ultrasound to guide the placement of a very small needle into the empty sac around the baby. The space where the needle has to be placed is a fraction of a millimeter in diameter. After extensive counseling the family underwent the first procedure that morning. The amnioinfusions were done about every 5-7 days.
For ten weeks, Marita remained in the hospital under the care of Dr. Yost and Dr. Kevin Magee. It is customary to admit women with PROM at 23 weeks to allow for close monitoring for signs of infection.
“We were trying to make it to 34 weeks,” Marita said. “That was the goal.”
But Damian had other plans.
On Friday, July 15, Marita posted a video to Instagram celebrating that she and Damian had made it to 30 weeks. The following day, Marita’s nurse, Macy, did a routine check on Damian but kept him on the monitor longer than usual.
As the morning progressed, more nurses came into Marita’s room. They did some tests, consulted with the on-call OB and then told Marita she’d be moving to the labor and delivery unit.
Damian’s heart rate was decelerating when she would contract, so they needed to deliver Damian.
“They wheeled us into the operating room … and I’m just crying and staring at Clayton,” Marita said. “And Dr. [Francesca] Perugini grabbed my hand, and she was like, ‘Honey, I’ve got this. Let us do what we’re supposed to do.’ I said a quick prayer, ‘Just let him breathe, God.’ ”
Within minutes, Damian let out his first cry.
“He Saved My Son’s Life”
From her first visit with Dr. Yost to the time Damian was born, Marita spent a total of 14 weeks on bed rest, 10 of those in the hospital. Both Dr. Yost and Dr. Magee were a constant presence during her stay. In particular, Martia recalled Dr. Magee’s kindness and comfort as she waited, hoped and prayed for a safe and healthy delivery.
On one particularly memorable visit, Dr. Magee saw Marita had decorated her walls with scripture passages that she found comforting. He asked her if she had noticed the importance of water in the Bible. He then gave her the assignment to find scriptures that referenced water as life-giving. Marita took him up on it and found great comfort in knowing her doctor took the time to connect and offer emotional and spiritual support.
After his birth on July 16, Damian spent 67 days in NICU. By September, he was ready to go home. Today, Damian is thriving. He’s hitting his developmental milestones and acing his therapy sessions. Damian sees pediatric cardiology specialists at Fetal Care Dallas but just recently had the chance to meet Dr. Magee for the first time outside of the hospital.
Marita and Clayton brought Damian to Fetal Care Dallas in October and asked to meet with Dr. Magee. The sight of Damian, healthy, happy and thriving, left Dr. Magee a little speechless, as Clayton remembered it.
“It seemed like he broke character for a second … seeing him as a healthy, vibrant little boy.”
When Marita looks back on her pregnancy, challenging as it was, she can’t help but be grateful for the whole Fetal Care Dallas team, especially Dr. Magee.
“He took a chance [on us],” Marita said.
There were no guarantees that Damian would survive, but “never once [did he say] we should just give up. He stayed the course with me, and he saved my son’s life.”