It was incorrectly reported in Monday's editions of The Washington Post that none of 16-year-old Carol Kent's relatives were at The Washington Hospital Center Sunday when her premature baby was delivered. Kent's brother, Earl, the baby's father and the father's mother were at the hospital. Kent's mother, Mary Kent, visited the hospital a few hours after her comatose daughter's 2-pound, 3-ounce baby was delivered.
After struggling for more than a month to keep a 16-year-old comatose cancer patient alive at least long enough to save her unborn child, physicians at the Washington Hospital Center yesterday delivered a two-pound, three-ounce boy by cesarean section.
Dr. Robert Pedraca, who led the four-person team on hand at the delivery to care for the baby, said the 10-week premature infant has about a 50-50 chance of survival. The next 10 days will be critical for the baby, he said.
The next 10 days may also be the period during which physicians caring for Carol Kent, the baby's mother, learn whether they will ultimately be able to save her.
Kent's chances "are not too good," said neurosurgeon Michael Dennis, who has been leading the battle against Kent's malignant brain tumor.
"She's still got a chance, but it's becoming grimmer and grimmer each day," Dennis said.
"What I'd like to see now is what happens now that her pregnancy is terminated," he said. Kent's tumor, which is located in the brain's main control center, is an unusual form of cancer that spreads much more rapidly than usual during pregnancy.
For about the past two weeks, Kent has had a bacterial infection in her blood, and it is that infection, Dennis said, that poses the greatest immediate threat to her life.
Immediately after the delivery, Dr. Howard Champion, chief of the hospital's shock-trauma service, operated on Kent to insert a tube that allows feeding directly into her small bowel.
The infection has prevented Kent's stomach from functioning properly, and the question during the next 10 days will be whether her small intestine will absorb enough nutrition to allow her to fight off the infection with the aid of antibiotic drugs.
Shortly before the delivery yesterday afternoon in Operating Room 6, anesthesiologist Dr. William Heron went about preparing Kent for the ordeal of surgery.
"It's a difficult choice to make," he said to a reporter in the room, "but right at this point, we're looking for factors that will help the baby. This is going to be a very critical moment. If we had to make a choice now, I don't know what we'd do."
The drama began in earnest at 1:31 p.m. yesterday when obstetrician George Ulma entered the operating room.
"Let's scrub the tummy up a little bit," Ulma ordered as he was being helped into his white latex surgical gloves.
Carol Kent lay on her back on the operating table, the slight swell of her abdomen more suggestive of overeating than pregnancy.
At 1:33, as curious nurses peered through the window in the door and the staff stood by, obstetrical resident Dr. Suba Vinayokon took a scalpel in her right hand and began the surgical procedure.
The 14 surgeons, residents and nurses in the operating room were unusually quiet as Ulma and the resident continued their work, the steady beep, beep, beep of a heart monitor a constant reminder of at least one of the two lives in jeopardy.
At 1:43 Vinayokon placed both her hands deep into Carol Kent's belly and withdrew holding Baby Boy Kent, whose tiny body and limbs were dwarfed by her gloved hands.
The baby lay immobile on Kent's chest as the umbilical cord was clamped off and cut. Vinayakon then handed the infant off to Jackie Verburg, one of the two nurses present to care for the infant.
Pedraca and his team immediately began suctioning yellowish secretions out of the baby's lungs, and Verburg used a minute swab to take a culture from the baby's throat on the assumption that he, like his mother, has an infection.
"It's not real good," said nurse Polly Watkins, who listened to the baby's heartbeat as the team worked.
Pedraca and Dr. Hsuan C. Huang, like Pedraca a neonatologist -- a specialist in the care of newborns -- had some difficulty forcing into the infants' throat a tube to help his feeble breathing.
But then, as Ulma and his team concentrated on Carol Kent -- success. "You're in!" Watkins told the doctors as she used her stethoscope to listen to the baby's breathing.
"How's the baby?" asked one of the nurses.
"Looks good so far," said Watkins at 1:47.
Three minutes later, with the baby bundled into a heated infant transporter, the nursery team began the trip to the 5th floor Infant Intensive Care Unit, one floor above the operating room.
Four minutes later Baby Boy Kent was wheeled in the door of the nursery to the oohs and ahs of the staff.
"She's big!" said one nurse.
"She's a nice baby!" called another.
"He! HE!" said Verburg, as she took the infant off the scale after announcing the two-pound, three-ounce weight -- a good weight for a baby of about 27 weeks' gestation.
Eighteen minutes after the baby was brought into the nursery, he had had a new tube placed in his throat and was breathing with the aid of a respirator. As his mother had done earlier, he lay on his back, his eyes closed, his life maintained by mechanical devices.
Aside from occasional movements in his tiny legs or doll-like hands, he lay still. But his color was quite pink, a sign that he was receiving enough oxygen.
"He's been very stable since birth," Pedraca said. His lungs "sound pretty good for a baby this size."
Within the next 10 days, Pedraca said, the nursery staff will learn whether the baby's lungs are sufficiently developed for him to survive and whether he will survive his mother's infections.
As Pedraca spoke of the infant, the mother was being wheeled along a 4th floor corridor back to her cubicle in the Surgical Intensive Care Unit.
When Carol Kent entered the hospital early in August, she was first placed in the psychiatric unit with a diagnosis of severe depression.
But doctors determined the next day that Kent, the mother of a 15-month-old child, had a malignant tumor, a discovery that has done little thus far to save her. A series of intensive radiation treatments apparently reduced the size of the tumor, which was as large as a chicken egg when first discovered.
There were no family members waiting for the 16-year-old in the intensive care unit, just members of the staff who have been caring for her. As he finished adjusting some of Kent's lines, Heron said, "She's essentially back to where she was before the delivery, which is not to say great."