Receiving a 3-D bas-relief model of her baby’s face in the mail was “really emotional” for Taylor Ellis, 26, a blind woman in Cockeysville, Md. “I was a little bit nervous about opening the box,” Ellis said. “I had never seen a 3-D [image], and now, it’s your baby, and it’s, like, wow.”
The idea evolved from a procedure developed several years ago at Johns Hopkins Hospital in Baltimore for fetuses with spina bifida. Jena Miller, an obstetrician and surgeon with the Johns Hopkins Center for Fetal Therapy, realized that a 3-D print would allow her to get a clear image of the spines of babies who needed surgery in utero for spina bifida.
Called fetoscopic myelomeningocele repair, the surgery is conducted through two small ports in the mother’s uterus. Surgeons in the past opened the uterus to perform the surgery on the fetus’s spine. This newer procedure, Miller said, means that the surgical team practices the minimally invasive surgery ahead of time — using a 3-D model of the baby tucked inside a soccer ball — “so we can know and anticipate as much as possible.”
Research hospitals such as Johns Hopkins have long used 3-D printing technology to create models of human organs and fetal hearts for surgery, to form prosthetics and even to make ventilator splitters, which can allow one ventilator to treat multiple patients.
The use of 3-D technology to create models of the fetus for blind parents was the brainchild of one of the ultrasound sonographers at the hospital, Miller said.
The 3-D ultrasounds are used for only those patients who might need a more detailed view of the fetus for diagnostic purposes. When the sonographer realized they were doing a scan for a blind mother, she asked Miller, referring to creating a 3-D model: “Do you think this is something we can do?” Miller responded, “See if you can capture a good picture.”
Since the 3-D ultrasound doesn’t scan the entire body of the fetus, the team decided the face was the obvious choice for an image.
Ellis and her husband, Jeremy Ellis, who is also visually impaired, have two daughters, ages 5 and 3. When they were born, Taylor Ellis said she had some vision. But since then, her glaucoma has gotten worse, so the chance to know baby No. 3 this way was a new world.
“It feels super-real when you can feel it,” she says. It was almost like she was pregnant for the first time because she had so much more detail. The ultrasound experience can be frustrating even for sighted parents, Ellis said, because technicians are limited in how much real-time description they can offer parents during the procedure. If the fetus has a problem, it is the doctor’s role to explain that, she said.
Miller said she was not aware of any hospital, other than Johns Hopkins, offering this service. The material cost is estimated to be about $1.40, and each print takes about 3.5 hours.
Pamela Lauer, a high school teacher in Snow Hill, Md., was the first parent at Johns Hopkins to receive a 3-D print of her baby’s face. She is sighted, but says that she needed 3-D testing because her fetus had developed a congenital cyst that was affecting his heart. Doctors had to place shunts to drain the cyst, and the monitoring required weekly ultrasounds until he was born. (The child, now almost 4, is healthy.)
Spending so much time at Johns Hopkins getting the ultrasounds and being shown 3-D prints led Lauer and her husband to ask questions about the 3-D printer. Since the technicians knew they were interested, after their son was home from the hospital, they sent a 3-D print of his face.
“That was awesome and amazing,” Lauer says. “It looks like him.”
For blind parents, this new possibility is exciting, said Melissa Riccobono, president of the Maryland Parents of Blind Children, a division of the National Federation of the Blind, where her husband, Mark Riccobono, is president. She and her husband are both blind, as are two of their three children.
When she was expecting her first child, who is now 13, technicians gave her a print from a technology that allowed the image to rise a bit from the page, a print that she describes as 2.5-dimensional, not 3-D. “It was always a little sad for me not to be able to actually see that ultrasound,” she says.
Melissa Riccobono would have loved to have 3-D printed models, she said. “It’s a really cool way to meet that little being inside of you before you actually meet that little being,” she said.
It would be a great service for a lot of people, she said.
“For families, instead of having to show them a picture of an ultrasound, how cool it would be for them to get their hands on it, what the baby is like now,” she said. By relying so heavily on pictures, “we really miss the opportunity to use our other senses,” she said. “More than blind people would enjoy that.”
Miller at Johns Hopkins struck one note of caution. While she could imagine 3-D printouts for fetuses with cleft palates or other problems requiring surgical intervention, ultrasound is a diagnostic tool and “not for fun,” Miller said. “We have to be a little bit careful.”
The innovations in surgery are what are “life-changing for babies,” Miller said. “But we should take every opportunity to enhance the pregnancy experience for moms, no matter what it is they’re challenged with.
“So if it’s blind moms, and we can give them a unique experience, we should always elevate their level of care.”
For Ellis, having a 3-D image means that she was able to answer one question about her baby before she was born June 10. “I don’t like my nose,” Ellis said. She wanted the baby to have her husband’s nose. “The one thing that is just super-distinct and obvious and just perfect is the nose,” she said. “It feels just like my husband’s.”