ADVANCED MEDICINE & SURGERY — Before she took her very first breath, baby Layla was already locked in a high-stakes battle for survival.
During a routine 16-week gestation scan, physicians detected a large mass expanding on the left side of her neck. Her mother, Ashley Manderle, was advised that the tumor required aggressive monitoring as the pregnancy advanced.
Over the subsequent weeks, the mass nearly doubled in volume, escalating fears that it would compress Layla’s trachea and completely obstruct her airway upon birth.
The Precision of the EXIT Procedure
Recognizing the fatal risk, a multidisciplinary medical team at UW Health’s Fetal Diagnosis and Treatment Center engineered a meticulous delivery strategy using an Ex Utero Intrapartum Treatment (EXIT) procedure—a specialized surgical operation performed while the fetus remains tethered to the placenta.
At 32 weeks gestation, Layla was partially delivered via a specialized cesarean section. By keeping her connected to the umbilical cord, surgeons ensured she continued receiving vital oxygen from her mother while they worked against the clock.
Over a critical 12-minute window, the surgical team successfully navigated around the growth to secure a breathing tube into her airway. Specialists emphasized that without this specialized intervention, any delay in establishing ventilation after full delivery would have proved fatal.
Removing a Tumor Larger Than Her Head
Once the airway was safely secured, Layla was fully delivered. Medical staff subsequently measured the tumor at approximately 17 centimeters—a mass larger than her head and weighing nearly two pounds.
In the days preceding her corrective surgery, neonatal intensive care teams had to position Layla strictly on her stomach or side to prevent the massive weight of the tumor from exerting dangerous physical pressure on her newly secured airway.
Just four days post-birth, pediatric surgeons performed a delicate procedure, successfully resecting the entire two-pound mass.
A Remarkable Recovery
Today, Layla is healthy, vibrant, and making an extraordinary recovery. Ashley shared that her daughter has healed beautifully, retaining minimal visible scarring from the life-saving operation.
Ashley credited her daughter’s survival to the seamless collaboration among fetal medicine specialists, pediatric surgeons, anesthesiologists, and neonatal intensive care nurses who united to give Layla a fighting chance.
Layla’s triumphant arrival stands as a powerful testament to the frontiers of fetal intervention, illustrating how rapid advancements in specialized perinatal medicine continue to offer hope to families confronting the rarest and most daunting diagnoses.