To say that there were few good options to save baby Scarlett LaPierre’s life was no exaggeration.
Two weeks after being born premature, Scarlett developed a massive blood clot inside her heart. If her doctors at Atrium Health’s Levine Children’s Hospital waited, the clot could completely block the flow of blood to her lungs or it could break off and cause a stroke in her brain.
Because Scarlett was so small – she was delivered by C-section at 26 weeks at less than a pound and a half – surgery could do more harm than good.
Fortunately, her doctors at LCH had advanced knowledge of a treatment that few babies around the world had ever been given.
The “only thing left to try” was a powerful clot-busting medicine called TPA, says Matthew Saxonhouse, MD, a neonatologist at LCH who treated Scarlett. The medicine, used in adults who have had strokes, posed a severe risk of bleeding in Scarlett’s brain – especially due to her size.
Without trying TPA, though, Scarlett would surely die, Dr. Saxonhouse told her parents. “They didn’t want to give up,” says Dr. Saxonhouse. “And neither did we.”
The TPA worked. Within three days, the clot disappeared completely. “We were prepared to say our goodbyes,” says Tracey LaPierre, Scarlett’s mother. “But Scarlett is a fighter.”
In fact, when the LaPierre’s daughter was born so early, they knew she was going to have struggles ahead of her. So they named her after the feisty heroine of their favorite movie, Gone with the Wind: Scarlett O’Hara.
Special teamwork for a special girl
Scarlett’s triumph was hardly an individual effort. Without the thoughtful planning of Dr. Saxonhouse and his LCH colleagues, Ashley Hinson, MD, a pediatric hematology and oncology specialist, Aaron Prosnitz, MD, a pediatric cardiologist, and the expertise and compassionate care from the neonatal intensive care unit (NICU) nurses, the outcomes could have been a lot different.
Dr. Saxonhouse and Dr. Hinson take care of all babies in LCH’s NICU who have blood clots. Even before treating Scarlett, they had used TPA in other infants. But none as small as Scarlett.
The two doctors had special knowledge that TPA could work. Since his days in residency, Dr. Saxonhouse had followed the scientific literature around the use of TPA in premature babies. There had been only about 10 similar cases published worldwide, and Dr. Saxonhouse knew that Scarlett could be a candidate for this high-risk treatment.
Did the fact that she was cared for at a hospital where her doctors were so familiar with the complexities of this treatment save her life?
“I think that’s a fair statement,” says Dr. Hinson.
Dr. Prosnitz, who had scanned Scarlett’s heart and found the clot, also credited the expertise of the neonatology staff. “I was very impressed with the NICU team for having guided her care so delicately through this big setback,” he says.
Scarlett did have to spend about four more months in the NICU, including her first Halloween. She was dressed as the “littlest mermaid,” says Tracey. Today, about 1 year later, Scarlett is growing fast.
Giving back to babies like Scarlett
The treatment of children with blood clots at LCH is also growing stronger.
Dr. Hinson and Dr. Saxonhouse are developing a pediatric thrombosis center that combines their joint experience in neonatology and hematology. This focus will allow them to streamline treatment guidelines for babies who have blood clots and follow these babies long-term to better understand the risk factors.
“We want to make sure all high-risk babies get the same level of care from the beginning,” says Dr. Hinson.
To help support the clinic, Scarlett’s father, Mike LaPierre, the general manager of Skybrook Golf Club in Huntersville, NC, is organizing a charity golf tournament this year. The LaPierres hope it will be the start of an annual tradition.
It’s their way of giving back to those who gave their family so much. “We owe Scarlett’s life to her doctors’ expertise,” says Tracey.
This story originally appeared in Daily Does on the Atrium Health website.