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American Morning

Septuplets Delivered in Three Minutes

Aired July 13, 2001 - 11:01   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
STEPHEN FRAZIER, CNN ANCHOR: A dozen hospital staffers, three minutes, seven babies, only one mother. Doctors in Washington keeping watch over seven septuplets this morning. We'll get details on their condition at a news briefing shortly.

For now, let's talk with CNN medical correspondent Rea Blakey, who is at Georgetown University Medical Center, the scene of all the excitement this morning.

Rea, good morning.

REA BLAKEY, CNN CORRESPONDENT: It is quite the scene here, Stephen. The doctors have just come in so we expect that at any moment they'll be ready to give us more information. What we're expecting to hear specifically, the status of the babies. We have five boys, two girls. We're also hoping that we'll learn more about their weights, how long labor took. We have been told that the labor began approximately 9:30 last evening. The delivery occurred at 11:25 be cesarean section.

You mentioned the team of people involved in this event. The obstetrician had assistance from 25 medical professionals during this procedure, which, again, was just a three minute birthing process.

We do not know specifically the details of the pregnancy, even though we are told it's very likely it was ovulation induction, by which I mean the mother actually takes medications to create more eggs in -- just checking -- more eggs available than a natural conception, if you will.

There is some controversy, apparently, regarding this case. We're hearing just on the outskirts, and we're going to try and find out more about that, because, again, we don't know the specifics. But we do know that there is a community physician in northern Virginia who referred this case to Georgetown because of the complexities of the case.

Obviously, any time you're delivering seven children there could be the potential for great risk. And so those are the kinds of things we'll be looking to hear more about. It's even possible, Stephen, that we might have a concept of what these babies' names could potentially be.

FRAZIER: That would be exciting, Rea. As the doctors take their seats behind you, let me ask you, as our medical correspondent, you're better suited than I am to understand how 25 physicians and assistants could move around in that operating suite.

BLAKEY: Well, it's quite cramped quarters and actually the thing that probably is more pertinent at this point is the fact that they had SWAT teams on standby for each of the babies. It turns out there were six members for each SWAT team and each of the babies at this point, as far as we know, are doing well.

Stephen, I'm going to go ahead and relinquish my moment here on television and let us go ahead and get to the news conference because I see the doctors are, in fact, in place, and maybe we'll learn more as the moments go by.

DR. RICHARD GOLDBERG: The Georgetown University Hospital. My name is Dr. Richard Goldberg and I'm vice president for medical affairs here at Georgetown. We're very pleased that (UNINTELLIGIBLE) to report on this historic birth of septuplets, a first for Georgetown despite our long history of delivering multiple births. Also, I might say, a first on the East Coast of America.

We believe that a momentous event such as this is a true demonstration of the high level of medical expertise provided by our outstanding academic medical center. I know that you're anxious to hear about the preparation of the delivery as well as the health of our patients, so let me introduce our panel of experts.

Before I do, however, I would be remiss if I did not mention that we would need a much, much larger stage than this one at hand in order to accommodate all of the medical...

FRAZIER: Well, obviously we could hear in the distance there the opening remarks of that news conference, but we couldn't hear it too well and they're just getting to the stage where they're introducing all the members of the medical team, quite a few of them. So those interactions will go on for a moment.

Now let's go back to Washington, where we think we've fixed our technical problems and we're going to hear things a little better now.

GOLDBERG: The first and second rows of the auditorium.

Beginning to my right, we have Dana Adamson, R.N. (ph). Dana is a nurse manager of the NICU, the PICU and pediatrics. We have Dr. Siva Subramanian, who is our chief of neonatology here at Georgetown University Hospital. Dr. Craig Winkel is to his right. Dr. Winkel is the chair of the department of obstetrics and gynecology at Georgetown University Hospital. To his right we have Dr. Fauzia. Dr. Fauzia is a community physician for the mother, who, due to the complexity of this delivery, referred the patient to Georgetown. To her right is Dr. Helaine Landey, who is an obstetrician, the attending physician here at Georgetown University Hospital. And to her right is Lynette Phillip, R.N. (ph), director labor and delivery nursing staff, Georgetown University Hospital. The staff we're very, very proud of.

We'd like to keep the press conference today to under an hour so that we may continue to care for our patients. So I've asked Drs. Winkel and Subramanian to provide opening remarks before we begin the questions and answers today. And before I turn it over to them, I would like to remind you that at this point in time the family has requested anonymity. Therefore, we will not be answering any questions that will lead to the identity of this family. When we begin the questions and answer sessions, I will field those questions. I will ask you to please state your name and the news outlet you are representing and perhaps I may ask the folks responding to repeat the question.

So if I could turn it over to Dr. Winkel at this point in time. Dr. Winkel?

DR. CRAIG WINKEL, OB-GYN DEPARTMENT CHAIR: Thank you.

As Dr. Goldberg mentioned, our patient was referred to us by Dr. Fauzia in mid-June because she thought that this complicated case would be best handled here at Georgetown University Hospital. During the last few weeks that the patient was here, we've been making preparations, including establishing individual assignments and even dress rehearsing for this event, while at the same time we've been monitoring the mom and her seven babies.

Last night at about 8:00 P.M., she went into labor spontaneously and we activated our pretty extensive pre-planned call back protocol to get all the doctors, nurses and other medical personnel here in preparation for the delivery. There were 25 medical personnel in the delivery room during the cesarean section and more than 25 medical personnel waiting in the NICU, neonatal intensive care unit, which is situated only about three steps from the delivery room.

Between 11:25 and 11:28 last night, five boys and two girls were delivered. The babies' apgar (ph) scores were all between seven and nine and their weights were between 900 and 1,110 grams, somewhat over two pounds. The mother is presently resting and is in good condition, and what I'd like to do now is turn it over to Dr. Siva to describe the action in the NICU last night as well as to report on the condition of the babies now.

DR. SIVA SUBRAMANIAN, CHIEF OF NEONATOLOGY: Thank you, Craig.

All right, let me add the welcome on behalf of all the NICU staff to already what has been said. Obviously this is an historic occasion and as Craig said, we were preparing for this and we have had several dry runs and to make sure everybody is available. And as planned, you know, life sometimes works out very nicely, it did happen. Everybody responded and on time. We were all ready and as he was talking about, more than 25 or 30 people were ready to take care of seven teams of people to address each baby that was going to come as to what their needs are.

But obviously we also needed other nurses and doctors to take care of all the other intensive care babies that we have. That was also done at the same time. And the babies, as he mentioned, there are five boys and two girls, and they vary anywhere between 910 grams to 1,100 grams, and with a variety in between. Almost all of those babies, except one, six babies are on ventilators, which are breathing machines, to assist in the breathing. But the babies are breathing by themselves and the settings are slowly coming down. There's one baby that never needed the ventilator, but just a little bit of an assistance with what is called a cpath (ph), which is a little bit of a prong that is put in the nose with a little bit of oxygen and the baby is still holding fine.

One baby needed support for the blood pressure and with medication and that actually the medication has been weaned overnight and he's on a very low dose currently. And the babies are expected to be in the critical condition for the next few days and we'll have to take one day at a time and see how the babies are doing.

And with that, let me stop here and open it up for questions.

GOLDBERG: Yes, let me field questions from the audience. Yes, ma'am, over here?

QUESTION: I'm Christian Faouz (ph) from CNN and I'm wondering what process was used here? Was it IVF? Was it ovulation induction? What was the process used?

GOLDBERG: Turn that to Dr. Winkel and then perhaps...

WINKEL: I think probably Dr. Fauzia can tell you a little bit about that. She was the physician involved.

DR. MUTAHAR, FAUZIA, COMMUNITY PHYSICIAN FOR MOTHER: Ovulation induction was used and that's all I can say. And thank god they have done wonderful and thanks to Dr. Winkel and Dr. Siva and Dr. Landey. I have been very lucky that the ending is going to be, god willing, good.

QUESTION: Can you describe ovulation induction?

FAUZIA: Ovulation induction is a process in which you give either medications by mouth or you give injections and you monitor the patient, see how their eggs are growing, the follicles you measure, and then that is called ovulation induction.

GOLDBERG: Can I have another question?

FAUZIA: I don't think I can go in detail. Probably the patient might not like it. I'm sure you will forgive me for that.

GOLDBERG: Yes, ma'am?

QUESTION: Hi. I'm Cheryl Colbert (ph) of the "New York Times." You probably know there's some controversy about the procedure known as selective reduction and I'm wondering if you can talk about the family's philosophy...

(CROSSTALK)

FAUZIA: OK. Very good question. GOLDBERG: Wait. Can I turn that first to Dr. Winkel?

WINKEL: Yes. As you know, Georgetown University is a Catholic hospital and that issue really never came up since the patient has been here. And she obviously came here at Dr. Fauzia's direction primarily because she knew that this was the place that had the ability to care for both mom and all seven babies.

QUESTION: I wonder, though, about prior, prior to that when the patient was in Dr. Fauzia's care. If you could talk about the patient's philosophy.

FAUZIA: Yes. This was discussed with the patient. And the patient is a Muslim and she did not believe in taking life of the babies. And I did my best as a physician to explain to them what was available.

GOLDBERG: Next question? Yes, ma'am?

QUESTION: Rita Rubin, "USA Today." I just wondered, how far along were the babies' gestation and had you hoped to -- she went into labor spontaneously and I just wondered if you had hoped to go further along.

GOLDBERG: Dr. Winkel?

WINKEL: Why don't we let Dr. Landey, a maternal fetal medicine specialist, answer that question.

DR. HELAINE LANDEY, DELIVERING PHYSICIAN: Thank you, Rita.

The patient got to 28 1/2 weeks of gestation and yes, ideally it would have been wonderful for her to get further on. She had been taking some medication over the past week to try and quell some of the contractions. We were expecting something to happen any day.

GOLDBERG: Next question? Yes, sir?

QUESTION: Bruce Lachampes (ph) from Channel 9 here in town. Dr. Winkel, and whoever else was there, could you just describe the scene over a little bit for us in the delivery room and what that was like and without revealing their identity, talk about the reaction of the parents and so forth?

GOLDBERG: Dr. Landey, you want to field that?

LANDEY: You've all seen TV regarding the medical channel. Well, picture an operating table surrounded by 25 people. These were several hours of preparation yesterday after several weeks of preparation of the various teams that you already heard us discuss. We had five doctors around the table preparing to do the actual operation. There were three anesthesia personnel who were taking care of the patient's vital signs and intravenous fluids and monitoring that aspect. There were dozens of nurses and support people within the few feet around the operating table, not to mention all the people out in the waiting room area and the hallway area waiting to receive the babies.

GOLDBERG: Siva, I wonder if you could comment on the activity after the baby is delivered, the babies are delivered.

SUBRAMANIAN: Obviously, because now we are going to be looking at seven babies that are coming one after another and there is a separate, what is called a radian warmer (ph) which also eventually converts itself to an incubator and is prepared for the babies and obviously they were ready for quite some time. And soon as Dr. Landey activated the call that the mom is going into labor, we brought all the medical team, nursing team, respiratory therapies and unit secretaries, nursing techs immediately and they were all ready and we were able to assemble and each team had an assigned table the radium warmer in which they helped in terms of stabilize each baby.

And that went very smoothly. It was very smooth operations that happened. And all the babies were fairly rapidly stabilized in the neonatal intensive care unit.

QUESTION: (unintelligible)?

GOLDBERG: Yes, sir?

QUESTION: Was the father in the delivery room and what was his reaction?

(CROSSTALK)

WINKEL: I actually was with the father. The father was in the delivery room throughout the procedure. To be honest, he was most concerned about his wife until all of the babies were out and he actually didn't want to go to the NICU until he knew his wife was OK and actually out of the delivery room, at which point he spent probably the next several hours in the NICU.

(CROSSTALK)

SUBRAMANIAN: You should also see, just one, let me just follow- up in terms of you should also see the tremendous anxiety and the expectation that he was having. If you can imagine, all of you might have had one baby with what expectation that you all had. He was expecting seven. And after the babies were born, after Dr. Winkel brought him, you could see the broad smile in terms of how he was happy.

GOLDBERG: Yes, sir?

QUESTION: I'm Bob Hager with NBC. Along the same lines, the mother's state of mind before this event happened, how she felt about what was going to happen?

FAUZIA: She was very comfortable and I must tell you one thing. The main thing which kept her comfortable was the feeling that god is going to help her. That I can tell you in a nutshell.

GOLDBERG: Other questions or comments? Yes, ma'am? QUESTION: Yes, Pam Colter (ph) from ABC Radio. Was this the first children for the couple or do they have other children?

GOLDBERG: That's a question that is difficult for us to answer at this time. The family wants to keep their anonymity and due to patient confidentiality we're not going to be able at this time to identify the patient in any way.

Yes, in the back of the room there.

QUESTION: Leslie Fox from Channel 9. I know that you can't identify them per se, but you said this is the first group of septuplets on the east coast. Can you give us some idea of whether they lived on the east coast, whether they came from a distance or...

GOLDBERG: Sorry. Wish I could, Leslie, but, again, we're going to hold firm to the issue of the patient's and the family's confidentiality. Yes, ma'am?

QUESTION: I'm Deborah Lisoth (ph) of NBC News Channel. Just to follow-up on that point, why the anonymity? When the other babies, the McCoy babies in Iowa were born and all the publicity, the family received lots of support from various companies and individuals? Does this family just not need that kind of help or not want it?

GOLDBERG: I think it's always important to respect the confidentiality of our patients and at this point in time the family wants to remain anonymous. That may change at some other point down the road and we're going to protect their confidentiality. Yes, ma'am?

QUESTION: Can you even say how old the mother is?

GOLDBERG: No, I can't. Yes, ma'am?

QUESTION: Betsy Nurs (ph) at Gannett News Service. I have another question about the mother. You've all implied that she's been in the hospital for a time before the babies were born. Can you say how long she was in the hospital and did the father have any reason to be concerned beyond the fact that his wife was giving birth?

GOLDBERG: Dr. Winkel?

WINKEL: Yes. The mom was here since mid-June. So about three weeks, a little over. And I'm sorry...

QUESTION: Did the father have any reason to be concerned about his wife's health beyond the fact that she was giving birth?

WINKEL: Not about his wife's health. Not at all.

FAUZIA: She was doing wonderfully.

GOLDBERG: Yes, ma'am?

QUESTION: Again, Cheryl Stalwark (ph) with the "New York Times." I'd like to hear a little more about the babies and their prognosis, the (unintelligible) of the baby who did not require the ventilator, a little more about that blood pressure medication, just what's the outlook for these tiny children?

GOLDBERG: Siva?

SUBRAMANIAN: Thank you. Let us separate the question in two parts, you know, specifically about the babies and then the general question about the prognosis. Let me, why don't I run this down, I think, in terms of the way that questions will be taken care of. The first baby, he was 980 grams. The second baby was 910 grams. The third baby was 940 grams. The fourth baby, 920 grams. The fifth is 1,100 grams. And the sixth, 1,010 grams and then the seventh, 1,000 grams.

And any time when you look at the prognosis, it is a combination of the gestational age and the birth weight in terms of how they will fare. All the data that has accumulated so far it about single term babies or twins, you know, at this gestational age. So to extrapolate that to straight, to septuplets, you know, even though they are in the same weight category, may not necessarily be very accurate and there is always a certain increased risk in that we will see over the next few days, because they're going to remain critical over the next few days, even though they have done very well at this point.

The one baby that requires the blood pressure medication, it is called dopamine, and that requires very low doses and that's to maintain the blood pressure, which, as I said, actually he's being weaned overnight to this fairly low dose at this point.

QUESTION: And is that a boy or a girl?

SUBRAMANIAN: It is the girl.

QUESTION: And what was the weight on that baby?

SUBRAMANIAN: Nine hundred and 20 grams. And the second question that you mentioned, the second part of the question, you know, the babies were generally between 900 and 2,000 grams, if you take a look at national statistics, they will be anywhere from 85 to 90 percent and in our hands at Georgetown in the last year, they have had 100 percent survival. But, again, all of them are not part of the septuplets. It's either single term or twins.

GOLDBERG: Yes, sir?

QUESTION: I'm Barry Nikotim (ph) from CBS. Can you describe what the continuing role of these medical SWAT teams is, what sort of things that they're looking out for, what they're planning to do?

SUBRAMANIAN: There are, again, two components to that, the immediate arrangement for stabilization of the babies right after delivery would require more number of people to stabilize that so each baby would have at least two doctors, one nurse, one respiratory therapist and an additional pool of people available to help in various different ways. And so each baby will have the kind of a team to stabilize the baby, and particularly when you are looking at seven babies coming, each and any one of the babies may be in trouble, so you need to be prepared for all of them.

The second part in terms of the continuation of that team is usually would be them going back to the regular staffing of this. For this high number of babies, both in terms of the nurses and the doctors, as the respiratory therapy team and the pharmacy, you know, all of those things that come up, and that is taken care of by being an economic medical center that Dr. Goldberg was talking about. There will be participation with the residents, the fellows and nurse practitioners in addition to the attending physicians will be taking care of these babies until discharge.

FRAZIER: Dr. Siva Subramanian of a neonatal care division at Georgetown University Hospital explaining the condition and the outlook for those seven babies born overnight to a family which would like to remain anonymous in Washington, D.C. But so far they say the prognosis is excellent, all seven babies doing well, mother and father, too.

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