August 24, 2001

When Laura Hajdukiewicz was 16 weeks pregnant in April, she received some good news and some bad news. The good news was that she was pregnant with a girl, which came as a pleasant surprise because Hajdukiewicz already had two little boys. The bad news was that her baby had contracted a viral infection.

Unknown to Hajdukiewicz, she herself had contracted the infection several weeks earlier, when a child in her son's daycare center came down with the virus called Fifth disease.

"Since I knew this was a pretty common childhood disease, I didn't think much of it when the daycare center staff told me about it," says Hajdukiewicz. "But when I found out that it could be dangerous to pregnant women who are exposed to it, I got nervous."

She immediately went to her doctor's office for an ultrasound. The procedure gave her the good news that the baby was a girl. But the testing for the virus was inconclusive. She then was referred to Allan Nadel, MD, director of the MGH Vincent Obstetrical Ultrasound Unit and Prenatal Diagnostic Unit. Another ultrasound was performed, which found evidence of anemia in the fetus, presumably caused by the viral infection.

According to Nadel, if the anemia was severe enough, Hajdukiewicz might lose the baby. He considered the option of giving the baby a blood transfusion in the womb, which would have been difficult because the fetus was so small. "We continued to monitor Laura and the baby for several days, and our testing revealed that the anemia might be getting worse," Nadel says. Reluctantly, he decided that the transfusion was the best option.

"It was a delicate procedure," says Nadel, who performed the transfusion with Michael Greene, MD, director of MGH Vincent Maternal Fetal Medicine. "Doing a procedure like this always poses some risk, but we felt it was the right thing to do." And they were correct: The fetal blood count at the time of the transfusion confirmed that the baby's anemia was dangerously severe.

Throughout the ordeal, Hajdukiewicz and her husband, Andy, had confidence in the medical care they received. "I felt really good about being Dr. Nadel's patient," says Hajdukiewicz. "We felt like we had his undivided attention, as if we were his only patients."

At the end of August, Hajdukiewicz is expected to deliver a healthy baby-- whom she and her husband already have named Maryna. This story is the kind that Nadel and his staff at the Prenatal Diagnostic Unit always hope for: one with a happy ending.

For cases in which the patient is at high risk, the Prenatal Diagnostic Unit-- located both at the MGH main campus and at Mass General West in Waltham--is an important resource. "We often get patients who have high-risk pregnancies; they might have had some kind of abnormality in their testing, a family history of congenital abnormalities, multiple miscarriages, pre-term deliveries or multiple-birth gestation," says Nadel. "Whatever the challenges are, we have the staff and the services to support the patients throughout their pregnancies."

The Prenatal Diagnostic Unit also offers a vast array of genetic counseling, testing and follow-up. From routine testing for conditions, such as spina bifida and Down syndrome to more complex genetic testing for conditions like cystic fibrosis, the unit staff work closely with MGH Genetics to provide high-risk patients the most inclusive information. "Our goal is to be able to tell prospective parents, after we've completed all the testing, that their baby is normal and healthy," says Nadel. "When this happens, we can add to the joy of the pregnancy. In the small minority of fetuses who are not normal, our mission is to communicate that message to the prospective parents in the most accurate and empathetic way possible and to assist them in their decision making." For more information about the Prenatal Diagnostic Unit at Mass General West, call (781) 697-2000 or the MGH Vincent Obstetrical Unit at (617) 724-2229.