Annual Report 2002-2003
Health Care
Preventing blindness in premature infants
Every week since 1981, Palo Alto Medical Foundation (PAMF) retinal specialist Michael Gaynon, M.D., has visited the Neonatal Intensive Care Unit (NICU) of Stanford University Hospital to examine the eyes of premature infants. Among other things, he looks for signs of retinopathy of prematurity (ROP), a rare disease that can cause retinal detachment and blindness if undetected. More than 500 premature infants are blinded by ROP every year in the United States, and the disease is even more prevalent in other countries.
Hallie's parents, Trina and Burt Lampl, grew up in the same small town in Oklahoma, where they dated in junior high school. After marrying, they made plans to start a family. But in 1997, Trina was diagnosed with scleroderma, a rare auto-immune disorder that, among other symptoms, compromises the vascular function so essential to the health of the placenta. After two lost pregnancies, the Lampls knew they faced a risky pregnancy with Hallie.
At 23 weeks, an exam revealed that Hallie's heartbeat was decelerating due to stress caused by Braxton-Hicks contractions on an insufficiently developed umbilical cord. The decision was made to have a Caesarean section two weeks later. "My placenta was just not supporting her," said Trina, "and we knew we were at a point where she would be better off outside than inside." Doctors told the Lampls that Hallie had less than a 15 percent chance of survival, recalled Burt, "but we had tremendous faith that she would make it, despite the odds." Hallie spent the first months of her life in a high-tech isolette, under constant care, in the Stanford University Hospital NICU.
In mid-December, when Dr. Gaynon first examined Hallie, her eyes were fine. But by his third visit, she had advanced to the latter part of Stage III ROP. Knowing that Stage IV meant retinal detachment, Dr. Gaynon and the Lampls decided immediately to schedule Hallie for panretinal laser photocoagulation, a delicate procedure that stops the progression of ROP. The operation was a just-in-time success. "Hallie lost some of her peripheral vision," said Dr. Gaynon, "but her field of view should be fine for normal activities like reading and driving." A few weeks after the surgery, the Lampls brought Hallie home: it was January 29, 2003, her original due date had she been a full-term baby.
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On October 21, 2002, Hallie Grace Lampl took her first breath and let out a cry that was louder than anyone ever expected. After all, she was only 12 inches long and weighed just 510 grams. Hallie was born at 25 weeks, her tiny eyes wide open. For first-time parents Trina and Burt Lampl, the journey to the moment of Hallie's birth had been arduous. Yet there were still more challenges to be met before they could take their baby daughter home from the hospital more than three months later.