Quick, coordinated care saves a mother and baby

Kaiser Permanente member Sondra Smith was in her 34^th week of a typical pregnancy when she awoke one morning to severe vision loss in her left eye. She made a same-day appointment with her optometrist, who noticed something wasn’t right and sent her to the emergency department for immediate testing.

The test results revealed an aggressive tumor growing on her optic nerve.

“I knew something was wrong,” recalled Smith. “When you hear the word ‘tumor’ you think, ‘Brain tumor — that’s it, my life is out the door.’”

Smitha’s case was complicated by the need to balance what was best for her and her baby.

“On one hand we have a baby not at term, yet on the other hand we have a patient losing her vision who needs emergent intervention,” said Abraham Boskovitz, MD, a neurosurgeon at Kaiser Permanente in Sacramento. A typical pregnancy is 40 weeks.

Kaiser Permanente’s integrated model allowed Dr. Boskovitz to quickly consult with Janel Crawford, MD, chief of obstetrics and gynecology at Kaiser Permanente in Roseville. They decided that the safest thing for both the mother and baby was to induce labor at the Roseville Women and Children’s Center and then transfer Smith to nearby Sacramento for surgery to remove her tumor.

A healthy Ava Smith was born that evening at 8 pounds, 7 ounces. A few hours later, her mother was transferred to the Sacramento Medical Center, where she underwent a 9-hour surgery to remove her tumor. When Smith awoke, her vision had been restored.

“They came in to remove my bandages, and I could see Dr. Boskovitz without a big dot in the middle of my vision” she said.

Soon after, Smith was reunited with her baby girl.

“I think Sondra’s story exemplifies very nicely the beauty of the Kaiser Permanente integrated model, where we could perform the complex surgery she required in a timely fashion, and she could wake up with a recovery of her vision, and her healthy baby delivered,” said Dr. Boskovitz.