Doctors Brave Icy Roads to Save Preemie's Life

Dec. 12, 2007 — -- Tuesday morning, a 2-pound baby named Dorotea Orgovanyi was born at 6:10 a.m. in Mount Pleasant, Iowa — three months premature and about 50 miles away from desperately needed treatment at University of Iowa Hospitals.

Late Monday, the infant's mother, Janel Orgovanyi, 38, went to the Henry County Health Center saying she felt pain. Tuesday morning, she gave birth to Dorotea — after only 26 weeks' gestation.

Under normal conditions, an ambulance or helicopter would have transported a special response unit to pick up Dorotea. But an ice storm made it difficult for the University of Iowa's Air Care helicopter and the ambulance to attempt such a dangerous trip. Travel advisories broadcast across the state warned people to stay off the dangerous roads.

The new mother said she hadn't expected to give birth so soon. Nor could she anticipate an ice storm would leave her daughter stranded from lifesaving treatment.

Knowing the small community hospital in Henry County didn't have the facilities to treat the preemie, Mike Acarregui and John Dagle, neonatal doctors at the University of Iowa, took action.

"The community hospitals don't run into extremely preterm kids every day. When they do, it's really hard," Acarregui told ABC News. "They are used to having the support of a tertiary care center."

Studies show that risk of death increases significantly when a preterm baby is born in a small hospital that does not have the specialized facilities for the tiny patients.

Acarregui grabbed a rescue pack and the two doctors drove Acarregui's Audi four-wheel-drive sedan to pick up Dorotea and bring her to Iowa City. Meanwhile, doctors in Mount Pleasant improvised their own resources, rebuilding a warming bed in an ambulance for the baby to use on the trip back to Iowa City.

Despite the lack of resources for extremely preterm babies, Acarregui said the community hospital staff saved the baby's life with its improvised and meticulous efforts. As the two doctors ventured onto the icy roads, the staff at Henry County Health Center went to work.

A respiratory therapist came up with a way to mix oxygen gas, so the baby would receive an appropriate oxygen level, even though the hospital did not have the usual materials to mix oxygen for babies. Another doctor at the hospital kept the baby's blood sugar up intravenously. Still others took a warmer bed from an ambulance, disassembled it, and reanchored it to stabilize it and properly fit the baby.

Of the Henry County Health Center staff, Dagle told local press, "They did a super job coming up with the needed items."

Preterm babies' lungs do not produce enough of a substance called surfactant, which is what prevents the lungs from collapsing every time you exhale. Preemies' lungs have a tendency to get stuck shut because of a lack of surfactant.

When the doctors arrived, they were most concerned about Dorotea's breathing. Acarregui and Dagle inserted a breathing tube into Dorotea. Acarregui put surfactant into the baby's lungs to help the baby breathe and treated her umbilical cord. Dagle used a hand-held ventilator to manually pump air into Dorotea's lungs during the entire ride. The tiny baby rode to Iowa City in her specially made warming bed.

"It's pretty amazing that the oxygen levels were adequate, and that's because of the community hospital's effort," Acarregui said.

When Dorotea finally arrived in Iowa City, the hospital staff at the University of Iowa neonatal unit weighed the baby, checked vital signs and took a blood sample.

They found that she weighed a mere 995 grams, or 2 pounds. The average full-term baby weighs around 7 pounds at birth.

Given her tiny size and the enormous odds stacked against her, Acarregui said that it will be important for doctors to watch her in the next few days and weeks.

Acarregui and Dagle still refuse to be identified as heroes, even though it is clear that, without their efforts, Dorotea would not be alive today.

When asked what convinced him to drive out to Mount Pleasant, Acarregui said, "It's compelling for me, because it's about helping the baby and helping the community hospital. It's hard to convey the stress level at a hospital when dealing with an unusually sick patient. It was a team effort.

"It wouldn't have mattered if the weather was 10 times as bad. We probably would have given it a shot. We're not heroes. We're just taking care of our little patients," Acarregui said.

Dagle said he could not recall the last time he experienced a situation like this.

It is certainly unforgettable for the Orgovanyi family as well — the baby's name Dorotea means "a gift from God."