Baby 'born twice' was saved by groundbreaking prenatal tracheostomy

A little boy diagnosed with an often-fatal condition has defied the odds and is now set to celebrate two 'birthdays' with his family this summer. 

Key Takeaways:

• Cassian Joubert was diagnosed with a life-threatening condition, but doctors saved his life with a risky procedure.

• Joubert was first partially born via c-section, where doctors performed a tracheostomy, and then was delivered safely and completely several weeks later.

• The family now celebrates two 'birthdays' for Cassian.

The Details:

Baby Cassian Joubert, who was diagnosed in the womb with Congenital High Airway Obstruction Syndrome (CHAOS), survived thanks to doctors’ lifesaving prenatal surgery that involved partial birth via c-section first, and his safe and complete delivery a few weeks later, thus giving him two birthdays.  

“He felt the air of the world on his face” said his mother with joy. “Cassian was born twice! Cassian is our twice-born miracle!”

CHAOS, an extremely rare condition affecting 1 in every 50,000 babies, is a condition in which a baby’s respiratory tract is blocked with a membrane that “obstruct[s] the flow of fetal lung fluid, which results in an expansion of the airways and lungs.” 

In Cassian’s case, he was diagnosed at 19 weeks in his mother’s womb, and quickly underwent laparoscopic surgery three weeks later, where doctors attempted to cut through the tissue covering his trachea. Unfortunately, the membrane was too thick. 

Baby born 'twice,' after likely life-saving surgery during pregnancy

“His lungs would end up crushing his heart if we waited too long” his father, Greg, recalled.

So, in week 25, Dr. Emanuel Vlastos at Winnie Palmer Hospital in Orlando, Florida undertook Cassian’s surgery. With only Cassian’s head and neck exposed, Dr. Vlastos performed a tracheostomy. Cassian was then safely returned to his mother’s uterus, where he remained until his mother’s water broke, and he was born a second time on August 5. 

“That was probably the riskiest thing because I couldn’t tell the parents what to expect,” noted Dr. Vlastos. But both parents were willing to fight for their baby’s life. 

Zoom Out:

Procedures like Cassian’s have been performed successfully only three times before. But this surgery was unique because Cassian was safely placed back in his mother’s womb to continue his prenatal growth, instead of being fully born.

A report from the National Institute of Health shows that parents are often advised to terminate the baby’s life, rather than fight to save it:

Prenatal early diagnosis of patients with CHAOS is necessary so that perinatal management can be undertaken successfully or elective termination of pregnancy can be undertaken.

Surgery and abortion are presented as seemingly equal options, even though one is potentially lifesaving, and the other is definitively deadly.

Although doctors often advise parents facing such lethal conditions to abort their babies (and many do), Cassian is proof that fighting for life can beat a dire prognosis.

The Bottom Line:

Cassian now has a ventilator and feeding tube, and still needs three more surgeries to continue to remove the obstruction in his airway before he turns two. But the family exudes resilient hope and profound gratitude for their baby’s unique human life. 

“We’re not through it yet, but aren’t we all in need of a good story?” Greg said.