Fetal Care
Patient Stories | Elle and Micrognathia

A Family of Medicine

Video Transcript

When they are at home, Melissa and Paul Kingma are mom and dad to baby Elle and her two big brothers.

At work, it’s Dr. Paul Kingma, neonatal director of the Cincinnati Fetal Center at Cincinnati Children’s. Kingma is part of a comprehensive team specializing in treating complex and rare fetal conditions. 

Melissa, a nurse practitioner, also works at Cincinnati Children’s taking care of the sickest babies in the Neonatal Intensive Care Unit (NICU).

“Every once in a while my wife and I will sit down for dinner and talk about what we do and we’ll say it’s a unique privilege to do what we do,” said Paul Kingma. “How many people in the world get to save babies lives that nobody else could save?”

In 2017, Paul and Melissa found themselves in a role reversal. When she was 20 weeks pregnant, an ultrasound revealed a problem with baby Elle.

“They saw the profile and I said that’s a really small chin and the ultrasound tech said yeah, yeah it is and she got quiet took a lot more pictures and then we had to meet with our ob,” said Melissa Kingma.

Their doctor referred them to a place they both know well, The Cincinnati Fetal Center. Tests revealed their baby girl had a life-threatening genetic condition called micrognathia, which means her small jaw will cause her tongue to crowd at the back of the throat making it difficult to breathe. To go over a delivery plan, the comprehensive team at the Fetal Center met with Dr. Kingma and his wife as a patient family.

“It’s surprising, even though we’ve been through that process the brain kind of shuts off a little bit,” said Paul Kingma. “We had lots of questions that on normal days I could have answered myself but when it’s your own baby it’s nice to have people there to say are you worried about this, are you worried about that?’

Together the team came up with a plan to deliver Elle at Cincinnati Children’s. On October 17, 2017, doctors performed a procedure with placenta support allowing Melissa to avoid going under deep anesthesia. This allowed her to see and hear what was happening around her including her baby’s first cry.

“It was this overwhelming sense of relief that despite what was coming I knew it was going to be difficult but I knew she was going to be OK. It was amazing,” said Melissa.

The next challenge was creating an airway. With the umbilical cord still attached, ENT surgeon Dr. Mike Rutter was able to successfully insert a breathing tube through Elle’s nose and avoid a more risky procedure of a tracheotomy which would have placed a hole in her neck.

“Your biggest fear would be what if they couldn’t get an airway at all, that’s not guaranteed and we would have lost her, and I was thankful that I got to stay awake for the procedure so I knew what was going because my biggest fear was that I was going to wake up and she wasn’t going to be there,” said Melissa.

The next few months would be a roller coaster of health scares, tests and surgeries. Elle has more trips scheduled in the future to the OR to help her with eating. Her parents say their journey has changed them at home and at work.

“My daughter was in the NICU for several months and I know what that means and it tires you out after a while and that’s perfectly understandable and be able to relate a lot better,” said Paul.

“I think from a mom standpoint I understand the stresses of what it is to have a baby in the NICU.  When things don’t go like they are supposed to go, moms automatically blame themselves,” said Melissa. “That deeper understanding has made me a lot more empathetic. I approach the way I talk to families differently now.”

It’s definitely changed my perspective in how I’m able to relate to the families that we work with,” said Paul. "Just the smallest little things can really make a deep impact.”