RESEARCH RESULTS: Geniene Korrall's son Jake was born with a healthy heart thanks to research that created new treatment options.
At 34 weeks in her second pregnancy and with no significant risks to her or the baby, this was a routine checkup for Geniene Korrall. The ob-gyn easily found the baby's heartbeat with an ultrasound device, but the routine test took longer than last time and worry started to gnaw at Geniene. Finally, the doctor switched off the device and met Geniene's gaze.
"The baby's heart is beating too fast," she told Geniene and she sent her directly to a nearby hospital for a "nonstress test." At 34 weeks, a baby's heart normally beats between 120 and 150 times per minute. Geniene's baby's heart was galloping at 280. Doctors at the hospital immediately booked her for more tests.
"I didn't sleep much that night," Geniene says, "and the next morning I went to the perinatal clinic at the Lois Hole Hospital for Women." With expertise in women's health at all life stages, the hospital's perinatal clinic in the Royal Alexandra Hospital sees the highest risk pregnancies in Northern Alberta. Geniene was admitted that day and soon met Dr. Lisa Hornberger. She and her baby became the beneficiaries of top-level research.
At the Lab
As a University of Alberta pediatrics professor and director of the fetal and neonatal cardiology program at the Stollery Children's Hospital, Hornberger routinely examines fetal hearts, revising what we know about pediatric cardiology, cardiac development and how to treat patients who haven't yet been born.
With expertise in women's health at all life stages, the Lois Hole Hospital's perinatal clinic sees the highest risk pregnancies in Northern Alberta and cardiac babies from across the province.
Her work is made possible thanks to the support of the Women & Children's Health Research Institute. The institute formed 10 years ago through a partnership between Alberta Health Services and the University of Alberta, with core funding from the Stollery Children's Hospital Foundation and the Royal Alexandra Hospital Foundation to support the hiring, research excellence, training and development activities of investigators from a wide range of disciplines, to improve health outcomes for women and children in the province.
On June 22, the institute received a $54.5 million donation, including $14.5 million from the Royal Alexandra Hospital Foundation - and $40 million from the Stollery Children's Hospital Foundation, the largest single gift in the university's history.
In the Clinic
As Hornberger looked at Geniene's test results, she recognized the signs of SVT, supraventricular tachycardia. "SVT means that the chambers of the heart are beating through an abnormal electrical conduction pathway. In this condition, the heart beats faster than you can tap out with your finger," she explained to Geniene, her own fingertip tapping rapidly on the desk to illustrate. Fluid was collecting around the baby's heart and in the belly, which suggested his heart was starting to fail. If they tried to deliver now, he might not survive.
Hornberger is as passionate a researcher as she is a clinician. She had already studied SVT, and her research and clinical trials, supported with funding through the Women and Children's Health Research Institute, have led to new treatments. She admitted Geniene to hospital and started medications to slow the baby's heart.
New Research Saves Lives
Geniene's baby was not the only patient - there was also Geniene. "My work is neonatal cardiology, but my first duty is to the mom," Hornberger says. It's tricky to give an unborn baby medicine - in most cases doctors give the heart medicine to the mother. Medicines to slow her baby's heart and improve its function might put Geniene's healthy heart in danger.
Recently, more than half of these babies died before birth. "Now the survival rate is up over 95 per cent," says Hornberger.
Fortunately, Hornberger's research enabled her to fine-tune the administration of these drugs and she was able to slow the baby's heart without harming Geniene's. After a week in hospital, Geniene was discharged and given a hand-held ultrasound device to monitor the baby's heartrate at home.
Hornberger has since started a study examining the use of the portable machines in home surveillance of fetal hearts. "This is exciting work that is changing the way we practice," says Hornberger. The home monitoring may demonstrate cost savings to the health system in addition to the decreased stress and added convenience for the moms.
Happy Endings
Baby Jake was born at full term with a strong heartbeat. A few days later, his SVT rhythm kicked in again and he now takes medicine to keep it in check. Some babies outgrow SVT after the first year, but the condition may return later in life. Some patients require surgery. But Hornberger's research has led to a dramatic increase in the viability of pregnancies involving SVT. Prior to the type of treatment Geniene received, more than half of these babies died before birth. "Now the survival rate is over 95 per cent," Hornberger says.
"Research saves lives and gives hope," says Sandra Davidge, executive director of the Women and Children's Health Research Institute. "The health of these populations is traditionally underfunded and under researched. The Women and Children's Health Research Institute is countering that with 450 members working on scores of projects." Projects cover the health of children and that of women of all ages and at all stages of life.
Where the Money Goes
The $54.5 million gift from the Stollery Children's Hospital Foundation and Royal Alexandra Hospital Foundation will be used to propel women's and children's health research in three ways.
- Approximately one-third will be allocated to peer-reviewed grants. These grants are researcher-driven, and the peer-review is a method for ensuring excellence.
- Another third of the gift will be dedicated to research catalysts, including recruiting international-calibre researchers. This part of the budget also leverages other grants with matching funds.
- The last third will help the institute serve as an incubator for health research. It subsidizes an expert research support team that includes nurses, coordinators, biostatisticians, data management staff, knowledge translation, patient engagement, qualitative research and more, enabling research to get off the ground sooner.