A Rainbow After the Storm: How UHealth Jackson’s Fetal Care Team Helped a Mother and Baby Overcome a Rare Diagnosis

By: Krysten Brenlla

When Rodh Ambroise learned she was pregnant with her second child, the 30-year-old felt a mix of happiness and fear – just a year earlier, she had suffered a devastating miscarriage that shook her to the core.

Now, the news of a new pregnancy felt like a rainbow after the storm.

“After my loss in 2023, finding out I was pregnant again on New Year’s Day felt like God telling me everything was going to be okay,” Ambroise said.

For the first few months, everything seemed normal. A nurse educator and mother of a healthy four-year-old daughter, she knew she was considered high-risk due to her history of gestational diabetes. Ambroise scheduled her early prenatal appointments as usual.

But when her doctor noticed that her baby’s bladder appeared swollen on an ultrasound, she knew something wasn’t right.
“The doctor told me it could be a chromosomal problem, or sometimes, it could correct itself,” Ambroise said. “She gave me two options – wait four weeks and recheck, or terminate the pregnancy. Because of my faith, abortion wasn’t an option.”

Four weeks later, the ultrasound showed that the bladder had grown even larger and the baby’s heart could barely be detected. That’s when her doctor knew something more needed to be done, and referred her to Rodrigo Ruano, MD, PhD, director of the UHealth Jackson Fetal Care Center and division chief of UHealth Jackson Maternal-Fetal Medicine.

Dr. Ruano quickly reviewed the ultrasound and agreed to see Ambroise immediately. The diagnosis was lower urinary tract obstruction (LUTO), a rare and severe condition that occurs in approximately one in 5,000 pregnancies. The obstruction prevents urine from leaving the baby’s bladder, leading to kidney damage and underdeveloped lungs, a condition known as pulmonary hypoplasia.

Without fetal intervention, the mortality rate can be above 90 percent.

“The baby had a complete obstruction, which meant there was almost no amniotic fluid,” Dr. Ruano said. “Without fluid, the lungs can’t develop, and the baby usually doesn’t survive. Through fetal intervention, we can bypass that blockage and give the baby a chance at life.”

At just 19 weeks, Ambroise underwent a fetal vesicoamniotic shunt procedure at Jackson Memorial Hospital, performed by Dr. Ruano and his multidisciplinary team. Using ultrasound guidance, they inserted a tiny tube from the baby’s bladder into the amniotic cavity to allow urine to flow out and restore the fluid needed for lung development.

“The surgery was a success,” Dr. Ruano said. “We were able to relieve the pressure on the kidneys and allow the lungs to continue developing. This is a perfect example of how fetal therapy can change the course of a disease.”

With the help of the team at Holtz Children’s Hospital, Ambroise carried her pregnancy to 37 weeks and gave birth to a baby boy, Raphael Moises.

“It was emotional,” she said. “But I knew everything would be okay, because God promised me that he would never leave me, and also, because I was in the hands of the teams at Jackson and Holtz Children’s.”

But after birth, baby Raphael faced another uphill battle. His ureters weren’t connected to his bladder, preventing urine from leaving his body and damaging his kidneys. At just three days old, he underwent surgery to create a new path that allows his body to drain urine safely.

He spent 257 days in the neonatal intensive care unit (NICU) at Holtz Children’s, battling infections, septic shock, and underdeveloped lungs.

“In the NICU, we were surrounded by angels,” Ambroise said. “My son was so sick – he almost died three times – but every doctor, nurse practitioner, nurse, respiratory therapist, and child life therapist fought for him. They cheered him on like he was their own child.”

Among those cheering was Brittany Anderson, one of Raphael’s primary NICU nurses.

“When I first met him, he was very sick,” Anderson said. “But over time, we watched him grow stronger. He learned to breathe on his own, sit up in a high chair, and even grab toys. Every little milestone was a big victory.”

Through the collaboration of the NICU team, pediatric urology, and fetal therapy, Raphael slowly improved.

“These babies are born with rare and complex conditions, but at Holtz Children’s, they get comprehensive care from day one,” Anderson said. “Every specialist plays a role in giving them a future.”

Once Raphael was discharged, he continued his recovery at home with his family. He continues to receive care from Jackson’s pediatric specialists.

Despite lingering challenges, his progress has defied all expectations.

“I walk into his room every morning and thank God,” Ambroise said. “They told me he wouldn’t survive, but everyone at Jackson never stopped believing. They gave me hope when I had none. Now he’s playing, laughing, and saying ‘hallelujah’ with his grandma. He truly lives up to his name — Raphael — which means God heals.”