Dean Balassi

The feeling of growing a new life can be exciting and awe-inspiring, but is also common to feel anxious, vulnerable, and overwhelmed by the big changes that pregnancy and a new baby will bring – especially with a first pregnancy. Hannah and Dominic from Imperial, MO were grieving the loss of Dominic’s mom and her 4-year battle with pancreatic neuroendocrine cancer in September, 2023. They found out Hannah was pregnant just two days after her passing. “The beginning of my pregnancy was perfect,” Hannah said. “We were sad we couldn’t share it with Dominic’s mom, but it was a positive emotional distraction from the grief our family was experiencing,” Hannah said. Dominic is an electrician for MSD and Hannah is a Team Lead at Target, Gravois Bluffs in Fenton. “I was going to my OBGYN regularly, and there were no indications of anything other than a healthy baby. Our anatomy scan at 20 weeks revealed that our baby was a boy, and my due date was Mother’s Day, Sunday, May 12!” Hannah said. After the buzz of the holidays, during the month of January 2024, Hannah and Dominic were excited to focus some time and energy around Baby Balassi. “We hadn’t settled on a name or packed a hospital bag yet,” Hannah said, “but we felt like we had plenty of time to do things over the next several months.” On January 29th, Hannah began experiencing intense stomach cramps which kept her up through the night. “Being 25 weeks pregnant, of course, I got on Google and started looking up reasons for cramping,” Hannah said. “I read that many times the uterus is growing and that cramps can be an effect of your ligaments stretching. The pain would come and go, and I also thought that I might be constipated. I figured I would just call my OB when the office opened.” Monday morning arrived, and Hannah reported for her shift at Target at 8:00am. “I debated calling off work and staying home to rest,” Hannah said. “But since I am a manager, I have daily tasks that need to be completed by end of day on Mondays so I figured I would go in for a few hours to complete those tasks, “Hannah said. “Driving to work was awful. The cramps were very extreme, so much so that I couldn’t’find a comfortable way to sit. But then they would go away and I felt I was just overreacting,” Hannah said. “I went into work and did an order pickup to start my day like usual. The cramping was so extreme that I would have to take a break from walking and take deep breaths to get through the pain. I finally was able to sit down at the computer and work on pre-tieing planograms for the upcoming weeks. I felt constipated and could not find any comfortable way to sit. I had a hard time focusing on the computer screen because my vision would go blurry while I was having cramps. I just kept taking deep breaths, Hannah said.”

“Still feeling as if I was constipated, I went into the bathroom to try to find relief. While in the bathroom my water broke. I immediately called my coworker, Dana, who rushed to me. With the help of my brave coworkers, my baby was born as safe as possible given the circumstances.”

Baby Balassi entered the world on January 29th, 2024 in the Fenton Target bathroom, in the first stall at approximately 10:20 am. Less than 10 minutes after Hannah’s water broke, and weighing only 1lb. 8 oz. Baby Balassi was delivered by Dana Taylor with the help of Caleigh Murphy and the 9-1-1 operator. Fenton Fire paramedics got to the scene within 8 minutes of Caleigh’s call and within 1 minute after the baby’s delivery. When the EMTs entered the bathroom, they stopped, surveyed the scene, and immediately stepped into action. “When they arrived, I was still standing in the stall and my coworker, Dana was kneeling down next to me holding my baby in a Joy Lab brand sherpa coat. I sat down on the toilet and watched Dana pass my baby to the paramedics to take over. I watched them clamp my baby’s umbilical cord and cut the cord. At the moment the cord was cut, I realized this was real and not a dream. They took my baby out of the stall to start working on him. The suctioned him ventilated him, and started chest compressions, trying to get him breathing. Officer Dilks was the police officer on site, and he was the one to call Dominic to tell him the news. Officer Dilks never left my side to make sure that my baby and I were in good hands.”

The EMTs got Baby Balassi breathing and his heart circulation pumping, but they needed Hannah’s heat to keep him warm for transport to the hospital. “They helped me stand up off the toilet and walk to the stretcher. Once I was laying down, they put him on my chest,” Hannah said. “One of the EMTs continued bagging and another doing chest compressions on my baby on top of me while they wheeled us to the ambulance. They never stopped working on him the whole time we rode, or when we rolled out of the ambulance as we arrived to St. Clare.” Hannah and her baby arrived via ambulance to SSM Health St. Clare in Fenton, MO. “The double doors to the Emergency Department opened and there were 20-30 people standing there waiting for our arrival. They took him quickly off me to work on him and put me in a room across the hall.” Hannah said. Colleen C. Claassen, MD, was the neonatologist on call.

“I was in route to St. Clare to round on patients when I got the call from the Emergency Room,” said Claassen. “I pulled into the circle drive and ran in to announce that I was the neonatologist on call. I knew I was responding to an infant resuscitation but was surprised to see a 25-weeker in the trauma bay,” Claassen said.

Neonatal resuscitation isn’t a regular occurrence for staff in the Emergency Department at St. Clare; however, neonatal resuscitation is, ironically, Dr. Colleen Claassen’s niche. Dr. Claassen specializes in neonatal resuscitation and critical care of premature and extremely low birth weight infants. Her research interests include simulation-based training for physicians and nurses, neonatal resuscitation education in resource-limited settings, and she teaches neonatal resuscitation more than 30 times per year as the Director of Simulation Program for SSM Health Cardinal Glennon Children’s Hospital.

“Simulation is recommended by the AAP (American Association of Pediatrics) to increase your comfort with intervention in critical situations. Our Glennon Care pediatricians typically see term babies. This was a very small person and somewhat outside of normal practice scope for them. I walked in and it was game time. As the neonatologist on call, I took over leadership. The baby didn’t have a lot of movement and the staff had been doing compressions and bagging. Two of the labor and delivery nurses (former NICU nurses) knew the importance of keeping the baby warm. They were excellent and improvised with their existing emergency supplies wrapping the baby in a specimen bag and supporting him with heat packs. I got a breathing tube in on the first attempt and his heart rate came up. It was a great team effort and we got Dean stable for next steps,” Dr. Claassen stated.

“Dr. Claassen was amazing and took charge of the entire situation. She made sure even though we were separated, that I had opportunity to see my baby,” Hannah said. “She explained they were arranging for a helicopter to come get him and take him to SSM Health Cardinal Glennon.” said Hannah. There was considerable fog that day, so the helicopter couldn’t fly right away. But within almost an hour, SSM Health Cardinal Glennon’s transport team arrived on the scene. Members of the team encouraged Hannah to put a transport blanket in her shirt while they talked. Her scent would then travel with Dean in the incubator on the way to the Neonatal Intensive Care Unit (NICU). After just a few short moments, transport team members secured Dean in the NxtGen Transport Incubator. The NxtGenTransport Incubator is the most innovative neonatal transport technology on the market and SSM Health Cardinal Glennon is the first in the country to have two of them adapted to fly in the transport helicopter. Dean was transported safely to Cardinal Glennon within minutes of leaving St. Clare and was admitted to the green hall of the NICU. Hannah recovered at St. Clare that evening, with plans for her and Dominic to join Dean at Cardinal Glennon the following day. “No one can prepare you for seeing your child for the first time in the NICU,” Hannah said. “He was intubated, on a ventilator, with so many tubes attached to him. He seemed so tiny and fragile.” “To see your child being kept alive by equipment is humbling,” said Dominic. “We realized quickly from the moment Hannah delivered, how much we needed to trust people with our son’s life. You take a leap of faith because you have to, and you don’t have a choice. All you can do is stay involved, ask lots of questions, and pray for the best.” said Dominic. “Having him at 25 weeks meant he had more than his fair share of risk factors,” Hannah said. Dean’s lungs were premature, so he developed BPD (bronchopulmonary dysplasia). He had jaundice that needed to be treated by bili lights. He had a PDA (patent ductus arteriosus), which is an opening between the two major blood vessels leading from the heart. He had a grade 1 and a grade 4 brain bleed on separate sides of his brain. He also developed MRSA (methicillin resistant staph aureus) which is hard to treat and a bad bacteria resistant to certain antibiotics, he had two spinal taps to see how far the MRSA had spread. Dean also had multiple blood transfusions throughout his NICU stay.

“The doctors and nurses were all so good about explaining everything and breaking it down to terms we could understand. The numbers and charts and reports were all like a foreign language, but they would draw pictures or take time to sit with us and work through it until they knew we felt more comfortable,” Hannah said. “We have to give special credit to Dr. Robert Fleming. He went above and beyond at explaining every single thing to us and weighing the pros and the cons of every decision that made for Dean’s care.”

“We were in the NICU every day with him while he was in the hospital,” Dominic said. “We had primary nurses and felt like we really had a team that loved our son. That helped a ton to give us peace to go home at night and eventually have a routine once I went back to work.” Dominic said.  “Aside from nurses and doctors, so many other people were helping Dean progress and helping us normalize life as NICU parents,” said Hannah. “Dean had Occupational Therapy, Physical Therapy, Speech Therapy and Music Therapy. We had Child Life services, the March of Dimes Family Support Group, and many other services and things that we’re sure he had too!” Said Dominic. “We celebrated our first Valentine’s Day, Easter and Mother’s Day in the NICU. The activities, keepsakes, the photos, the custom outfits made for holidays – all of those things were greatly appreciated.” said Hannah. “The Music Therapist would even leave us notes to let us know how Dean would calm down in response to music and singing. Being able to watch our Dean on the NIC View camera – helped us feel comfortable in seeing him being cared for when we could not be there.” said Dominic. “Many times, we felt like we took a nice step forward but then there were always a few steps back,” Dominic said. “Our little guy was only 1lb. 8 oz. when he got here, but somehow, he powered through the obstacles like a champ. His brain bleeds each resolved on their own with minimal damage. His PDA ended up not needing surgical intervention. He made his way from being intubated on a conventional mechanical ventilator to extubated on a nasal cannula to reintubated to self-extubating himself causing him to be reintubated to extubated on Babi CPAP to RAM cannula on CPAP then to nasal cannula. None of this wasn’t without bumps in the road, but knowing what he MIGHT have had to face, we are grateful he did as well as he did.” said Dominic.

Hannah and Dominic received CPR training, training on oxygen delivery and training on monitoring equipment prior to Dean’s discharge. The initial plan following discharge was for Dean to get established with his pediatrician, have regular visits with developmental therapists and return to NICU follow-up clinic every 4 months. On May 14, just two days after his original due date of Mother’s Day, May 12, Hannah and Dominic celebrated taking Dean home from the NICU.

Three SSM Health Cardinal Glennon clinicians visited Fenton Fire District recently to present Tom DiMercurio | Division Chief of EMS and the two paramedics who rescued Dean and Hannah with a Lifesaving Award in recognition of their actions and the overall outcome. “We appreciate that our SSM Health partners offer awards such as these. We all felt internally and within our partnership that this was an extraordinary call,” stated DiMercurio. “We do post incident analyses, but we often don’t know the outcomes. This call involved a dispatcher, 4 paramedics, 2 ambulances, the pumper truck, and a duty vehicle. It was excellent to have the Cardinal Glennon clinicians come out to let us know how the baby was doing and to answer questions from our staff.”.

Hannah and Dominic have plans to bring Dean to visit the rescue crew from Fenton Fire District one day.