There’s a reason Callista and Jason Puchmeyer named their daughter after their doctor, Dr. Melissa Mancuso. After 29 ultrasounds and 3 in utero transfusions, Vincenza Melissa William Puchmeyer was delivered safe and sound Nov. 14 at 33 weeks gestation.
The Puchmeyer family doesn’t believe the stork had anything to do with the most recent blessing to their family, which already includes 4 girls. Driving over an hour from Westlake for weekly appointments with Dr. Mancuso just isn’t part of a stork’s migration habits. Besides, Callista, who is acting chief of legal at NASA, would have been able to track the stork’s movements on her agency’s extensive radar.
“Dr. Mancuso was the only doctor who would take on our case,” said Callista, who suffers from a rare disorder called Rh disease. “She helped us deliver our fourth child 3 years ago, and when we realized we were expecting another baby, there was no doubt who was going to help us add to our family.”
Dr. Mancuso, Maternal Fetal Medicine specialist, director of Akron Children’s Fetal Treatment Center and chair of Maternal Fetal Medicine at Akron Children’s, says that physicians must be vigilant with Rh disease and it must be managed early on in the pregnancy.
“Rh disease, also called isoimmunization, causes fetal death by anemia,” said Dr. Mancuso. “When the mother is Rh negative her baby may have the Rh antigen which causes the mother’s immune system detects the baby’s blood as ‘foreign’ and creates an antibody response. The antibodies cross the placenta and attach to the baby’s red blood cells, destroying them. When the baby becomes anemic the heart works overtime and then basically fails. This can lead to hydrops and ultimately death.”
The Puchmeyers first 3 pregnancies were smooth and uneventful: Annabella is 11, Lucy is 9, and Cecilia is 8. But because Rh disease gets more serious and apparent with each pregnancy, the Puchmeyers lost their fourth daughter at 17-weeks gestation.
“During my fourth pregnancy, I came in for a normal blood test and my doctor at the time started freaking out about the antibody level, they couldn’t figure out why it was so high. The 17-week ultrasound showed she had passed, and I had to deliver on April 22, 2014,” said Callista. “As part of my grieving, I decided I would do anything to have another child.”
But finding an OB to take on the case was anything but easy. The family met with several perinatologists but none would agree to help them. Luckily, Jason’s mother, Judy, noticed an Akron Children’s Hospital commercial featuring a family with Rh disease. They made an appointment and met Dr. Mancuso and embarked upon their fifth pregnancy.
“With the invention of Rhogam, which is basically giving the mom an antibody to trick her own system into not producing antibodies, the incidence of fetal anemia from Rh disease has fallen drastically,” said Dr. Mancuso. “Given the rarity of Rh disease, only Maternal Fetal Medicine specialists who are trained and proficient in offering in utero blood transfusion are equipped to handle her case. These cases are rare. We probably see 10-15 moms per year with this condition.”
Francesca was born healthy on April 7, 2015, and only had a 2-week stay in the neonatal intensive care unit (NICU). Callista felt their family was now complete, as she juggled her full time job at NASA and mother duties for 4 healthy, vibrant girls.
But as fate would have it, Callista found out she was pregnant again this spring. And she knew exactly who to call. Dr. Mancuso was ready to help, and Callista was in for a rough pregnancy that included weekly appointments and 29 ultrasounds. After 3 back-to-back blood transfusions in utero, Dr. Mancuso decided it was time for Vincenza to be born.“Even though 33 weeks is still quite premature, I felt it would be safer for Vincenza to leave the womb at that point,” said Dr. Mancuso.
So the family made preparations over the weekend, which is no small task when you have 4 girls who are involved in so many activities and still have school to attend, all of it an hour away from Akron Children’s. Judy, dubbed the “best mother in law in the world” by Callista, gets the credit for holding down the fort while Jason and Callista were at the hospital.
Vincenza, who is called Vinnie by her family, arrived early in the morning under the watchful eye of Dr. Mancuso. She has thrived in the NICU, only needing 1 transfusion. She will continue to be followed by Dr. John Fargo, a hematologist/oncologist in the Showers Center for Child Cancer and Blood Disorders, for the next few months, but Dr. Fargo doesn’t expect there to be any issues.
“We could have had a much shorter commute by going to a hospital closer to Westlake, but we have never considered going anywhere else since we started seeing Dr. Mancuso,” said Callista. “Our daughter’s middle name, Melissa, is not a coincidence. We named her that because we are so grateful for her excellent care these past 2 pregnancies.”
Vinnie has been thriving at home with the rest of her sisters since Dec. 15.