When 20-year-old Ariyanna McGee went in for her 20-week anatomy scan, she expected a routine prenatal checkup. But the ultrasound revealed something unexpected: her unborn baby, already named Genesis Gianna, was surrounded by an excessive amount of amniotic fluid. Ariyanna was told that her fluid levels would need to be monitored closely as the pregnancy progressed.
A few weeks later, around 24 weeks, during a visit with a specialist, Ariyanna and her partner, 20-year-old Oscar Pineda, received a mix of reassuring and concerning news. On one hand, they were relieved to hear that Genesis was doing well. However, Ariyanna’s amniotic fluid levels remained high and now her blood pressure had begun to spike.
Ariyanna’s hypertension, or elevated blood pressure reading, led to weekly visits going forward and she was advised to monitor her blood pressure at home. Ariyanna said her home blood pressure tests were normal but her blood pressure checks at her weekly doctor visits continued to reveal hypertension.
“The doctor told me hypertension at any point during pregnancy is not something to ignore,” Ariyanna said. “As the pregnancy went on, I was hospitalized for a few days when my blood pressure got too high.” In total, she was admitted four times.
Hypertension during pregnancy carries several risks including the potential for preeclampsia, a life-threatening condition that can develop after 20 weeks of gestation. It can also reduce blood flow to the placenta, increase the risk of preterm delivery and may require delivery by Cesarean section.
Thankfully, Ariyanna was not diagnosed with preeclampsia. However, she did undergo a C-section not necessarily because of her blood pressure, but because she wasn’t dilating properly after being induced at 37 weeks.
3D Scan Reveals Cleft Lip
At Ariyanna’s seven-month visit, she underwent a 3D ultrasound. “It was so cool to see my baby in 3D. I loved getting a peek at her adorable face before she was born,” said Ariyanna.
At the same time, Ariyanna’s joy was tempered by learning Genesis had a cleft lip. “She was being shy that day and covering her face partially, but the doctor told me they could see the cleft lip on the 3D scan and that they weren’t sure how bad it was,” Ariyanna said. “They also said she might have a cleft palate but they couldn’t confirm that until she was born due to the baby’s positioning. Both conditions would explain why there was so much amniotic fluid. Genesis was not drinking as much as she should be.”
That’s when Ariyanna and Oscar were referred to Children’s Memorial Hermann Hospital in Houston. Before Ariyanna gave birth, they met with pediatric plastic surgeon Danielle Sobol, MD, an assistant professor in the Division of Plastic & Reconstructive Surgery at McGovern Medical School at UTHealth Houston and a pediatric plastic surgeon affiliated with Children’s Memorial Hermann Hospital, to learn how Genesis’ cleft lip and possibly cleft palate could be surgically corrected.
“Dr. Sobol was really sweet. I was so nervous the first time I met her but I realized there was no need to worry,” Ariyanna said. “She told us she had completed this surgery many times with great outcomes and provided reassurance. She was very supportive and answered all of our questions.”
Thanks to advances in 3D ultrasound and prenatal care, Dr. Sobol noted that a majority of cleft lip cases in our region are now diagnosed in utero. Surgical correction after birth is a fairly common procedure at a high-volume referral center such as Children’s Memorial Hermann Hospital. “While the condition in isolation is often not life-threatening, it can cause complications,” Dr. Sobol explained. “For many parents, seeing a cleft lip on ultrasound can be emotionally difficult and raise concerns about their baby’s health and well-being.”
A cleft lip, a birth defect, is a separation in the upper lip that occurs when facial structures do not fully fuse during early pregnancy. A cleft palate involves an opening in the roof of the mouth and can extend all the way through the gum line.
Welcome to the World Baby Genesis
Genesis Gianna Pineda entered the world on June 4, 2024. She weighed in at 4 pounds, 13 ounces and was a healthy 21 inches long. Ariyanna was able to hold her baby after she was born. She admits she was worried about what Genesis would look like and whether she would be able to eat and drink normally.
“But as soon as I saw her I realized I was worried for nothing,” the new mom said. “She was beautiful. The cleft lip didn’t matter to me. I knew that whatever needed to be done to correct her birth defects were going to be done. I know she will have a happy life.”
Dr. Sobol echoed that sentiment. “Genesis was diagnosed with both a cleft lip and cleft palate. These conditions can affect feeding, speech and overall development,” she said. “However, with timely intervention, coordinated care and ongoing support, children with cleft lip and palate can go on to lead healthy, thriving lives.”
Two Surgeries: Repairing Her Cleft Lip and Palate
When Genesis turned 4 months old, it was time to repair her cleft lip, a procedure Dr. Sobol performed on Oct. 11, 2024. “The surgery closed the gap in her lip and nose. This reshaped her facial structure to support feeding, growth and overall development.
Following medical guidance, Ariyanna and Oscar chose to wait until Genesis was closer to a year old before moving forward with her cleft palate repair. In mid-July, Dr. Sobol performed the second surgery. This procedure is typically done around a child’s first birthday and is essential for supporting proper eating, hearing and speech development.
“Both surgeries went so well,” Ariyanna said. “Now we have an amazing future ahead of us thanks to Dr. Sobol and Children’s Memorial Hermann Hospital.”
The team at Children’s Memorial Hermann Hospital continues to monitor Genesis’ growth and support her through every stage of care.
Looking Forward with Confidence
Thanks to the coordinated, compassionate care at Children’s Memorial Hermann Hospital, 1-year-old Genesis is thriving. Ariyanna and Oscar are proud of how far their daughter has come and grateful to the medical team who supported them.
“She was, and still is, worried that kids might tease her,” Ariyanna said. “But we’re going to do everything we can to help her understand her birth defect. She’s beautiful just the way she is and we’ll always remind her to stand up for herself.”
Genesis is babbling often and has already said “mama” though her parents are still waiting to hear “papa.” “We know her speech might be affected, but we plan to wait until she’s saying more words before seeing a therapist,” Ariyanna added. She will have a routine check-in with the cleft team speech and language pathologist in a few months.
Genesis is a curious and active baby who loves playgrounds, anything that rattles, being outside and watching cars pass by. She currently weighs 20 pounds and eats a variety of foods, including baby food, bread, wafer cookies, cake and ice cream, though she occasionally gags when eating.
Dr. Sobol noted that most children spend just one night in the hospital following cleft palate surgery and wear soft arm restraints early in recovery to prevent them from touching their mouths during healing. “Feeding after surgery can feel like a whole new world,” she explained.
Looking ahead, Ariyanna and Oscar know there may be more decisions to make. “Before kindergarten, there’s a reconstructive surgery we can consider,” Ariyanna said. “But we don’t want to put her through anything she doesn’t need. Right now, you can hardly even see her scar.”
Reflecting on their experience, Ariyanna wants other families facing a similar diagnosis to know where to turn for specialized care and support: “If your baby is born with a cleft lip and/or palate, I want you to know that Children’s Memorial Hermann Hospital is the place to go. Your entire family will be in excellent hands. The staff and doctors provide outstanding care for your baby. Rest assured, there is hope and a bright future ahead for babies with cleft lips and palates.”