“Your baby is looking skyward today …”
Fetal echo sonographer Baba Wilhm is tucked into a small exam room with a mom who is close to her delivery date, moving the transducer expertly around the patient’s amply jelled belly.
With a calming demeanor and a twinkle in her eye, she begins by orienting herself and her patient to what she is observing.
“There are his eyes and the little nose,” Baba says, as she studies the monitor. “A cutie.”
But Baba’s mission at Johns Hopkins All Children’s Hospital is a serious one.
For decades, she has committed herself to the task of studying unborn babies’ hearts — often as tiny as a nickel or a dime — to look for signs of defects or disease.
Baba has a bit of a reputation. A good one.
“You’re going to have to come up with a better adjective,” says pediatric cardiologist Bevin Weeks, M.D., when asked if Baba is good at what she does.
“I will tell you that Baba is easily one of the best fetal sonographers I’ve ever worked with in my career. She just sees it.”
To borrow a sports term, Baba is part of a “deep bench” — one of many talented players at Johns Hopkins All Children’s Heart Institute who may not receive the same level of attention as some well-loved physicians and surgeons, but whose role is integral to diagnosing disease and setting babies up for the highest level of care possible.
“It takes a very keen eye,” Baba says. “And most important, patience.”
Unlike newborns, a fetus does not tend to lie still for a sonographer. And it can often be tricky just to tell what is right and what is left. Baba uses a particular method to do that, called the Situs Sweep.
“Then you go to the heart and you start splicing,” Baba says. “You look for the four chambers, then to one valve, then the other. You go to the main arteries, then you look for the arches.”
Perhaps what sets this sonographer apart is what happens after that.
Baba can surely help identify a range of issues in an unborn baby’s heart, from abnormal heart rhythms to structural defects such as hypoplastic left heart syndrome. But she also possesses the knowledge and the experienced eye to pick up on signs of rare congenital anomalies that others may find difficult to detect, such as scimitar syndrome.
Her deep understanding of both congenital heart disease and fetal physiology makes her a sought-after resource for perinatologists, cardiologists and surgeons, as well as others who comprise the Fetal Heart Program team who treat these babies.
“She is a rare bird,” says Michelle Miller, M.D., a cardiologist with Johns Hopkins All Children’s Heart Institute. “She has a deep understanding of what she’s looking at, and with her ability to recognize patterns and pull it all together as she does, it takes decades to achieve this level of expertise.”
Baba did not take a traditional path.
Born in the Panama Canal Zone (when there was one), she was raised there and met her husband. Baba followed him back to his home state of Kansas to attend college. After achieving advanced degrees, the couple joined the Peace Corps and served for a time in Venezuela before returning to Kansas, where she worked in labor and delivery at a local hospital.
In 1979, a group of OB-GYNs in Topeka recruited Baba to come on board to learn to operate one of the first sonography machines that allowed an operator to see actual movement in the fetus.
“At first, all I knew to do was to measure heads, bellies and femurs,” Baba says. “I’d do that over and over. Heads, bellies, femurs.”
In those days, there were few opportunities in her area for training and certification on those early machines. Baba wasn’t satisfied. A natural student, she bought a book about the fetal heart — and picture by picture — she began to teach herself.
It was the beginning of finding her niche — of a long and fulfilling career.
She was officially certified a few years later, and eventually moved to Sarasota, Florida, where she worked with a group of physicians, honing her craft.
She had been attending heart symposiums at Johns Hopkins All Children’s (All Children’s then) and had admired the program. When she was offered a position as a fetal echo sonographer with the Heart Institute, she jumped at the chance.
That was nearly 15 years ago. She has never looked back.
“I’ve had wonderful experiences,” Baba says. “I’ve worked with phenomenal physicians. Every single one has brought something to my history, has helped to make me who I am.”
Baba has other interests, too. With her relentless curiosity, she devours books and articles and lectures. She also serves as a Spanish translator for patients. In her spare time, she’s learning Turkish. She admits to being hooked on Turkish TV soap operas, a genre known as Dizi.
But her mission to help save babies is her first love, as is evidenced by the families whose lives she impacts.
Even years after she sees patients, Baba will get holiday cards and photos and updates on how their children are doing.
Eight-year-old Kara, for example, is thriving today. Baba helped diagnose myriad heart issues before her birth, so that Kara could receive the best course of care. Her mom, Lauren, still remembers the talented sonographer who helped make a difference for her child.
“Baba was always incredibly kind, patient, knowledgeable and understanding,” Lauren says.
“She has an eye for even the smallest detail. It was amazing to have her in my corner.”