THEY'RE CRADLING HOPES AND DREAMS; RARE AILMENT COULD HAVE BEEN FATAL, BUT COUPLE OPTED TO GO THE DISTANCE.

Byline: Heesun Wee Daily News Staff Writer

It was an unusually crowded Thursday night inside a delivery room on the second floor of a Tarzana hospital.

Twenty people worked and watched as Angela Rosetti, 31, of Castaic lay on a hospital bed and pushed with all her might. Rosetti's husband, Richard, 33, gripped the left hand of his wife of five years, encouraging her from behind a blue surgical mask and gown. The rest of the delivery-room entourage wore the same medical fatigues.

``All I saw were eyes,'' Angela recalled.

``They were coaching me along, saying, `Push! Push! Push as hard as you can!' '' she said. ``It was like running a marathon.''

Angela's neonatal support group at Encino-Tarzana Regional Medical Center was particularly large because Angela and her baby were not supposed to make it.

She was 13 weeks pregnant when a visit to her ob-gyn revealed she had a hydatidiform mole, a pregnancy-related chromosomal mix-up that results in a benign tumor.

Angela was carrying two fetuses - a healthy one with the normal combination of genes from its parents, and an abnormal one with a double dose of genes from only one parent.

The condition's cause still eludes medical experts.

``Why? We don't know. We'd like to know,'' said Frank Witter, an associate professor of gynecology and obstetrics at Johns Hopkins University School of Medicine in Baltimore. Witter co-authored a 1996 medical-journal article on the hydatidiform mole.

What they do know is that it's a rare condition, with only 26 well-documented cases in the United States since 1977. And of those cases, seven infants survived.

Removing the tumor - and thus jeopardizing the healthy fetus - was an option, but never a choice for the Rosettis, who had experienced two miscarriages.

But choosing to continue the pregnancy and allowing the tumor to grow also threatened Angela's health.

While the tumor was benign when first detected, its chances of becoming cancerous would increase the longer it remained untouched.

The first sign of trouble

When the Rosettis' ob-gyn examined initial ultrasound images and first spotted a small black dot next to Angela's placenta, the couple was stunned.

``My heart just fell,'' Angela recalled. ``I was afraid.''

The Rosettis were referred to Dr. Waleed Doany, a high-risk obstetrics specialist, who said the ultrasound pointed to two possible scenarios: a normal fetus and the tumor, or a terminal chromosomal disorder involving three sets of genes in one fetus.

An amniocentesis confirmed she was carrying a healthy fetus, a boy. And the tumor.

Despite the dangers ahead, the Rosettis were determined to carry out the pregnancy as far as possible.

``We wanted a baby badly for so many years. When these cards were dealt to us, we were like, `Well, whatever happens happens,' '' she said.

For the next three months, they visited Doany every three weeks to monitor the pregnancy. At every session, Doany doled out a sobering dose of medical information about the health risks involved - ultimately including Angela's life.

She could develop toxemia, the presence of bacterial poison in the blood stream; hyperthyroidism, a condition in which the neck's thyroid gland overproduces hormones leading to severe sweating, a racing heart and feelings of nervousness; and preeclampsia, an abnormal occurence marked by high blood pressure.

Doany and his staff would break medical protocol by treating Angela's life-threatening, mole-related ailments with various medications to prolong the pregnancy.

But Angela refused to give up hope.

She nicknamed Dr. Doany ``Dr. Doom.''

She focused on one goal: enduring the pregnancy for as long as possible. A longer pregnancy would mean a stronger baby at birth and fewer dangers associated with premature babies.

Doany fashioned a chart that tracked the likelihood of complications common to premature babies: brain damage, blindness, deafness, breathing difficulties and intestinal ailments. Odds of developing each condition dropped with each additional week of development in the womb. As each week passed, the couple drew an ``X'' inside the respective chart column.

``She (Angela) always chose the option that would keep the pregnancy going. She's a stubborn woman,'' said Doany, with a shrug and a grin.

But each week that made the fetus stronger jeopardized Angela's health. ``There was a daily fear her life was in danger,'' Doany said.

During week 26 of the pregnancy, her body eventually reached a near breaking point.

Crisis point

On Jan. 21, Angela developed preeclampsia. Her blood pressure skyrocketed. Richard rushed her to the hospital.

Her extended family flew in from Palm Springs, Las Vegas and Missouri and camped out in the High Risk Unit lobby near Angela's room.

``She realized everything I told her could happen was happening,'' Doany said.

Angela's condition then worsened. She began having problems breathing. Tests revealed she had pneumonia.

Cardiologists crowded Angela's hospital room. ``I really thought I was going to die,'' she said.

Physicians and Angela's family mulled over inducing labor at 26 weeks. It was risky. After birth, the premature baby probably would need help from a respirator to breathe, Doany said.

But before the family had to make a decision, Angela responded to medication and began breathing normally.

By week 30 in February, ultrasounds showed that the baby's growth had reached a standstill. His chances of having major health problems as a 30-week-gestation premature baby were relatively low. And Angela's health was stretched to the limit. Her physicians induced labor with drug injections.

At 5 a.m. on Feb. 13, she awoke in labor. Around 11:30 p.m. the same day, she was ready for delivery.

Afraid to stimulate too much blood loss with a Caesarean section, physicians helped Angela deliver the baby vaginally.

Tiny bundle of life

With a final push at 11:44 p.m., Austin was born. The pink- and red-complexioned 2-pound, 11-ounce bundle no bigger than a football screamed and cried - all signs of a healthy baby.

Members of the medical team smiled behind their blue masks. After Angela briefly cradled her newborn son in her arms, they hustled him off to the Neonatal Intensive Care Unit, leaving Angela with Doany as he removed the nearly 10-pound tumor. Luckily, it remained benign.

Angela, lying on the operating table, said to Doany in her soft, soprano voice that belies her toughness and tenacity: ``You're going to be part of my life forever.''

Angela's gamble with her life paid off better than her physicians had anticipated - a healthy baby and a medical milestone.

But Witter of Johns Hopkins cautions other women who develop the tumor not to emulate Angela. ``I wouldn't advocate doing that again,'' he said. ``Just because you do it once doesn't mean you can get away with it again.''

Angela, naturally, disagrees. ``We have helped future women who are told, `Your situation is doomed,' '' she said.

No more `Dr. Doom'

For six weeks, tiny Austin lived in hospital incubators. He was so small, Richard slipped his size-14 wedding band onto his son's wrist.

By March 28, the Friday before Easter, Austin was ready to go home with his parents.

Today, 15-week-old Austin is a healthy, 11-pound baby boy. ``He's doing great,'' Angela said. ``It's a miracle that he's here.''

But Angela isn't out of the woods yet. She has about a 20 percent to 40 percent chance of developing another tumor in the following year, even though she has no family history of cancer or difficult pregnancies. And Angela can't get pregnant for at least another year. Her physicians are monitoring her regularly.

The Rosettis, however, are positive and fixated on the future. In May, Austin was baptized, and Angela, an insurance broker in Pasadena, returned to work.

Angela added she hasn't ruled out the possibility of having more children. ``I'd do it a hundred more times if the outcome was a healthy baby,'' she said with a big smile.

As for Doany, he has been welcomed into Angela's family. She now calls him ``Uncle Waleed,'' as will Austin.

CAPTION(S):

3 Photos

PHOTO (1) Angela and Richard Rosetti, with Austin, now 15 weeks old and weighing 11 pounds. Says Angela of her risky pregnancy: ``I'd do it a hundred more times if the outcome was a healthy baby.''

(2) Born 10 weeks early, Austin weighed 2 pounds, 11 ounces; Richard's wedding ring fit around the baby's tiny wrist.

(3 -- color) Against all odds

David R. Crane/Daily News