I was diagnosed with a unicornuate
uterus several years ago. After 12
IUIs and 2 IVF cycles, I finally
became pregnant in October 02. I asked
both my RE and my OB whether my
uterine anomaly meant that I should
see a high-risk OB, but neither seemed
concerned. I had spotting throughout
the 1st trimester and always contacted
my OB ASAP. I went for an U/S almost
every other week because of the
spotting.
At one of those U/S in mid-February we
found out our little Squiggle was a
girl and everyone reassured us that
there was little cause for worry at
this point in the pregnancy. We had
already told a lot of friends and
family about the baby, but now
EVERYONE found out! We announced that
her name would be Emerson Holley
(Emme) and two baby showers were
planned.
A couple small concerns arose on
3/6/03 when my AFP result was elevated
and an U/S showed an echogenic bowel
and bilateral club feet. We were
urged to do an amnio for more
information but made it clear to my OB
that we weren't willing to risk the
small chance of membrane rupture, nor
were we willing to terminate if any
problems were discovered. That
weekend the invitations to the first
baby shower were mailed.
On Friday 3/14/03 at 19w5d I woke up
from a quick nap at work thinking that
I was leaking amniotic fluid. There
was *very* little wetness -- just a
barely noticable damp spot on my
undies -- but I called my OB since I
was concerned. She was sure it was
just discharge or a urine leak, but I
convinced her to see me that evening.
At about 5:00 PM she did the 1st
speculum exam, which showed some
pooling of fluid and the nitrazine
strip showed that it might be amniotic
fluid, but there weren't any signs of
ferning under the microscope. An U/S
was done and our daughter looked fine.
My OB commented that "the fluid level
might look a little on the low side,
but there aren't really any standards
for assessing that at this point."
She had me walk around the hospital
for an hour or so and then checked me
again. At the 2nd exam there hadn't
been any additional pooling, the pH
didn't look as alkaline, and there
residue still didn't show ferns. The
3rd exam was still better than the
2nd. My OB said that if the 3rd exam
had been the 1st she wouldn't be at
all concerned, but since the 1st exam
did show some bad signs, she scheduled
an appt. w/ a maternal-fetal
specialist for Monday. She told me to
come back in if I had any more
symptoms over the weekend.
While stopping for ice cream on the
way home I felt a small popping
sensation (I didn't notice any
dampness). We decided to stop at home
for a change of clothes and
toothbrushes since we didn't know how
long I'd be in the hospital. I rested
for a little while and listened to
Emme's strong heartbeat on the home
doppler we'd rented.
We arrived back at the hospital around
12:00 AM. My OB was busy, so a nurse
handed me a slide and said "you know
what to do." I didn't. She told me to
hold it under myself and cough to
release fluid onto the slide. I tried,
but didn't get anything collected on
the slide until I bumped it against
myself. I took it out to the nurse and
told her I wasn't able to get a good
sample. She took it to my OB in the
lab. A few minutes later my OB came
into the room and said "things don't
look good -- we'll need to end the
pregnancy."
She told me she'd seen ferning under
the microscope and gave me the choice
between induced L&D or a D&E, but the
D&E would have to be scheduled for the
next week since my OB doesn't perform
them. I was told that lots of women
have the urge not to do anything, but
that wasn't an option since it could
jeopardize my chances of having a
successful pregnancy in the future.
Wanting to meet my baby, I opted for
L&D and started Cytotec at 3:00 AM. 24
hours and 23 minutes later, our
beautiful, beautiful daughter was
finally born at 9 ounces, 9 inches --
still alive, although only briefly. I
will always cherish the short time we
had together.
It's been a year since this happened
and I'm now convinced that I didn't
receive adequate testing to confirm
the seriousness of my condition, nor
was I given the option of expectant
management. With more information and
20/20 hindsight I now have a thousand
questions I wish I'd known to ask at
the time: how was she so sure w/o a
speculum exam to obtain a good sample?
why no 2nd U/S to check on the baby &
fluid levels? what about consulting
the high-risk doc on call? and HOW
could she give termination as my only
option on the basis of one poorly
obtained sample?!
Especially as I find more women with
similar stories, I feel so guilty that
I wasn't more agressive at the time,
but I wasn't in any condition to think
clearly. Part of the reason I chose
to see a Harvard-educated OB at a
major metropolitan teaching hospital
was to help ensure I received the best
possible care throughout my
pregnancy. I never would have
expected something like this to happen
with a doctor I trusted so much.
Thanks for listening,
Chris
Emme 3/16/03-3/16/03
m/c 7/03
http://www.babiesonline.com/babies/e/em
ersonholley/
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