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Test Results

The first question everyone asks after hearing our story is "Have the doctors told you anything about why this happened?" Well, the answer is yes and no.

After we left the hospital, an autopsy was performed on Owen to determine whether or not there was any genetic cause for his death. Those results came back normal - he was a perfect baby.

Further tests were done on the placenta and with the many vials of blood that were drawn the day after the c-section. These tests did yield some answers, but also left us questions that we may never have the answers to. Following is my best (non-medical) explanation as to what happened.

Apparently, the tests on the placenta revealed that it was littered with blood clots. In case you don't know, the placenta is the organ that develops during pregnancy to supply nutrients from the mother's blood to the baby. It is attached to the mother via the uterus and to the baby via the umbilical cord. These blood clots in the placenta caused it to separate from the uterus, and according to my doctor, there was one large clot in particular that caused a major separation (called an abruption) which must have severely cut off the nutrient supply, killing the baby. According to my doctor, this happened quickly, and it is unlikely that there would have been anything I could have done had I suspected sooner.

Oftentimes, when there is a placental abruption, the mother will feel a sharp pain or notice bleeding. I did not have any of these symptoms. I did feel some mild cramps, but I had confused them with early signs of labor. All of the blood that was lost from the separation was trapped between the placenta and the uterus, so I never experienced any bleeding.

Why were there blood clots? Unfortunately, that is the one question that has yet to be answered. Clots in the placenta do not show up on an ultrasound, so there is no way to see that they are forming during the pregnancy. Blood tests were done on me afterwards to see if I had a type of "thrombophilia", which is a term for someone whose blood clots easily. Those tests came back negative, indicating I do not carry the genes for the thrombophilia disorders that they are aware of. My doctor did mention, however, that this is a relatively new area of study and that there may be disorders that they do not know of yet. She said that even when she did her residency they did not know about the disorders that they do know of now.

But what about all the other complications that happened? It is likely that the placental abruption triggered the other complications that I endured, however the exact cause of those complications is not really known.

I developed a complication called pre-eclampsia, which includes symptoms of high blood pressure and increased amounts of protein being released in the urine (due to decreased kidney function). The exact cause of pre-eclampsia is not known, but risk factors include being over the age of 35, obesity, and cocaine-usage - none of which apply to me in case you wondered... The only other known risk factor for pre-eclampsia which will be of concern to me for subsequent pregnancies is the fact that I now have developed it once before.

Often, pre-eclampsia shows up earlier on in the pregnancy, and it is not usually a terrible risk to the mother or the baby if it is carefully managed by watching the mother's diet, stress, and activity level in order to keep blood pressure levels down.

I did not have any signs of pre-eclampsia until after we discovered the baby had died. Up until that night I had perfect blood pressure and normal urine tests. The pre-eclampsia came on suddenly, and it came on severely. It was most likely triggered by the placental abruption, and it developed quickly into what is referred to as HELLP syndrome.

HELLP is an acronym that stands for Hemolysis (the breakdown of red blood cells), Elevated Liver enzymes, and Low Platelets. HELLP syndrome can be very dangerous for the mother, in that it causes uncontrollable bleeding because of the low platelet levels (Platelets help the blood to form clots). I was not able to have an epidural during labor because of the risk of bleeding at the injection site, and there was much debate about whether to perform the c-section, due to the risk of hemorrhaging. I was given a transfusion of blood platelets just before the c-section to reduce this risk, and I also needed to receive another blood transfusion during the surgery because of the amount of blood I lost.

I was very fortunate to recover from all of these complications (and the surgery) very quickly. While it is somewhat relieving to get an understanding of what happened, I still have concerns about why this all occurred.

The cause for the blood clots is unknown, so that is worrisome for future pregnancies. I met with a maternal fetal specialist at Women & Infant's Hospital in Providence to go over the test results and discuss treatment options for future pregnancies to prevent something like this from happening again. His recommendation for the next pregnancy included taking a baby aspirin every day as a blood thinner to prevent the blood clots from forming. He also mentioned that he would recommend to my doctor that regular ultrasounds be performed to monitor the baby's growth. That way if it appears to slow or stop, they will have enough measurements to compare it to.

Again, there is no known cause for pre-eclampsia or HELLP syndrome, except that since I have already developed these complications once, I am at increased risk for developing them again. I know though, that I will be under extremely good care, and will be carefully monitored, so I am sure if something does start to go wrong, the doctors will detect it as early as possible. I cannot imagine that even if I were to develop any of the complications I endured during this pregnancy, that I would possibly lose another child in the process.

Most likely, my doctor will perform an amniocentesis towards the end of the pregnancy, in which some of the amniotic fluid around the baby is withdrawn with a needle. They can tell from this test whether or not the baby's lungs are fully developed, and if the baby will be able to breathe on it's own outside of the womb. If so, they will most likely deliver the baby early via a c-section. I can guarantee you that day will be the happiest day of our lives.