Oy! You mean they could have avoided this?

[captain optimism]

I posted here about my co-worker who came down with really bad pre-eclampsia and had to have a c-section. Her baby was born at 30 weeks. He's still in NICU. He's doing okay, getting her breastmilk through a tube. The moms get an hour (!!!) of "kangaroo time" a day, according to my other coworker who went to visit.

(I thought that was so terrible, I almost started to cry. Only an hour? My coworker who isn't a mom thought this was fine. She just doesn't know how many hours a newborn who nurses spends up against his mom, or cuddled against another parent or grandparent, asleep. :cries It's just sad to me.)

Anyway my coworker told me that our friend "looked better than I've seen her in a long time." She said that the new mom had been "swollen" through her whole pregnancy. Apparently the nurse practitioner in the OB practice was kind of lackadaisical about the swelling and her blood pressure (!!!) and other hints that pre-eclampsia was coming on.

I suspect that this is because my friend is fat. I think she was a victim of anti-fat discrimination in her medical care in this case. She was, as she put it, "a plus-size petite" (she was complaining about the lack of maternity clothes!). I think the nurse who was seeing her thought the swelling was because she was fat.

I'll never know.

But I'm still really mad that my poor friend went through this.

[Evergreen]

That is so sad on so many levels

[laurata]

OMG, that is so wrong, and so, so sad.

[tuffykenwell]

I know with preemies of that gestational age sometimes it is very hard for them to maintain basic functions when they are handled very much so that is probably the reason for the limitations on kangaroo care. It is a very sad story though and I hope both your friend and the baby are alright!

Steph

[mezzaluna]

i'm sorry your friend didn't get the care she needed... i hope her baby does better and better every day!

my OB has checked me for swelling by just pressing on my ankle and seeing that there isn't a lingering indentation. i imagine this simple check would work on someone of any size?? and what doctor doesn't take high blood pressure seriously during pregnancy??? i am truly baffled by that... my doctors were in a state of high anxiety when i started pregnancy at 145/95 and talking about medication vs. vitamins, etc. and they were concerned about my weight even though i was only ~25lbs overweight to start...a pain for me, but at least they were paying attention, unlike your friend's doctor

[crazy_eights]

Actually, swelling isn't considered a reliable indicator of the development of pre-eclampsia anymore, esp. in the lower extremities (the pressing on your ankle or the skin over your shinbone bit). Not sure what you are thinking they could have avoided. They might have diagnosed it earlier, but highly, highly unlikely it would have changed the outcome.

[Justice2]

That time period, although seemingly sad, is pretty accurate. Preemies can be overstimulated very, very easily. That time period should be upped rather quickly though, depending on the health of the baby. When my dd was 1-3 days old, they didn't want me 'handleing' her very often. After that third day, I could hold her about 2 hours, twice a day. I was the ONLY one allowed to hold her though. Overstimulation. It can really distress a tiny little one! Oh, and the Kangaroo Care is a wonderful way to encourage nursing. Wonderful!!! I hope that your friend's baby is making strides everyday!

About the misdiagnosis...Unfortunately, it really doesn't surprise me. It sickens me, but it really doesn't surprise me.

[captain optimism]

Chava, it's always good to get your insider perspective. I am thinking that they could have caught the pre-eclampsia sooner. I understand that swelling alone isn't a reliable symptom, but I think they also missed stuff about the blood pressure. I didn't realize that an early diagnosis would have no effect on the outcome. Okay, that is a bummer.

So there isn't any treatment besides giving steroids and ending the pregnancy with a c-section? Wow.

I didn't realize just how close this wonderful woman came to not making it. She was so sick. I knew that all her blood vessels had collapsed, and then also she lost consciousness days after the c/s...man. The world would not be as good a place without her. Thank God she is okay now.

[crazy_eights]

Originally Posted by captain optimism

So there isn't any treatment besides giving steroids and ending the pregnancy with a c-section? Wow.

Nope. A earlier diagnosis might have meant they ended the pregnancy earlier, and her disease might not have gotten as bad. Or maybe not. Unfortunately, sometimes the moms that get the 'sickest' are ones have a sudden onset of symptoms or might have mild symptoms. The only full-blown eclamptic seizure I've ever seen was a 23 weeker who came in for a 24 hour observation and her BP was 140/90. I've also seen women wind up very sick postpartum with apparently mild disease. Or mild symptoms but develop HELLP syndrome. Scary, scary, scary.