July 16, 2012
Cooling Procedure Saved Pregnant Heart Attack Victim; What Happened to the Baby?
A 33-year-old pregnant woman at 20 weeks collapses while attending a church function and a physician at the scene began receives CPR (cardiopulmonary resuscitation). According to a recent article in the Annals of Emergency Medicine, emergency workers arrive and shock her heart out of a life-threatening irregular heart rhythm and 25 minutes later, it beats in a normal pattern. The patient however, appears to be in a coma which occurs when the brain doesn’t receive enough oxygen. The hospital physicians enter unchartered water and perform a procedure that has rarely been done in pregnant women. They cooled her body temperature to 90 degrees, a procedure known as hypothermia for an hour in an attempt to improve her condition and then slowly rewarmed her body back to its normal temperature in order to save her life. It worked and during the procedure an ultrasound showed the fetus shivering.
Heart conditions during pregnancy are rare, affecting only 1 to 4% of patients. This particularly patient had a condition called cardiomyopathy which is an enlargement of the heart, causes heart failure and is often fatal. It is a disease that hits close to home because it killed my grandmother six months after she delivered my aunt. The heart is considered a pump that helps circulate blood throughout the body and heart failure means the “pump” is not working properly. No one knows exactly why cardiomyopathy occurs but it tends to affect
- women over 30
- African American women and
- women who have several children
Fortunately, the patient had a device implanted 8 days after her heart attack that helped her heart beat in a normal pattern. The patient was discharged home from the hospital after 10 days, returned to work in 4 weeks and then delivered a normal baby boy at 39 weeks who weighed 5 lbs. 15 oz. The baby was evaluated at 1, 2, 3, 6, 12 and 36 months of age and is completely normal.
Although hypothermia has been used as a treatment for heart attack victims since 2005, pregnant women were previously excluded. However as a result of this case, I suspect they won’t be excluded anymore.
Jeanee Andrewartha said,
July 19, 2012 at 8:12 am
Linda, that is one amazing story. I am sorry to hear about your grandmother dying of heart failure in pregnancy, it must have affected your family greatly. I too, wonder how different life would be for my own family if I had died last year of heart failure in pregnancy and so I have become passionate about raising awareness about Peri/postpartum cardiomyopathy, through the sharing of PPCM stories.. http://www.myheartsisters.com is a site where women have shared their ppcm stories. I hope all women and those involved in the care of pregnant women will know the signs of heart failure in pregnancy, that more lives will be saved. Thank you for sharing this incredible story – it is quite unforgettable.
drlindagalloway said,
July 19, 2012 at 1:29 pm
Dear Jeanee,
Sometimes as I write these posts, I ask myself, why am I staying up half the night doing research, writing, being uncompensated for all of this effort and then I receive an email such as yours and it renews my spirit.
First, let me say that I’m so grateful you’re among us to share your story and I thank you for sharing that very important website. My colleagues who “sit on high” should really try coming down to earth and not only connect with our patients beyond our offices and delivery rooms, but also become fully engaged in their struggles.
Your email made my day. Hope you will share my website http://www.smartmothersguide.com with your colleagues and like me on FB. I am truly humbled and grateful by your response.
Jeanee Andrewartha said,
July 19, 2012 at 10:29 pm
Linda, through our stories, we break down the walls and come to a greater understanding. I have added links to your websites, under PPCM pregnancy (which is currently on the recovery page) and also a link to this page from the blog page. I hope you might find time to write an article on heart failure in pregnancy and share http://www.myheartsisters.com . I think it is important for all women, doctors, doulas, midwives, nurses to know the signs and consider the possibility of ppcm.
Working on the web for close to a decade, I have seen it transform the world. People like you, Linda offer a unique insight that needs to be heard. There is a maternal care crisis in maternal and infant mortality and morbidity. Your article on early inductions was very insightful and coming from an obstetrician, it carries with it an authority.
Due to having very quick labors, where I only have 2-7 contractions 10 minutes apart and delivering on the last contraction, and having 8 homebirths, I have also been able to connect with women who homebirth and want a natural childbirth and because of PPCM, connect with women at the opposite end of the extreme who have medically managed births and those who have lost babies through SIDS, miscarriage and still birth. My understanding of pregnancy and childbirth is as broad as it is long and I just wish I could somehow bridge the gap of understanding and that is what I hope to do. For the myheartsisters.com site, cardiologists can also join and I hope they will. We hope to add a page for them to also add their stories and experience.
We can all do our little bit to change the world and little by little change will happen. Hopefully, not too many lives will be lost in the meantime. Linda, you too are blessed to be who you are because you have come from generations of midwives and can understand pregnancy from both the natural and medical point of view. I was just thinking how wonderful it would be to read articles from an obstetrician who had a more balanced view. Thank you for sharing!!