Can you imagine having to decide whether or not you want to terminate your unborn child?
And to further complicate this, how about being given only a week to make this decision?
No parent should have to make this decision. But this is a reality when dealing with possible complications of a pregnancy.
The developing baby relies on the amniotic fluid for protection and proper development of muscles and organs. When we think of a baby swimming in the womb, the amniotic fluid serves as the medium of movement.
By the second trimester, the baby will begin to swallow the amniotic fluid and breathe. The mother provides the fluid up to 20 weeks of development and later the baby's urine will add to the fluid. For proper development, there must enough amniotic fluid.
In a condition know as Oligohydramnios, the placenta has low amniotic fluid, which is problematic for the developing fetus. Because of the low amniotic fluid a number of outcomes are possible: the developing fetus may not make it to term (and die in utero), experience delayed development in the organs, or may be born normally.
When the ultrasound reveals findings indicative of Oligohydramnios, the Obstetrician and Neonatal Specialist must inform the parents about their options. And one option is to terminate the baby in utero with an injection of potassium chloride into the heart to stop future contractions.
This option is complicated in the case of a twin pregnancy, when there is another developing fetus. Injecting into the womb poses the risk of infection to both fetuses, as well as premature delivery. Also, the terminated fetus would not be delivered; it would remain in the womb. So, the mother will be continue to carry both fetuses: one that is viable and one that has died.
It is hard enough to make such a decision. But how about carrying a dead fetus for a few months?
There is no way to know what is the right option or decision. The mother and her family will need to carefully consider each option and the impact it will have on their lives. It's difficult to even fathom being placed in such a situation.
And yet, this is what Jane and I were discussing at her last prenatal appointment.
About Me
- Eisha Z
- San Francisco, CA, United States
- I am a graduate of the University of California, San Francisco School of Medicine. I will be starting my residency in obstetrics and gynecology at the University of Michigan. When I am not playing doctor (or at least learning how to play doctor), I spend my time running, excercising, cooking, and looking behind the lens of my camera. My essays have appeared in the San Francisco Medicine Magazine and on the UCSF School of Medicine website. If you read any post and feel enlightened or have something to say, please do so. Leave some love if you have any to share.
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1 comment:
My wife was diagnosed with olighydramnios at 12 weeks and anhydramnios (no amniotic fluid) at 13 weeks. Every Perinatologist we visited said there was basically zero percent chance of survival. Today Sebastian is 15 months old and doing fine. There are multiple treatment options that your local OB or Perinatologist may or may not be aware of. These include amniopatch, amnioinfusion, etc. We tried all and consulted with doctors in six countries. My wife underwent surgical procedures at NYU and Johns Hopkins. In the end what worked was bedrest and steroids at the last moment. If you are facing a similar situation, please please email me prior to making a decision you will have to live with for the rest of your life. I can direct you to doctors who can consult with your doctor. rvolmer @ crosbyvolmer.com
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