pátek 18. listopadu 2011

A Mother's Story




How My Feisty Preemie Came Into the World


It was over four-and-a-half years ago, but it often seems like yesterday that my daughter Aria was born. The way she came into the world, at 32 weeks old, was nothing like the way I’d envisioned. There were no birthing classes, no labor, no excited trip to the hospital.

Several weeks before she was born, I thought I’d gotten food poisoning from some past-its-prime frozen spinach. After what seemed like an obvious bad reaction to the food, I kept feeling intermittently sick and a dull but persistent pain at the top right quadrant of my chest. I went to my OB/GYN and he sent me to my primary care doctor to make sure it wasn’t some kind of tapeworm or parasite. She -- arrogantly -- insisted that it was just food poisoning and didn’t think there was any reason to do bloodwork. In retrospect, I should’ve insisted on it but I trusted her. At 30 weeks pregnant, I’d also gone for a growth scan and it showed that the baby was growth restricted. But I was told that I shouldn’t be too concerned and they’d just keep monitoring me.

The day Aria was born, I had gone for a routine check-up with my husband David. When my doctor took my blood pressure, it was high -- which it hadn’t been before. He said he’d feel better if we went to the hospital nearby for an ultrasound. When we arrived, I got an ultrasound and at the same time they received a call from my doctor that there’d been protein in my urine. They then sent me upstairs to get bloodwork and to be monitored further. We were there several hours doing tests and waiting for the bloodwork results to come back, but nothing seemed urgent. They told me I’d likely go home and do a 24-hour urine test to monitor the protein in my urine.

But things suddenly turned into what felt like an episode of ER. As soon as the blood-test results came back, a nurse bolted into the room and told me that I wouldn’t be going home -- I’d be having an emergency C-section immediately. “How can I be having the baby now -- it’s only 32 weeks old?” I asked, confused and panicked. Suddenly, I was told that I had the HELLP Syndrome, a variant of preeclampsia that involves hemolysis (the breaking down of red blood cells), elevated liver enzymes and low platelet count and that I was at risk for having a stroke or seizures. The baby -- whose sex I didn’t know -- had to be delivered immediately because we were both in danger. I was spiraling into a state of confusion and despair. How could this be?

Because I was considered high-risk, my OB/GYN wouldn’t be able to deliver her. I’d have to be delivered by a maternal-fetal specialist I’d never even met. My husband and I were both reeling from shock. But Dr. Fereshteh Boozarjomehri (it’s no coincidence that her first name means “angel” in Farsi) assured us that I’d be okay. Within minutes of being prepped, I was in the operating room and having a C-section. Aria was born at a tiny 2 lbs. 10 oz., and because of her prematurity and issues with her breathing, she was whisked away to the NICU. In my precarious condition, I wasn’t allowed to leave my bed for 24 hours as they stabilized me. It was horrible and surreal. I’d just had a baby and I saw her for what felt like 1 second. And now she was in the NICU and I had no idea what would happen next.

I couldn’t leave my bed as I recovered, so I asked for a NICU doctor to come to tell me about my new baby’s state. They assured me that though she was tiny, she wasn’t quite as tiny as many of the “peanuts” in the NICU -- she was more like a cashew. Little Cashew soon became her nickname since we hadn’t named her yet. Twenty-four hours later, during which I was convinced that I'd missed the window for bonding with her, I was wheeled up to the NICU to see her. I was shocked. She was tiny and hooked up to tubes. She looked so frail that it broke my heart. I would repeatedly ask if she would survive but no one could tell me anything definitively. I was plunged into fear that I'd lose her.

My feisty little girl -- whom we didn’t name for two weeks -- fought her hardest. There were many scary moments, like when we would do kangaroo care with her, skin-to-skin snuggling that has been proven to have positive health benefits for preemies, and she would suddenly have an apnea episode and stop breathing (which is very common in preemies). The nurse would grab her from me and resuscitate her while I stood by crying. She also had a PDA (patent ductus arteriosus), an open artery in her heart that typically closes in full-term infants but not always with preemies. Luckily, the artery closed with medicine and she was able to avoid getting surgery.

Other than going home to sleep, I lived at the NICU every day and night with Aria. During her six weeks there, I was grateful for the incredible hospital staff (who sometimes had to tough-love me through my fearful moments) and the parents who became my support group -- and who I still count as friends over four years later. We were in it together, celebrating the tiny milestones of our tiny babies as we waited -- during what felt like an eternity -- for them to be able to leave the hospital.

Six weeks after she was born, Aria was finally discharged. Weighing a little over 4 lbs., she came home on an apnea machine to monitor her breathing (which she was constantly connected to for two months other than during bath time). Having her home was surreal: The first night, I honestly didn’t know if I could handle being on my own without the nurses’ guidance. It was overwhelming.

It took us a while, but she learned to nurse, which she hadn’t been strong enough to do until she was five weeks old (before that, I pumped and she was fed through a feeding tube or tiny bottles). And as time went on, we were assured that she didn’t have any developmental delays. Though small in size, which she still is to this day, she was a feisty little fighter. The joy I felt in having her home -- and not having to visit her in the hospital -- was immeasurable. My baby was with finally me.

On World Prematurity Day today, I am grateful that I was given the gift of my teeny-tiny Little Cashew, who is now an incredibly funny, joyful, curious little dancing machine. It doesn’t feel like it’s over four years ago that Aria first came into the world in a way that was anything but ideal. But that experience has made us both stronger.


Serena Kappes is iVillage’s Entertainment Editorial Director.

http://www.ivillage.com







Prematurity Awareness Month


http://www.youtube.com/watch?v=hqxVRnk1H90

Does A Bigger Brain Make For A Smarter Child In Babies Born Prematurely?


New research suggests the growth rate of the brain's cerebral cortex in babies born prematurely may predict how well they are able to think, speak, plan and pay attention later in childhood. The research is published in the October 12, 2011, online issue of Neurology®, the medical journal of the American Academy of Neurology. The cerebral cortex is the outer layer of the brain covering the cerebrum, and is responsible for cognitive functions, such as language, memory, attention and thought.

"In babies born preterm, the more the cerebral cortex grows early in life the better children perform complex tasks when they reach six years old," said study author A. David Edwards, DSc, of Imperial College in London. "The period before a full-term birth is critical for brain development. Problems occurring at this time have long-term consequences, and it appears that preterm birth affects brain growth."

The study looked at brain growth rates of 82 infants who were born before 30 weeks gestational age using MRI scans of their brain between 24-44 weeks. Brain scans were collected repeatedly from immediately after the babies were born until their full-term due date. Their cognitive abilities were tested at two years old and again at six years old.

The study found that the faster the rate of cerebral cortex growth in infancy, the higher their scores were on the developmental and intelligence tests as children. A five to 10 percent reduction in the surface area of the cerebral cortex at full-term age predicted approximately one standard deviation lower score on the intelligence tests in later childhood. Motor skills were not correlated with the rate of cerebral cortex growth, and the overall brain size was not related to general cognitive ability.

"These findings show we should focus on the growth of specific regions of the brain like the cortex when trying to understand or diagnose potential problems in babies and fetuses," said Edwards.

The study was supported by the Health Foundation, the Garfield Weston Foundation, Wellbeing of Women and the NIHR Imperial College Healthcare Comprehensive Biomedical Research
Center.


http://www.medicalnewstoday.com