My name is Felix Twum, a Ghanaian student in the US currently studying for my doctorate degree in Public Health at the Georgia Southern University. I just want to share our story and struggles trying to have a baby all because of the life-threatening condition known as preeclampsia. My wife (Rose) and I have endured the pain of losing three (3) beautiful baby girls to preeclampsia although we did all we could to save them. Let me now take you through the agonizing chronology of events that led to losing our baby girls.
Having known Rose since we were in JSS, we got married in 2012 when I was working at the time as a tutor in Chemical pathology and Biochemistry at a private tertiary institution in Accra and my wife worked with an agency that took care of aged clients in their homes (Geriatric care). My wife took seed after our wedding in March and was due to deliver in February,2013. Being our first pregnancy, we did not know what to expect but tried to take all the necessary precautions and attended all her antenatal clinics at the La General Hospital because we lived in Teshie in Accra at the time. On one fateful day, I was at work when she called and told me she was bleeding and therefore was rushing from work to the hospital to see a doctor. I quickly ended my lectures and picked a taxi to meet her at the hospital. She was around 26 weeks of gestation by then. The doctors said she was losing her baby because of placenta detachment (placenta previa) and was therefore admitted for observation and management. After some few days on admission at the hospital, her blood pressure (BP) started shooting up astronomically that the doctors started giving her medications to control, but her refractory BP would not cooperate. Eventually she was told she had to be operated (caesarean section) because of signs of preeclampsia. The doctors did the c-section at 27 weeks 3 days and sent our first baby girl to the NICU. I was very excited as a father seeing my first baby irrespective of her weight which was 900 g. Our baby girl survived at the NICU for about 10 days until one morning when I got there to see her as usual before I went to work, I was told she had passed on. I came home and woke my sleeping wife up to break this bad news to her. We both cried like babies and later went on to bury our first child. Our first Christmas in marriage was not what we had hoped for because our baby died in December 2012.
In 2013, my wife got pregnant again and this time we were hoping for a better outcome. We went to see a specialist at a private hospital in Teshie who said there was nothing much to do about my wife’s problem other than constant monitoring of the pregnancy. He advised us to attend the Lekma hospital for her antenatal services since they had good and experienced doctors. We did all we had to do again and saw the doctor once a month. When we got to 24 weeks, the BP started shooting up again hence I rushed her to see the doctor. She was admitted for 3 days until her BP became normal, but we were advised and given signs and symptoms of preeclampsia to look out for, so that we rush her back to the hospital when they start showing up. As a Biochemist, I was also monitoring her BP and urine proteins daily to know what was happening subclinically. Unfortunately for us again, on the 24th December 2013 at dawn, Rose started showing signs of imminent eclampsia so was rushed to the hospital. She was subsequently operated upon after she was given Magnesium sulphate and other medications to prevent seizures and delivered another baby girl at 27 weeks with a weight of 700g. My precious baby girl lived for about 12 hours and died because of respiratory distress syndrome. My wife was still on admission when our girl died but we could not tell her because we thought it might make things worse since she was still recovering from her c-section and her BP was still not normal. I lied to her that our baby had been sent to Korle-bu teaching hospital for better care so that she would not think of going to the NICU to see her when she was able to walk. Finally, I was able to break this devastating news to her when she was discharged almost a week later. Losing two babies in two years, both at almost 28 weeks of gestation, and both in December was hard for us to take. As usual in our Ghanaian setting, we and our families started reading spiritual meanings into what was happening. I began to get scared of and hate the month of December even though I am a December born myself.
After the second baby loss, I started reading more about pregnancy induced hypertension and preeclampsia and gained so much knowledge of the etiology and management. I read a lot of scientific articles on Clinical trials using calcium and soluble aspirin to manage women at high risk of preeclampsia. Being an MPhil student in Chemical Pathology at the University of Ghana Medical School at the time (2012-2014), I decided to get all the needed information before we decided to try again. Armed with the knowledge I had acquired from the literature, we went to see an OBGYN specialist at a clinic near Korle-Bu to discuss our problem and what else to do when my wife got pregnant again. After seeing the doctor, we had a plan and so decided to try once more. She got pregnant and the doctor and I agreed to give her soluble aspirin at 12 weeks gestation to delay the spike in BP. In addition, I was asked to constantly monitor her BP at home and plot graphs to show daily BP trends every week as well as check her proteins in urine using a dipstick. The doctor looked at the graphs every other week when we visited.
At 20 weeks, something unexpected happened. The amniotic fluid around the baby started reducing (Oligohydramnios) and that was not good news because it had the potential to affect the lung development of the baby. Quickly I started reading around and heard of amnioinfusion, a procedure that was not common in Ghana. I brought it up during our visit to the doctor one day and he agreed to try it although he had never done it before in his long years of practice, according to him. He got normal saline and put about 50 ml of it in the amniotic sac under ultrasound guide. The baby responded well to it and that was continued almost every week from then. He also started giving my wife steroid injections to start maturing the lungs of our baby early. All the interventions helped us in reaching 32 weeks of gestation before the BP started rearing its ugly head. She was operated upon on 23rd January 2015 and we had our first and only child (another girl) who weighed 1.65 kg. She is a beautiful girl who is 4 years 6 months old now. We were very glad and thanked God for having a healthy baby after two losses. I wish this was the end of our story with a happy ending but unfortunately that is not the case.
With our success of having a baby, we decided to try one more at the same hospital before I left for the US for my studies. She got pregnant, did everything like we did for the previous successful pregnancy except that the doctor this time decided not to give my wife the soluble aspirin. I remember protesting vehemently but he (doctor) thought the aspirin may have caused the amniotic fluid reduction (Oligohydramnios) in the previous pregnancy and therefore decided not to repeat the aspirin but was confident he could control the BP if it started increasing. To cut a long story short, the BP rise started early this time (22 weeks) and was admitted from that time till 27 weeks on different combinations of anti-hypertensive medications. All the meds were not able to reduce her BP and her proteins in urine was almost always 4+. One day my wife was not feeling the movement of the baby and told the doctor, so he quickly rushed her to the theatre and performed a c-section. This time the baby weighed 650 g and was really struggling to breath. She died within 24 hours at the Korle-Bu NICU just because the nation’s top-most referral hospital did not have a ventilator to help my daughter breathe. I remember the doctors called me and said they were manually ventilating her but could not continue with that and so they were going to stop for her to die. Her skin had started turning purple because of lack of oxygen. I remember touching her and she looked into my eyes, struggling to breath and hoping I could save her, but her daddy could not. I left the NICU to go to a park near Korle-Bu to pray during the night and came back in the morning to hear she had died during the night.
As a soon to be Public health professional (Epidemiologist), I have become very interested in preeclampsia research because of the loss of OUR THREE QUEENS. I know with advocacy and the right policies, we can reduce the maternal and neonatal morbidity and mortality due to preeclampsia and help save our precious women. My wife and I will try for the last time here in the US because of the better facilities and healthcare they have here and hope to get our second child soon.
Life is not fair, but God is good!