Loss of a child in utero

After two and a half years of trying, in April 2002, we conceived twins through IVF/ICSI. I had moderate OHSS* so the first month or so took a bit of a toll but we were so excited to be having twins. I had some mild bleeding at 5 & 6 weeks but the doctors believed this was associated to the progesterone I was taking as part of the IVF treatment. At 7.5 weeks it was confirmed that we were having twins.

At 13 weeks we had a nuchal translucency scan** as we did not want to have an amniocentesis (which were advised to do due to my age – 35 yrs). The reason for not wanting the amnio was we did not want risk losing the babies. Twin A had a great measurement of less than 1mm but Twin B had a measurement of 3.2mm, and this situation combined with my age, showed a high risk for chromosomal abnormalities. Even after this news we decided not to do an amnio and that we would look to Level II ultrasound for tentative diagnosis.At 16 weeks we had another scan and it seemed that Twin B had Hypoplastic Left Heart Syndrome, a situation where the left side of the heart does not develop. At 19 weeks, we had another scan and this diagnosis was confirmed. It was also determined that Twin A was a girl – Catherine, and Twin B was a boy – Marcus.

At 22 weeks we went in for a fetal echocardiogram followed by an appointment with the Pediatric Cardiologist. Unfortunately Marcus had died between my OB appointment the week before and the scan. We were aware that there was a high chance that Marcus could die in utero but you have to hope. Three days later I was admitted to hospital and put on bedrest due to a disease I have called adenomyosis. This is like endometriosis but it is only in the uterine muscle and during pregnancy it can cause severe pain when the uterus grows, plus the uterus is enlarged. They did a transvaginal ultrasound 3 days later and found my cervix had shortened and was only 1cm long Consequently, I was put on full bedrest. At 24 weeks, Marcus’ water broke and I was put on intravenous antibiotics. At 25 wks, 2 days I went into premature labour due to a uterine infection, from Marcus’ water breaking. At 12.29am the next morning, just squeaking into the next day, Catherine was born followed by Marcus at 12.30am. Catherine was intubated and taken to the NICU, though not before we heard a couple of little cries from her.

In recovery the hospital staff brought Marcus to us and we had the Chaplain name and Bless our precious little Angel. Afterwards we held him and said goodbye. This is something that meant so much. I needed to hold my much wanted little boy, as did my husband. The nurses took photos of us with Marcus plus photos of just Marcus, as well as little footprints. These were given to us in a beautiful memory box along with the clothing that he had worn. The hospital also gave us a beautiful urn in a box with Raphael angels on. We had Marucs cremated and put his ashes into this beautiful urn. Next Spring we will scatter his ashes on a small island that we love. The pain is always there but I believe that Marcu is watching over his sister and giving her strength to survive being such an early baby.

My advice for those who endured such a loss would be remember that your baby is yours and if you want to hold and see him/her you make enough noise until they bring him (them) to you. Be prepared for the fact that they may not look like the beautiful baby you want them to, but the most important thing is to say goodbye. I miss being pregnant as while I was pregnant I still had my son with me. But all things must come to end and we must move on. I hope that you are able to find strength if you are going through a stillbirth or birth loss. Just remember it does get better. I believe I am lucky to have had Marcus with me for 22 weeks and to still have her sister to love and hold. We will raise her to know about her special twin brother.

Gina in Canada

*Ovarian Hyperstimulation Syndrome (OHSS): is a side effect that can occur during infertility treament with ovulation inducing drugs. In these cases, the ovaries are very sensititve for these drugs and respond with growth of multiple follicles. Symptoms of this syndrome may include ovarian enlargement, accumultion of fluid in the abdomen and gastrointestinal disorders (nausea, vomiting, diarrhoea). Severe cases of PHSS are however very rate (1-2%). In case of multiple follicular growth there is also a risk of multiple pregnancy and sexual intercourse is therefore prohibited. OHSS can be very painful because of the swollen ovaries. (Source: www.ferti.net/library/faq/tretment-5.asp)

**Nuchal translucency scan (NTS): is the swelling just under the skin at the back of the fetal neck. It is important because if the fetus has a greater-than-normal amount of swelling at the back of the neck, there is a high likelihood that the baby will have Down Syndrome or a major heart problem or both. For greater detail on NTS, please visit www.obgynsono.com/nt.html.

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