Expect the Unexpected During Pregnancy

Background: The birth of a child is a joyous occasion that parents and family look forward to. Though most parents plan even the smallest details of their deliveries, most do not give a second thought to planning for medical complications during the labor and delivery process.  This blissful occasion can change to fear and terror as unforeseen complications arise, and maternal life becomes threatened.  Patients need support, education and a multifocused approach.  Emotions such as terror and fear cloud patient’s thoughts to what sound education and decisions have to be made. Education needs to come from a calm knowledgeable team that is both protective and supportive for each individual case.  

Case:

Three cases have presented to our 7000 delivery Level III LDR in the past year allowing for case plans to be established.  The expertise of the maternal fetal medicine discipline and the Level III NICU perinatologists attracts patients from neighboring states, as well as our own, allowing for case plan to be implemented for complex patients. The first case was a G6P4 inpatient with a known Increta/Accreta, a care plan was established outlining surgeon, obstetric, and nursing responsibilities, but even the best thought out strategies can incur complications.  The second case involved a G1P0 who became pregnant through Invitro fertilization.  Labor went as expected, with an uncomplicated vaginal delivery of a baby girl, but when the placenta would not separate an accreta was suspected.  The last case was a G3P2 known placenta previa, the scheduled Cesarean took an unforeseen turn as an accreta became apparent.

Conclusion:

Doctors and nurses worked side by side to solve each complication as they presented.  Individually these three women had specific complications and hurdles to overcome, but the outcome for each became similar as they all were discharged from the hospital to care for their infant.

Keywords: Accreta, Increta, pregnancy complications