For more than 10 years, April Foster, 41, and her husband, Jamal, dreamt of having a baby. Sadly, after Foster’s lengthy battle with polycystic ovarian syndrome (PCOS), having a baby seemed like a dream that would never come true.
“Although my husband and I desperately wanted children, we didn’t want to resort to fertility treatments,” said Foster. “So, we left it in God’s hands and hoped that someday our prayers would be answered.”
What is PCOS?
PCOS, a common cause of female infertility, affects approximately five million women in the United States. With PCOS, small cysts grow on the ovaries, causing hormone imbalances and irregular periods, making it difficult to get pregnant.
“More importantly, if not properly managed, PCOS can lead to more serious health problems, including life-threatening diseases,” said Michael Paul, MD, an obstetrician/gynecologist at Missouri Baptist Medical Center who specializes in high-risk pregnancy. “For example, women with PCOS have a greater risk of developing diabetes, heart disease, heart attacks, high blood pressure and endometrial cancer.”
That’s what happened to Foster. In 2008, she was diagnosed with type 2 diabetes, further complicating her battle with infertility. Facing two chronic health conditions, Foster knew her chances of conceiving were even more limited. Plus, if she did get pregnant, her pregnancy would be considered high-risk.
Managing a High-risk Pregnancy.
Every pregnancy has risks for potential problems that can affect a woman’s health and the health of her unborn baby. However, certain preexisting health conditions or those that develop during pregnancy can be characterized as high-risk.
The good news is proper prenatal care can help detect and manage such high-risk conditions as:
- Heart disease
- Diabetes (types 1, 2 and gestational)
- High blood pressure
- Kidney disease
- Sexually transmitted diseases
- Multiple pregnancy (carrying more than one baby)
- Prior pregnancy problems (preeclampsia, miscarriages)
- Being over the age of 35
“Although the phrase ‘high-risk’ may seem alarming, it’s simply a medical term physicians use to make sure you receive extra special care during your pregnancy,” said Dr. Paul. “As a high-risk patient, your doctor will monitor you closely throughout your pregnancy to help identify any problems in the earliest stages and manage them accordingly.”
A Dream Come True.
Despite the odds, the Fosters finally received the news they’d been praying for: Foster was pregnant and due June 8, 2014. Given that she was over 40 and had type 2 diabetes, Foster knew she needed advanced prenatal care to better manage her high-risk condition.
“I did quite a bit of research before coming across Dr. Cahill and the Washington University Maternal Fetal Medicine Group at Missouri Baptist Medical Center,” said Foster. “I had also heard a lot of great things about MoBap and its physicians and nurses.”
In November 2013, Foster had her first appointment with Alison G. Cahill, MD, MSCI — a board-certified gynecologist/obstetrician maternal fetal medicine specialist at Missouri Baptist Medical Center.
“April’s advanced age and type 2 diabetes qualified her for specialized prenatal care,” said Dr. Cahill. “Her diabetes put her and her unborn baby at risk for certain pregnancy complications, including high blood pressure disorders of pregnancy, abnormal growth of the baby, preterm delivery and even stillbirth.”
The first couple of months of Foster’s pregnancy went smoothly. Dr. Cahill and her partners closely monitored Foster using advanced prenatal care, regulating her insulin at every visit.
“Our primary goal with April was to properly control her blood glucose levels, which is particularly important for expectant moms with diabetes,” said Dr. Cahill. “Early in pregnancy, high blood glucose levels increase the risk of miscarriage and birth defects. In the last half of pregnancy, high blood glucose levels can cause the baby’s size and weight to be larger than average and increase the risk of complications during and after delivery.”
Foster appreciated the time that Dr. Cahill and her partners spent with her during every office visit. As a first-time mom dealing with a high-risk condition, she often had a lot of questions. “I always felt like it was worth my time to be in their office,” said Foster. “They answered every one of my questions and never rushed through my visits, reassuring me that I was in good hands.”
Taking Quick Action.
At 31 weeks, Dr. Cahill scheduled Foster for a standard stress test. Her blood pressure had slowly started to increase. As a precautionary measure, Dr. Cahill ordered Foster to monitor her blood pressure at home and check her blood sugars six times a day. Then, during a routine check-up on Thursday, April 10, Dr. Cahill noticed Foster’s blood pressure was higher than normal, so she was admitted to the hospital for additional testing and close observation.
“I didn’t realize how sick I actually was,” recalled Foster. “At the time, I had started feeling really tired and out of breath. I also felt my heart beating a lot, but I just assumed that it was all part of being pregnant.”
Dr. Cahill and her maternal fetal medical team ran several diagnostic tests over the next four days, ultimately diagnosing Foster with severe preeclampsia. By Monday, April 14, the tests indicated that Foster’s organs — specifically her liver and kidneys — were starting to fail.
Delivering a Miracle.
“At that point, we knew that April’s condition had changed,” said Dr. Cahill. “For both April’s health and the health of her baby, an emergency C-section was our best option. It was the only way to reverse the organ failure from severe preeclampsia.”
Less than 40 minutes later, Dr. Cahill and her team performed an emergency C-section, delivering the Fosters’s baby girl eight weeks early. Amelia Faith weighed five pounds and one ounce and measured 17 inches. As a preemie, she required a three-week stay in the special care nursery. More importantly, Amelia is a healthy baby girl, who has been thriving since being released from the NICU in early May.
Foster has done well since giving birth to Amelia. Her diabetes is now well controlled, and she and her husband are enjoying life as new parents. Given her high-risk condition, Foster realizes how important the specialized prenatal care was throughout her pregnancy.
“Dr. Cahill and her team were persistent with caring for me. They held me accountable for my own care, but gave me the guidance I needed to succeed,” said Foster. “My pregnancy was a gift, and they allowed me to have that experience. They worked with me to improve my condition and delivered my healthy miracle baby. The end result was completely worth it.”
Alison Cahill, MD, is a board-certified maternal/fetal medicine ob/gyn on staff at Missouri Baptist Medical Center, and chief of maternal/fetal medicine at Washington University. She received her medical degree from the University of Connecticut and completed a combined internship/residency at the University of Pennsylvania-Hospital of Obstetrics/Gynecology and a fellowship in maternal/fetal medicine at Washington University School of Medicine.
Michael Paul, MD, is a board-certified maternal/fetal ob/gyn on staff at Missouri Baptist Medical Center and a member of the BJC Medical Group. He received his medical degree from Northwestern University Medical School and completed his residency in obstetrics/gynecology and a fellowship in maternal/fetal medicine at Northwestern University Feinberg School of Medicine.