Conditions that threaten women’s lives in childbirth & pregnancy

Alison T

Female
Age at interview: 44
Age at diagnosis: 42

Brief outline: At 32 weeks Alison T developed pneumonia and multiple blood clots (pulmonary embolisms). She stayed in hospital and took drugs to thin her blood. Alison was induced and quickly developed a condition called amniotic fluid embolism. She haemorrhaged and doctors had to perform a hysterectomy to save her life.

Background: Alison T is married with 5 children. She is a housewife, her husband is a sheet metal worker. White British.

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This pregnancy was Alison T’s 4th, and not planned. Her other children were aged 8 and in their teens. She is a petite woman and she was concerned during the pregnancy, as her previous babies had been large (over 10lb). With her previous pregnancy she had developed gestational diabetes. The early pregnancy went OK but things started going wrong when she developed a chest infection and multiple pulmonary embolisms (PEs) five weeks before her due date. She spent some time in hospital receiving a drug to thin her blood, called Fragmin (dalteparin). Because she was on this blood thinning drug, her doctors were very concerned that she did not have a caesarean operation, so they induced the baby at 37 weeks.
 
As her labour progressed, Alice began to feel very unwell. She developed amniotic fluid embolism, a very rare complication of pregnancy, in which amniotic fluid, fetal cells, hair, or other debris enters the mother's blood stream via the placental bed of the womb and triggers an allergic reaction. Her baby’s heart rate dropped and the doctors had to perform an emergency caesarean to deliver her. The baby was unwell and sent to the neo-natal ward where she stayed for 9 days suffering respiratory distress syndrome, jaundice and sepsis. While the caesarean was initially straight forward, within 30 minutes of the operation she had developed bleeding from virtually every part of her body, especially from the operation site. The doctors were ultimately forced to do a hysterectomy to try and stop the bleeding. Alison was extremely unwell and her husband was told to pray for a miracle. 
 
Alison was kept asleep for 4-5 days in intensive care (ITU) and was ultimately in ICU for 8 days and 2 days in a high dependency unit (HDU). The interview took place almost two years on from leaving hospital. She was still on drugs to thin her blood, and she remained concerned to about the vena cava filter (a filter inserted into her vascular system) which remains in situ – she has been told that it is not possible to remove it. Her daughter is now doing fine, but Alison has suffered panic attacks and post traumatic disorder (PTSD) since her discharge. Her trauma is mainly related to memories she has of her stay in ITU. She has received counseling from the hospital, which she has found very helpful. She has had good follow up from the hospital, seeing lung and heart specialists. 
 
The hysterectomy does not prey on her mind, other than some residual bleeding that she has as a result of the operation being incomplete. There is an operation that could solve this, but she does not feel ready to embark on the surgery at the moment. Her family were profoundly affected by her illness. While her 8 year old daughter seems to be OK, one of her teenage sons has since been referred to the local Child and Adolescent Mental Health Services (CAMHS) service for counseling and support.
 
This interview took place 22 months after Alison’s amniotic fluid embolism and hysterectomy. 
 

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