High-risk pregnancies

Summer 2017

Jessica Drummond had been married only 10 months when she was hit by a truck as she walked across the road in downtown Listowel in May 2009.

Her skull was severely fractured in two places and Jessica was airlifted to the trauma unit at London Health Sciences Centre. Brain surgery was required to save Jessica’s life.

“I scared my husband a little bit,” says Jessica.

Jessica was in a coma for three weeks. Slowly but surely she emerged from her coma and was able to leave Victoria Hospital. Two years of rehabilitation followed and she had to adapt to new health challenges.

“Balance was an issue, I had vertigo,” says Jessica. “It was such a long recovery, very emotional, and I was scared. I couldn’t do everything I was used to doing such as cooking and shopping, and I didn’t know where some of my belongings were because we had just moved.”

That December she had her first seizure, a result of her traumatic brain injury.

“I have a seizure about twice a month. When I have a seizure I am usually in bed because I get very tired beforehand. When the seizure is coming on I feel twitching in my cheek and in my left hand,” says Jessica. “If I’m lying down I just won’t be responsive. Some seizures can last two minutes and some can last up to two-and-a-half hours.”

Despite her seizures, Jessica and her husband Jason knew they wanted to start a family, and in 2012 they went to a specialist in high risk pregnancies at LHSC to get the green light.

There is a benefit to seeing patients susceptible to seizures before they are pregnant, to optimize the environment and care.

“With seizures, a key issue is the nature and dosage of medications because the increase in blood volume of pregnant women means the medication is diluted and may be less effective. As well, there are some medications that can affect the baby, and there would need to be an adjustment of the drug choice,” says Dr. Jordan Schmidt, Obstetrics and Gynaecology at LHSC.

While some patients suffering from seizures are able to come off medications for a while or significantly reduce medication, this was not the case for Jessica.

Even with the medication, in pre-pregnancy Jessica had seizures about twice a month, and during her first pregnancy she had five months of daily seizures.

Throughout her high-risk pregnancy, Jessica was under surveillance by the specialist team at LHSC to monitor the seizures and blood work every two weeks.

As well, contingency plans were in place with her family physician in Listowel in case Jessica wasn’t able to make it to London to give birth. Luckily the contingency plans weren’t necessary.

 “I didn’t spend too much time in the hospital. I was at Victoria Hospital for just four days after giving birth,” says Jessica.

In 2016, Jessica and Jason were expecting their second child, however this pregnancy proved to be an even more difficult challenge.

During the pregnancy, Jessica had multiple seizures each day along with severe nausea. As a result, Jessica spent about six weeks in hospital until she gave birth to her second daughter, Emily.

 “Generally seizures don’t affect the baby unless the patient is seizing for a long time, then it could impact the oxygen supply.   During a seizure the uterine muscles are not affected, as seizures affect the skeletal or voluntary muscles, not the ‘smooth’  muscles,” says Dr. Schmidt.

“For Jessica it was an issue of frequency and intensity of the seizures and the concern was not for the baby but worry for the mom, as she could perhaps hurt herself through a fall. The hospitalization allowed for configuring and adjusting her medications, monitoring to see if we could reduce the frequency and severity of her seizure activity.”

For Dr. Schmidt it also comes down to reducing any additional stress for his high risk patients. “The best scenario for a happy and healthy pregnancy is a happy and healthy mom,” he says.

Says Jessica, “The hospital first saved my life and then it helped me give birth to my babies. It all turned out well. They put me back together.”

 

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