Like the movie Gaslight, where a husband slowly manipulates his wife into believing that she is descending into insanity, Shanley Peterson could not convince her obstetricians that something was terribly amiss during the second trimester of her first pregnancy.
The story began when Shanley and her husband, Mark, attempted in vitro fertilization (IVF) in Palm Springs five years ago.
“My first doctors made me feel like I was too old at 44 and would never be successful,” says Shanley, “It was demoralizing.”
After a period of joy, profound sadness
They then traveled to Las Vegas, where, after three tries, they managed to get eggs to transfer successfully in September 2020, at the height of the Covid pandemic. After conceiving, Shanley returned to Palm Springs, where she saw a high-risk doctor once a month. “But there was nothing abnormal about my pregnancy,” says Shanley.
However, her blood pressure soared near the end of April as her hands and feet experienced swelling. “I was unsettled because my blood pressure was on the cusp of preeclampsia (range: 140-160 diastolic),” she reported, but several doctors said it was simply the heat and sent her on her way. “But I didn’t feel right.”
One May evening, she drove herself to the emergency room. “I had a scary amount of blood loss,” she remembers, adding that she had gone to the hospital earlier that day with vaginal bleeding and had been sent home after some cursory tests. “I knew as I was driving there something was wrong,” she says. “I didn’t know if my baby was alive. I felt like I was in the Twilight Zone.”
Her worst fears were realized almost immediately when an ultrasound showed a stillbirth. Her daughter had died at a gestational age of 36 weeks (in the third trimester).
The cause was severe placental abruption, where the placental tissue detaches from the uterine wall before childbirth.
How common is Placental Abruption?
Placental abruption, also known as abruptio placentae, is a relatively uncommon (0.5% to 1% of pregnancies) but a very serious complication of pregnancy. It occurs when the placenta detaches from the uterine wall before delivery, either partially or completely. This condition can lead to significant risks for both the mother and the baby, including severe bleeding, preterm birth, and, in severe cases, stillbirth. Placental abruption is related to about 1 in 10 premature births.
Women with this condition are at risk for a massive, life-threatening hemorrhage during delivery. This can occur partially or entirely and may lead to pregnancy complications. “My elevated blood pressure was an indicator the baby was demanding more from my body,” says Shanley, an editor for a pharmaceutical ad agency. “I was trying to make sense out of something that didn’t make sense.”
What causes Placental Abruption?
Risks of placental abruption include:
- Smoking
- Cocaine use
- High blood pressure (hypertension, pre-eclampsia)
- Advanced maternal age
- Fetal heart rate abnormalities
- Previous incidences of placental abruption
- Premature rupture of membranes (your water breaks before the fetus is full term) or losing too much amniotic fluid
- Thrombophilia (a blood clotting disorder)
Discovering how the placenta works
After the tragedy of stillbirth, Shanley discovered she also had adenomyosis placenta, a condition where the placenta can’t grow and attach to the uterus from the onset of pregnancy.
She spent the next six months recovering from her ordeal. Then, it took another two years to have a second successful embryo transfer.
A detail-oriented woman, Shanley typed up the sequence of events that led to her stillbirth. “I had been trying to piece together what happened,” she says. “I just wanted to understand better what might have gone wrong.”
Shanley finds insight and help from the Star Legacy Foundation
She gained valuable insight with the Star Legacy Foundation, an organization dedicated to reducing pregnancy loss and neonatal death by improving care for families who experience such tragedies. Shanley benefited greatly from the Foundation’s online support groups.
The Foundation pushes for greater awareness and vigilance regarding the placenta’s importance. “It’s a very misunderstood organ despite its importance,” says Shanley.
Through the group, Shanley learned about the important work of Dr. Harvey Kliman, a researcher and physician known for his work in reproductive and placental biology and genetic abnormalities of the placenta. He is associated with Yale University and has contributed significantly to understanding placental function and pathology.
Working with his father, mathematician Merwin Kliman, Dr. Kliman developed the estimated placental volume (EPV) calculator. It uses three measurements collected from a 2-D prenatal ultrasound: the placenta’s width, height, and thickness.
Shanley meets placenta expert Dr. Rad
When a woman from her group recommended taking advantage of Dr. Steve Rad’s expertise, Shanley reached out to him. “Dr. Rad was disappointed with the health care I had received, and my being brushed off and downplayed,” she says. “It was so nice to meet a high-risk doctor who liked to listen and understood what I had gone through.”
An extra benefit was that Dr. Rad and Dr. Kliman both championed the importance of placental measurement. After Shanley asked Dr. Rad what he would have done differently from her previous doctors, she knew she’d finally found the right physician. “He said my placental volume should have been monitored. As soon as he said that, I thought, this is the doctor I need to see.”
Call (844) 473-6100 or click here to schedule online
Dr. Rad and his team guide Shanley through her second pregnancy
Understandably traumatized by her stillbirth experience, Shanley needed reassurance during her subsequent pregnancy. “Dr. Rad said if I can get through the first ten weeks of my pregnancy, he would get me the rest of the way,” she says. “Having a doctor that could get me through my pregnancy was critically important to me.”
Patients benefit from Dr. Rad’s upbeat outlook. “I always have a positive attitude and strive to make my patients feel as comfortable as possible, even if they are in danger,” explains Dr. Rad. “I was pleased that in this pregnancy, Shanley’s initial checkups indicated a healthy placenta, which is crucial for fetal development.”
After driving two hours from Palm Springs to Beverly Hills several times, Shanley temporarily relocated to Los Angeles to be as close as possible for the last two-thirds of her pregnancy. “It made me feel a lot more at ease,” she says.
During her 37 weeks of pregnancy, Shanley saw Dr. Rad weekly. “Comfort is a big part of his practice. I texted with him all the time,” she says. “I felt supported knowing that he and his team were at the ready and would see me whenever I needed it.”
And let there be life!
Though many women with placental conditions require a cesarean section (C-section), everyone’s attentiveness paid off perfectly when Liz, now five months, was born via a vaginal delivery during natural childbirth. “She is a very strong little soul,” gushes Shanley.
Shanley and her husband have the child they always wanted. “When I got to Dr. Rad, it felt like he had a sense of ownership in a successful outcome. He was invested in my healthy pregnancy,” she says. “His practice seems less clinical and more friendly. I felt like his whole team was invested in my success.”
Though Shanley still mourns her first baby, she has happily adjusted to life as a mom. “I don’t think we will ever be fully okay. I don’t think I can fully recover, but I am constantly improving,” says Shanley, who is now back at work. “I’m just thankful there are physicians like Dr. Rad.”
Why trust Dr. Rad with your high-risk placental pregnancy?
It is important to note that any pregnancy can become “high risk” and no pregnancies are ever classified as “no risk.” For example, many of the 26,000 annual stillbirths in the United States are preventable. A stillbirth is the death of a baby before the moment of birth. In most states, babies who are stillborn before 20 weeks of gestation are classified as miscarriages.
Expectant mothers worldwide are finding their way to Dr. Steve Rad’s Beverly Hills offices. Dr. Rad is recognized as one of the premier healthcare providers for high-risk pregnancy and maternal-fetal medicine.
A maternal-fetal medicine specialist (perinatologist) receives a traditional obstetrics and gynecology education but with an additional three years of training to treat medical complications and promote a healthy pregnancy.
Dr. Rad treats pregnant women with a full range of accurate diagnoses, including placenta accreta (adherent placenta), placenta increta, placenta percreta (invasive placenta), and placenta previa.
Call (844) 473-6100 or schedule your consultation online. We are currently accepting new patients.
Dr. Rad offers in-home prenatal care and a fly-in program for out-of-town and international patients. He travels to patients who need him throughout the U.S. and worldwide and offers virtual consultations.
Sources
Risk Factor Profiles of Placental Abruption in First and Second Pregnancies – Journal of Clinical Epidemiology
https://doi.org/10.1016/S0895-4356(99)00017-7
Pregnancy after orthotopic continent urinary diversion
https://europepmc.org/article/med/8211586
Racial and ethnic disparities in assisted reproductive technology outcomes in the United States
https://www.ncbi.nlm.nih.gov/pubmed/19081561
A review of disparities in access to infertility care and treatment outcomes
https://www.ncbi.nlm.nih.gov/pubmed/34980166
