# Autopsy findings.



## StarMama (Jun 25, 2002)

Ok, so if you don't want to wade through all of the stuff I'm gonna throw atcha here, the bottom line is my poor girl had a really not working well placenta in many ways.

Starting with my blood work. I likely have a Protein S Deficiency, which is a blood clotting disorder. I will have to retest in a few days, the levels can be skewed from the pregnancy because the levels are lower. But even for the lower level normal range in pregnancy mine was lower that that too. Treatment for a future pregnancy if this second blood test confirms the Protein S Deficiency would be anticoagulant therapy.

The bitty clots from the Protein S Deficiency was only a small part of the problem.

There were *SIX* problems with the placenta. I'll go over each one separately.

First, Fiona's umbilical cord was hypercoiled (which is a cord with more than 2 twists per 10cm of the cord... the oh 4 inches of cord left on her that pathologists counted 16 twists). This can be associated with several adverse fetal outcomes including growth restriction, intolerance of labor, and intrauterine demise.

Secondly, she also had a marginal cord insertion. Meaning the cord attached at the edge of the placenta.

Third, the placenta had this crazy sounding thing "patchy acute subchorionitis" which is a maternal inflammatory response to amniotic fluid infection (although I was told that the blood tests came up with no infection).

Fourth,the blood vessels had "fetal thrombotic vasculopathy" which I believe this refers to the actual blood clots in the villi (lots of itty bitty clots). The hypercoiled umbilical cord may have predisposed the fetal vessels to vasculopathy (a disorder of the blood vessels).

Fifth, there was "placental malperfusion" which means that the uterine vessels that went into the placenta were damaged.

Sixth, Chronic marginal abruptions. I think most know the term, but I was having mini hemorrhages because of peripheral placental separation.

My poor baby.

And can I tell you how fucking *creepy* that I know now how much my daughter's BRAIN and HEART weighted and their color?! My I did say I wanted the reports, but you don't think of things like that.

But I've got some thoughts here about some things on the report. It says "...it may be related to clinical evidence of pregnancy-induced hypertension and gestational diabetes during this pregnancy." I had NEITHER of those conditions!

I spoke to my friend who used to work in a high risk ob office... she said that when they say clinical evidence they mean they are looking at everything that was wrong with the placenta and cord and from that making the jump to saying I had high blood pressure and high blood sugar that caused it.

So I could have been spiking both at times, but it still really is hard for me to understand how I could be spiking my blood pressure and never have it show up when they took my blood pressure. And how I could be spiking sugars when I took the GD test the day before and was golden.

Now I just feel guilty. I refused the GD test until the day before we discovered her heart had stopped, after I had the midwives and then we couldn't afford them I didn't make an appt for a prenatal with kaiser until like 6+ weeks later. So I would have had no way to know if my bp was spiking. I didn't know that gd could affect the placenta. I was just so petrified of kaiser after Orion's birth there.


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## SMR (Dec 21, 2004)

Wow, that is a lot of information to swallow. Big hugs to you guys! I still feel so torn about not having an autopsy done on Dresden.. I mostly feel like we just would have never known what happened. It seems like they are just grasping at straws on Fiona's results.. making guesses about what might have happened.. it's so hard to not know.. but you can NOT beat yourself up over the possiblity that you might have had GD or high blood pressure.. it doesn't help anything to make those asumptions. You are not to blame.. I had the GD tests, blood pressure readings every month and my baby died too.. after a perfectly lovely pregnancy. So many of us have the same story.


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## NullSet (Dec 19, 2004)

We all have those same feelings of guilt, when in reality we lived and did the best we knew for ourselves, our bodies and our babies.







I'm like SMR, had all the GD test and BP stuff and still my dd died. You just never know. I felt broken for a long time, like my body killed my baby.

I wish I could give you a hug right now.


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## mamacita angelica (Oct 6, 2006)

ah, starmama, we all make the best decisions we have with the information available to us. if you did the routine urine test every time you have a midwife appointment and you had GD, they would have seen protein in your urine, but you actually did have a good blood glucose level and normal blood pressures during testing, there would have been no way that anyone would have gone any further than they did. the report is simply saying that MAY be the reason, but it clearly isn't the reason, because you didn't have either of those conditions.

at any rate, smr is right. i got my blood pressure taken every appointment, did the glucose test...my daughter is still dead. and that is just it, at least for me, no matter what the reason for her death, my daughter is still dead. i'm waiting for the autopsy too. and i do want to know how to stop this from happening to my daughter some day, or to another baby if we decide to try again, but, i am at the point where i cannot think of everything i could have done, because simply, they weren't done.

you did the best you could for your baby, star mama. you were good mommy.


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## Fireflyforever (May 28, 2008)

Huge









What a lot to digest. I just wanted to echo the other mothers here. Please work through the guilt and let it go ... I have had to deal with the guilt feelings too, as I chose a vaginal birth over a repeat planned section and my daughter suffocated in my birth canal. I know how horrible the guilt feels when it sits in the pit of your stomach gnawing away at you.

But, mostly, I'm a peace that the choices we all made here, we made because we cared ... because giving birth, giving life to our babies mattered to us profoundly.

We all have "what ifs" but, without any scientific basis for this, I believe my daughter was with me for the amount of time she was supposed to be. I hate that so much but it means that I do believe different choices would not have changed the outcome ... and I glean peace acceptance from that.

I've read your posts and seen your beautiful pictures .... you are a wonderful mama to Fiona Star.


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## Vespertina (Sep 30, 2006)

Please don't feel guilty, mama.









That definitely is a lot to take in. As for the glucose intolerance of pregnancy, complete BS. I think many times they pull that card when there's nothing else that leads to the cause of death. Glucose intolerance of pregnancy doesn't cause stillbirth. Long standing and uncontrolled diabetes puts a mom and baby at risk for a variety of problems. Just having elevated blood glucose levels won't cause any problems.

I ran into some problems with the whole "GD" issue when we went to the hospital for confirmation. The OB brought up "GD" as a possible cause of death and I can't say I was surprised. It was the one test they didn't have on file since I stopped dual after 25 weeks and just saw my CPM. I'm also fluffy so I'm sure they assumed that I have sugar problems due to my size.







She did a random blood draw and it came back normal. I never had elevated glucose in my previous pregnancies. All of the evidence we have contradicts the information that is still used and passed around as doctrine. I called maybe four days after having Duncan to find out about some of the blood work results and was told my A1c was normal, so I didn't have *real* diabetes. Glucose intolerance of pregnancy is not real diabetes and doesn't carry the same risks associated with either type 1 or 2. I contacted both Marsden Wagner and Henci Goer about glucose intolerance of pregnancy and they both confirmed what I already knew.

In our case the pathology results determined he had T21/Down Syndrome. So much for having diabetes like he initially said.


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## maylanna (Jul 22, 2006)

Sending healing to your heart and soul.


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## Milkymommi (Aug 29, 2003)

It seems that med professionals make alot of assumtions prematurely and without warrent. On my son's cert. of "fatal demise"... under the section that states "other contributing factors" my delivering Dr. wrote in Chronic Hypertension. Shocking considering there was absolutely NO WAY he could make that assumtion the day after my baby died. The cause of death was unknown and there was nothing indicating a reason for him to write that. But now it's there. And yes, I have chronic hypertension and I was treated through my pregnancy... and my baby still died. So, mama don't kill yourself emotionally with guilt because there's guilt on the other side of the fence too. Even if it WAS an issue for you in which you were unaware it doesn't mean treatment would've made things better. I was treated and had controlled pressures and they STILL threw the blame on me in that area.

We're all in the same boat. We all deal with different levels of guilt. It's just part of the package I guess. I can't say I'm not dealing with it myself because I am. Cognitively I know Im not to blame but I go in and out of heavy emotions of blame and searching for answers as do we all.

I'm so sorry







I hope this post made sense... I'm not too clear right now.


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## hollycat (Aug 13, 2008)

just sending love.


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## Cheshire (Dec 14, 2004)

I'm so sorry. Just know that women who are perfectly "healthy" have had the same issues happen in their pregnancy. It is just statistically more probable that having GD and hypertension can cause the same things. Sometimes they grasp at straws.

I had GD, perfectly controlled with diet. My doc should have caught the issues that caused my son's death. I had so many of the risk factors but she missed it. Even after mentioning it and that she would come back and check for it again she didn't. She and her team missed it over and over, sonogram after sonogram. I had a ton of them because of the GD, and we feel they just got in a hurry and didn't look as closely as they should have because I was a "model" patient.

As others have said, please don't blame yourself. We do the best we can with the knowledge we have at the time.

Hugs to you and your family.


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## jeliphish (Jul 18, 2007)

I'm so sorry....I simply cannot imagine what you have been through. Please do not blame yourself as you had no control over this whatsoever. Even IF you had high BP and GD (which you didn't) that within itself couldn't be to blame.
With all this info, will there be a different game plan for next pregnancy? Could an ultrasound map out the placenta early on so that you would know to be monitored more frequently? Or at least see that everything was fine so you wouldn't have to be as concerned about the placenta issues?


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## Amy&4girls (Oct 30, 2006)

I am so sorry. You and your family are in my thoughts.


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## mommaof5 (Sep 6, 2006)

My good friend has two living children but then lost two babies (separate pregnancies) late in pregnancy, they never knew why. Until they discovered that she too had the blood clotting disorder. They say that the blood clots in the cord and slowly kills the baby. The mother's health is usually not effected by the disorder. It was horrible to watch her go through her losses not knowing why. But since they discovered the disorder she has had a baby that is two now and is pregnant again. She takes shots everyday throughout her pregnancy. When I read your story I just thought I would give you some hope. It will be interesting to find out if all the cord problems came from the blood disorder? I am so sorry for your loss, nothing could be worse!


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## Cuddlebaby (Jan 14, 2003)

huge huge hugs to you. that IS a lot.....


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## Katana (Nov 16, 2002)

Just wanted to give you some


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## meredyth0315 (Aug 16, 2007)

Huge hugs to you mama







Don't blame yourself even if it feels like what you *should* do. Like everyone has said we make the best choices we can with what info we have. Fiona doesn't blame you, so neither should you


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