Thursday, May 2, 2013

Birth Records Update

Ever since Allie was diagnosed, we have been trying to get and look through her birth records to see if there was any indication that she had a stroke.  Well, we are now a year and a half post-diagnosis and her doctors have finally received the records and trudged through all 500 pages of them.

Her neurologist says that a couple things caught her eye but that nothing was obviously "wrong" (her quotes, not mine).  Here are a few of the highlights:
  • Vacuum extractions (Allie had two attempted vacuums to try to get her out):  Her neurologist said that "vacuum extractions increase the risk of complications but there are lots of vacuum extractions that go perfectly well."  From what I've read, vacuum extractions can often lead to brain bleeds, which can cause cerebral palsy.  But, Allie had a clot and not a bleed. 
  • Transverse position  (Allie was a little crooked and they hoped that she would straighten out during labor):  The neurologist thinks that it is "a little curious" that they attempted a vaginal delivery but she's "not sure that she can make that a cause in anyway".
  • Fetal heart rate changes (Allie's heart rate would change during contractions but they had me lay on my side and that seemed to resolve the issue).  The neurologist notes that "fetal heart rate changes can be a sign of distress but what is written here is pretty mild as far as heart rate changes go."
  • True knot in Allie's umbilical cord (Allie's cord was tied in a figure eight true knot, which could have easily killed her on its own by tightening and cutting off oxygen.  Oxygen deprivation can also cause cerebral palsy.  But, Allie's oxygen was not cut off, it was just that one stupid clot):  The neurologist notes that the "true knot in the cord in curious but again I can't make that the cause."
Figure Eight Knot

The neurologist said that there is not "a smoking gun" in the birth records to indicate a cause.  She wishes that Allie's placenta was sent to pathology to see if there was any indication of blood clots or damage, but hospitals usually only do that if something is obviously wrong.

It seems to me like there are potential causes for any other origin of CP (bleed, oxygen deprivation), just not the one she has (clot).

We also sent the full birth records to the OB/GYN that followed us throughout the pregnancy but did not actually deliver Allie.  She said that she doesn't see anything out of the ordinary but that what she has read about cerebral artery infarts (aka, blood clots that block oxygen to the brain) indicates that there aren't much data on risk factors other than clotting disorders (which Allie and I have not tested positive for) and random chance.  She said that she will keep looking into the issue but she can't identify any real risk of it happening again if we decide to have another kid.  She suggests that if I get pregnant again, I take a low-dose aspirin to lower my clotting risk.  

So, a year and a half wait, a couple hundred dollars for the birth records, and a whole lot of hassle ended up telling us very little.  Still, it makes me feel better knowing that we've looked into it and that Allie seemed as healthy to everyone else as she did to us when she was born.

Cue the self-satisfied face for trying...

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