Never give up hope

It was an uncomplicated, easy pregnancy and at 23 weeks, Catherine Pate had left some of the pregnancy complaints behind. She was feeling strong, healthy and happy when she went in for the 23-week foetal assessment scan at Kingsbury’s Foetal Assessment Centre.

Everything changed that day when they saw that our baby had a massive heart abnormality. In fact, it was actually three different abnormalities all manifested at the same time and included: Transposition of the Great Vessels (where the two major vessels that carry blood away from the heart – the aorta and the pulmonary artery – are switched); Double Outlet Right Ventricle (DORV, where both the pulmonary artery and aorta come from the same pumping chamber and no arteries are connected to the left ventricle); and no separation between the ventricles on the left or right sides of the heart.

Many consultations with a cardiac specialist, foetal heart surgeon and psychologist (later) and we were advised that the best course of action would be to terminate the pregnancy. We were told that our baby girl had little to no chance of surviving once born and the chances of successful surgery and a good prognosis were very slim.

On 19 October we had a medical termination at 25 weeks and the following day I was induced and delivered a tiny stillborn baby girl. It was the hardest thing I, and my husband, have ever been through.

But we chose to try again. Luckily, I fell pregnant just a few months later and, after early monitoring of baby’s heart, was told that all was fine – our baby was absolutely healthy! Then at 19 weeks, I realised something was not right and went to our local hospital emergency room, where it was discovered that I had dilated and uterus was bulging through my cervix.

I was rushed in for an emergency cerclage (cervical stitch) which didn’t work and my water broke. We were devastated at the news and after a week of lying in hospital flat on my back hoping for the best, I delivered another stillborn baby girl at 20 weeks in April 2012.

I was subsequently diagnosed with an incompetent cervix and told we would need another cerclage placed early in the next pregnancy. I did loads of research and we were not happy with the stats for success. Some more research later and a consult with my doctor and we found a doctor at Tygerberg, (also a professor at Stellenbosch) who does what is called a Transabdominal Cerclage (TAC) – basically the stitch is placed inside your abdomen at the very top of the cervix.

“Everything changed that day when they saw that our baby had a massive heart abnormality.”

After an examination by Professor Hall, it was decided that I was a candidate for the procedure as my cervix was damaged with lots of scar tissue, possibly from a previous tear. After a year of trying to fall pregnant again, and then once pregnant, another stringent round of scans and tests to assess the baby’s health, at 14 weeks I went in for the procedure in Tygerberg.

The TAC involves the surgeon making an incision like they make for a caesarean; they then move the uterus (baby and all) out of the way before placing the stitch at the top where the cervix starts and the uterus ends. I spent a week in Tygerberg being monitored as the procedure is not without risks of infection, early labour and water rupturing. Thankfully, all went well and I went home with my “bionic cervix”, as they call them.

We were very lucky to find Professor Hall and for him to agree to do the TAC procedure. Other South African women have flown to the US to have it done, as it is very popular/common there to treat incompetent cervix – whereas in SA we tend to opt for the less successful TVC (vaginally placed cerclage).  I found a website called Abbyloopers which helped hugely as a means of support.

From there on out it was a high-risk pregnancy and I had to my regular OB-Gyn every two weeks. I suffered a fair amount of pain due to the operation and as my uterus stretched so too did the fresh scar tissue, which was very uncomfortable. The worst was probably the anxiety that something would go wrong again!

Thankfully I managed to carry our little boy to term and he was delivered via caesarean at 36 weeks. The caesarean was scheduled earlier so that I did not risk going into labour naturally, as this can cause tearing at the site of the stitch. Interestingly, the stitch stays in forever now unless I wanted to have it removed via another abdominal op – which I won’t be doing.

Our perseverance paid off. People asked us if we were mad trying again for a baby after everything we had been through, but when I look at our little miracle boy running around and feel the joy that he brings us I know I would do it all over again a thousand times!