The mother, aged 30, was ‘clinically dead’ for 45 minutes. When she woke up, she found out that she gave birth to triplets
When Marisa Christie arrived at the hospital for surgery to give birth to her three children, everything seemed to be going well. But soon after giving birth, something strange happened.
“The doctors had discharged all three (children). Actually, they were resting on my stomach to hold me with a rope,” Christie, 30, of Tombball, Texas, told TODAY.com. “My arms flew up, and that’s when my heart stopped.”
Christie had experienced amniotic fluid embolism (AFE), a rare, but often fatal, birth complication. Fortunately, the doctors quickly realized what was happening, and began to stabilize Christie. Nevertheless, he spent a week in a coma. When he woke up, he heard shocking news.
“My husband was like, ‘Hey, so we had kids. They’re healthy and beautiful,’” Christie recalls. “I was very scared. … How could I not remember having my children?”
Unexpected triplets and pregnancy complications
Marisa and Dillon Christie have a 4-year-old son and have been trying to have another child for almost two years. Finally, Christie talked to her doctors and started an ovulation trigger shot, which stimulates ovulation to help get pregnant.
She was happy when she got pregnant, but she got some unexpected news after her first ultrasound.
“They were like, ‘We’re sure it’s twins. There may be a hidden third,’” he says. “I was completely shocked.”
“She cried for most of that month” as the couple contemplated life with four children.
“I was like, ‘There’s no way we can do this physically,'” he says.
Soon, their anxiety turned to joy, although conceiving repeatedly was difficult at times. Christie felt tired all the time and felt “very sick” for the first five months. At the end of her pregnancy, she was tired of standing for too long.
Then, they learned that one of the triplets had a fraternal twin that never grew, and had to be operated on while still in the womb.
“Our baby C was sharing a sack with a twin, but that twin didn’t get a heartbeat,” explained Christie. “That (twin) was still bleeding.”
Doctors had to remove the remains because the reduced blood flow was “putting a lot of stress on baby C’s heart.”
“That was a little scary,” Christie said.
On August 21, at 33 weeks pregnant, Marisa and Dillion Christie arrived at Memorial Medical Hermann in Houston for a scheduled C-section. Her OB-GYN, Dr. Amber Samuel, gave birth to three children successfully. However, as they rest in Christie, Dr. Ricardo Mora, an anesthesiologist, realized that he was in a seizure.
“He was really gray,” Mora, an anesthesiologist who works with Memorial Hermann at The Woodlands Medical Center, told TODAY.com. “I knew something bad had just happened.”
About 15 years ago, Mora was the anesthesiologist during a delivery where the mother suffered an amniotic fluid embolism, basically a severe reaction to the amniotic fluid after giving birth. Immediately, he knew Christie was facing a similar emergency.
“It’s really a tragedy. When it happens, about 80%, 85% die,” said Mora. “I asked Dr. Samuel, what did you do? He told me that he had just started to deliver the placenta and that’s usually the time when this happens – the separation of the placenta from the uterus.”
Mora called code blue because he knew they needed help and medical personnel rushed to the room. The situation was difficult.
“He wasn’t breathing,” Mora said. “We started CPR because he didn’t have a pulse.”
Mora and his colleagues performed CPR while he was bleeding. The doctors kept changing her blood, while Samuel tried to stop the bleeding by closing the uterus.
Meanwhile, Dr. Stephen Maniscalco, a cardiovascular surgeon, prepared to put Christie on ECMO, a machine that works for the heart and lungs to help the body recover. About an hour after her heart stopped, ECMO was pumping Christie’s blood.
“He actually lost what we consider to be his entire blood volume,” Mora said. “We changed his blood volume. So, for 45 minutes, he was dead.”
While Christie was in the intensive care unit after being stabilized on ECMO, she started bleeding again, and Samuel took Christie back to the operating room.
“Anything that’s bleeding is bleeding because you don’t have normal clots,” Samuel, who is also a pediatric obstetrician at Memorial Hermann in the Woodlands Medical Center, told TODAY.com.
Samuel tried drugs and devices to encourage the uterus to “hold down” and stop bleeding. But nothing worked and Christie felt uncontrollable bleeding from her uterus.
“We tried to revive her and prevent her from removing the uterus,” said Samuel. “Going into (him) was very dangerous.”
However, they eventually need to remove the uterus. To help her recover, the doctors left the incision open so they wouldn’t have to do a subsequent operation.
“There are very small blood vessels that in normal conditions just clot and stop bleeding on their own,” said Samuel. But in patients with amniotic fluid embolism, “if you close that, what inevitably happens is (the blood vessels) dump a lot of blood into that space, and cause it to open up again.”
Amniotic fluid embolism
Amniotic fluid embolism is “a very rare event.”
“The chances of this happening to any mother who might be reading this are very small,” said Samuel.
However, doctors are still not sure what causes it, although multiple pregnancies are a risk factor.
“It’s like being struck by lightning,” Samuel. “Unfortunately, it happens sometimes to some people. I probably won’t go to the same people again if they survive.”
As uncommon as they are, doctors know they are a life-threatening emergency and many hospitals prepare to deal with them if possible, he adds.
Amniotic fluid embolism occurs when something from the fetus passes from the fetus’s veins into the mother’s circulation, Samuel said. In the past, doctors have thought that tissue gets into the mother’s lungs, causing an embolism or blockage that affects the normal functioning of the heart and lungs by blocking blood circulation.
“Recent research shows that what happens is a type of anaphylactoid – which means an allergic reaction but not – to certain proteins that mothers are exposed to that causes a lot of problems,” said Samuel.
The body responds by cutting off blood flow.
“It’s something called DIC, or disseminated intravascular coagulation,” Samuel said. He quickly forms a lot of blood clots, but he also starts bleeding everywhere.
This makes treatment challenging for doctors. Clots can cause further blockages, making it harder for organs to function properly, and blood loss means patients need constant transfusions.
“All parts of the body fail quickly, so you need people to take care of all parts of the body,” said Samuel. “Having access to blood products, access to ECMO, which Marisa continues to have, those things are essential to survival.”
‘Stronger and stronger’
For a week, Christie remained in a coma while sleeping and on ECMO. Mora visited him regularly, hoping to see signs of improvement.
“You can do the best CPR in the world, but if you don’t get enough blood to the brain, they’re actually alive but with brain damage,” he said. “I needed him to live to raise his children. So, it was a personal thing for me.”
After a few days, Mora noticed that Christie opened her eyes and seemed to hear people talking around her. These signs gave him hope. After she was weaned off the ventilator and ECMO, he spoke to her, relieved at the way she was doing.
“In fact, he got stronger and stronger,” he says.
Christie felt confused and thought she was having vivid dreams that she had during her pregnancy when she first woke up. After realizing that she had given birth to her three children, she felt the pain of an open wound, which made her realize that being in the hospital was real.
He says: “It hurts me, I feel like this is not true. “That’s the first coherent thought I remember having.”
The three girls were “perfectly healthy” but stayed in the intensive care unit to gain weight and learn to eat. When Christine first met babies Charlotte, Kendall and Collins, it felt “very surreal.”
“I remember thinking, ‘I don’t know these kids. This is very strange. They feel like they’re not real. They feel like they don’t belong,’” he says. “They were already more than a week old when I met them. … It took a while to find that connection with them. “
But the children knew him. Staff put baby clothes on Christie while she was in the ICU, then wrapped the babies in them so they would know what their mother smelled like. Christie also made skin to skin with them while she was unconscious.
He says: “They saw that I was their mother. “They answer me when I talk to them unlike other people.”
When Christie returned home, she still had an open wound. Fortunately, he was able to rest at home for a week before the eldest child, Charlotte, came home – the first of three.
“Actually, I was living on a bed in our living room because I couldn’t stand up and move.” I had a puncture wound,” he said. “My heart has completely disappeared. So, it was really hard for me to move.”
Kendall and Collins followed Charlotte, who is already showing the strength of the eldest daughter and is the “leader” at home. Leaving the children at the hospital one after the other helped Christie adjust to life with a toddler and multiple babies.
He says: “That was a blessing that I did not see.
Nine weeks after giving birth, her wound finally healed. Coping with a health problem has been difficult.
“I feel very disconnected from whoever (I) was before,” Christie said. “I have become stronger, but I have also changed a lot because going through a painful situation like that changes the way you look at things.”
Christie is sharing her story to raise awareness of amniotic fluid embolism and give others hope.
“It’s rare, but it does happen,” he says. “There are many miracles that led me to live instead of dying and we are grateful.”
This article was originally published on TODAY.com
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