Last night was a night for fetal cardiac anomalies. Both of my patients were having babies that had multiple cardiac anomalies, in differing severities. One woman birthed her baby (sans epidural), and baby was actually doing very well immediately after birth. Sats from mid 80's to upper 90's - which was exceedingly well, considering that her anomalies included the need to keep her ductus arteriosis patent, which results in mixed blood flow through her heart (and would make her look purple as a normal side effect, with sats in the 80's). She was set to be flown out this morning to a higher level center for immediate cardiac surgery today. I really hope she does well.
Her cardiac anomalies were confirmed last night after birth, and are the kind of issues that will lead to multiple correct heart surgeries down the line, or even a heart transplant. I looked at her chest in the NICU, and thought to myself, this child is going to very soon have a huge incision right there. This is one of the few times the parents are going to see intact skin on her chest. It's just strange, what things pop in my head. Mom and dad had excellent bonding time immediately after birth, thanks to how stable the baby was, and they were extremely grateful for that time. I also was able to get them into the NICU for some more skin-to-skin bonding time, and it was just beautiful! I had tears in my eyes!!
My other woman I was caring for was in for PPROM, and was only 33 weeks. We're trying to keep her pregnant as long as we can, to give her baby the best chance of survival. Her baby also has complex fetal cardiac anomalies, and will need multiple surgeries to correct them. My heart just aches for them, as they lost a preterm baby before birth already. They have no living children at home - just heartbreak after heartbreak. The good news is that when I left, she was still very stable, and very pregnant. Fingers crossed that the good luck continues.