Warning: I'm venting about a fetal demise, my first, of a full-term, beautiful baby girl. Here goes the story...
Had a pt admitted to the hospital at 35+ weeks gestation for diabetic teaching and management of gestational diabetes, usual workup: NST, BPP c EFW... Neither she nor her husband speak English. G3P2. According to prenatal, had rec'd diabetic couseling as outpt since diagnosis with repeated notations of non-compliance with diet, refusal of insulin. I was her nurse that day. She showed up 6 hours late and, even though MD had told her to be prepared to spend at least 24 hours, up to 5 days as inpatient, had brought her two children and husband with her. She had never planned on staying even overnite, lied about her blood sugars, dietary intake... everything. She did have a reactive NST and 8/8 BPP. I heard the MD telling her that if she continued as she had been, the baby could very well die. She obviously didn't believe him. After the MD left, she was ready to walk out AMA. I, through a translator, asked her if she was prepared to trade her daughter's life for the inconvenience of staying for a few days in the hospital? She stayed overnite but walked out early the next a.m. before the MD returned.
Our hospital has started admitting scheduled C/S straight to pre-op holding (I won't even go into how we feel about that) and the OB nurse goes down, does FHTs by doppler just prior to delivery. She was sceduled for PC/S for breech presentation 37 wks gestation. So... down I go to pre-op with my trusty little doppler... can't find the tones... go get the MD... no tones... When was the last time she felt the baby move? "This morning." He asked her 4 times, in front of me, when she last felt the baby move... all 4 answers: "This morning." Stat US... dead baby. The decision is made to deliver by C/S. Out comes a beautiful, perfect baby girl, 9-10, no cord, no visible anomalies, not recently dead. The last NST c BPP had been a week before, reactive and 8/8. The MD had tears in his eyes and closeted himself in the dictation room for awhile by himself.
When she came up to the unit, I was passing in the hall. We made eye contact, briefly. I touched her arm, said "I'm sorry." She started sobbing. Daddy held his dead daughter briefly, Mom refused. I collected a lock of hair, took pictures and put together a bereavement package for the family. I don't know that I'll ever forget that baby's face.
I have mixed feelings toward the parents. They definitley were made aware of the risks of gestational diabetes and the possible outcomes. I'm angry that she could blithely lie, while looking so earnest, about her compliance with treatment. I'm sorry that they lost their daughter. I'm so very sorry that a baby girl died because Mom and Dad couldn't be convinced of their responsibility to their unborn child.
I think I'm done venting. Thanks for reading. Thoughts are welcome.
