Jill Young knew nothing about the pregnancy related condition, preeclampsia, until three years ago when her daughter Cara Kernohan died from a severe form of it.
“On Saturday evening, Sept. 30 2017, our lives changed forever.”
Cara was only 29 years old and 35 weeks pregnant.
She too had never heard of the disorder, that affects about one in 20 pregnancies and is characterized by high blood pressure after 20 weeks gestation.
Symptoms of preeclampsia can include rapid weight gain, severe swelling, headaches and blurred vision. They can appear suddenly and escalate quickly.
“Her blood pressure, they couldn’t even get a reading because she was failing and in so much pain,” said Jill, remembering the night Cara was rushed to the hospital after experiencing what felt like severe indigestion and vomiting.
“She was in excruciating pain.”
Cara went into cardiac arrest and within 14 minutes of arriving at the hospital was nearly dead. Doctors kept her on life support and were able to deliver her baby: a girl named Blakely.
“She’s a miracle. How she even survived that with everything that was going on in Cara’s body so quickly, she shouldn’t have survived,” Jill said.
“This little girl is just something else and it’s just so sad her mom never met her.
“She was so looking forward to having this little girl.”
Cara was kept alive for five more days. It was determined she had suffered a liver bleed, many brain bleeds, and that a bleed in the stem of her brain was inoperable. Cara’s cause of death was listed as cardiorespiratory failure, secondary to a hemorrhagic stroke as a result of preeclampsia.
Young believes there is a widespread and general lack of knowledge about preeclampsia among everyone from pregnant women to doctors, nurses and other healthcare professionals. She believes that with more knowledge and awareness, Cara’s death might have been prevented.
“This was a senseless — very senseless — loss,” said Jill, who now spends her time raising funds and awareness for preeclampsia and is getting some help from Calgary’s medical community.
Led by Calgary doctor Jo-Ann Johnson and backed by private donations, the Implementation of Preeclampsia Screening and Prevention Study is currently being conducted at an EFW Radiology clinic, where patients between 11 and 14 weeks of pregnancy are being screened for preeclampsia during their regular first trimester screening (FTS) appointment.
“We can’t bring her daughter back but we can certainly do all we can to ensure at least, in our hands, that we decrease the chance of this happening again.”
Johnson is a professor at the University of Calgary in the department of Obstetrics and Gynecology Section of Maternal Fetal Medicine.
Along with Johnson, the study is being carried out and monitored by a team of multi-disciplinary healthcare experts to help determine if the additional early screening for preeclampsia is feasible.
Using an evidence-based screening test, a woman’s medical history is collected, her blood pressure is recorded twice in each arm, blood flow to the uterus and a substance called placental growth factor are also measured.
“When you enter all these variables into a risk algorithm developed in the UK, it will determine a risk… of preeclampsia,” said Johnson.
“Our pilot has shown it (the testing) is very feasible to add these four additional parameters on to their existing visit with minimal additional time and hopefully a lot of benefit.”
Research has already shown there is a lot of benefit to the early screening.
With no definitive cause of preeclampsia, and delivery the only known cure, patients determined early on to be at an increased risk of developing the condition can reduce their chances of getting it by up to 80 per cent by regularly taking one of the most common over-the-counter-medications available.
“If you initiate low dose aspirin before 16 weeks of pregnancy, you can impact by preventing a significant proportion of the most severe forms of preeclampsia,” said Johnson, pointing to medical research published the same year Jill lost her daughter.
“A large New England Journal article in 2017 showed that (aspirin) would reduce your chance of preterm preeclampsia by up to 80 to 90 per cent of less than 32 weeks, up to 60 to 70 per cent, less than 37 weeks.
“So the final sort of synthesis is that if you treat the right women at the right time, with the right dose, you have a significant chance of impacting on the frequency — particularly this early — most severe form (of Preeclampsia) and the most severe form accounts for the vast majority of maternal and neonatal morbidity and mortality.”
“Can you imagine that? Doesn’t that make you want to punch the wall?” Jill said.
“Yeah, a baby aspirin per night could have saved her life if we would have known this.”