After a very difficult pregnancy comes the unexpected Mother’s Day

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Maria Gelastopoulos did not expect to become a mother on this Mother’s Day. But a difficult pregnancy – one that included seven blood transfusions and a three-week hospital stay – brought her daughter Athena into her arms 10 weeks ahead of May 28.

Now, weighing just over six pounds, with black hair, she is ready to deliver on Sunday a bouquet of disarming smiles, a few kicks and a wave of her arms for variety as families gather to honor all who brought life to the world.

The arrival of Athena is her own timely tribute. Her middle name is Eleni in memory of her great-grandmother Elena Karis, who died six years ago, right after Mother’s Day. According to her, through the hardships of a difficult pregnancy she felt the presence of her grandmother.

“We had problems with pregnancy, so from the beginning it was our miracle, and with what we went through, we’re both here, so someone was watching us closely,” said Maria, gently stroking her daughter’s breasts next to her husband Gaudensio. . Mendoza Suarez, at the couple’s apartment in North Park this week.

When they settle into life as new parents, the couple can’t help but recognize how close they are to the tragedy.

Previously diagnosed with type 1 diabetes, Maria was enrolled in a high-risk pregnancy program at Scripps Health when her blood pressure jumped in the second trimester. Her condition gradually deteriorated, leading to preventive hospitalization before her medical team called a 30-week delivery with Athena, who was born March 20 weighing two pounds nine ounces.

Complications she experienced during her pregnancy, which have not yet been fully elucidated, included massive edema that caused rapid weight gain of more than 40 pounds, starting in the lower body and moving to the lungs and heart, disrupting her circulation and respiration. .

“It was hard to breathe and I was given oxygen; they said I was very close to heart failure, ”Maria said.

Intensive care, which lasted as long as two weeks after delivery, eventually turned the situation around, but not without interdisciplinary efforts that included specialists in cardiology, nephrology, endocrinology, and neonatology.

While her example is extreme, Mary’s situation is becoming more frequent. Insurers Blue Cross and Blue Shield analyzed claims of 1.8 million women who gave birth between 2014 and 2018 found that complications during pregnancy increased by more than 16 percent in two years. According to the Blue Cross-Blue Shield analysis, postpartum depression, a condition that can cause hopelessness in women after childbirth, also increased when in 2018 almost every 10 mothers were diagnosed.

As with other medical problems, the risk of postpartum depression increases if early symptoms of distress, such as anxiety, are not treated.

A career in working with women at high-risk pregnancies has led Dr. Shahram Daneshmand, medical director of the Mother and Fetal Medicine Program at Scripps Clinic, to feel that more can and should be done to try to prevent poor outcomes in difficult pregnancies. The group, which monitors childbirth at all four Scripps hospitals, recently took concrete action by hiring its first manager who specializes in complex pregnancies. Although for most of Mary’s pregnancy this position has not yet been used, she is expected to help in similar situations.

If multiple specialties are involved, Daneshmand said, patients can quickly become overwhelmed. A huge number of medical appointments can lead to misunderstandings between patients and providers, as well as between one specialist and another. Transplant medicine, which typically covers many medical specialties, has long turned to nurses who act as care coordinators to make sure stress levels in patients don’t increase simply through the sheer amount of planning and follow-up that their treatment plans require.

“The idea is to have one person who really treats these complex patients around the clock,” Daneshmand said. “Yes, you can always send an email to your doctor if you have a question, but it’s not the same as having someone with whom you can talk regularly to answer any questions you have to make sure this person is guided by all the different paths you have to go through to ensure a healthy pregnancy. ”

Coordinators also have the time needed to screen expectant mothers for early signs of depression, referring those with difficulty to counselors for early therapy. Collaborating with a local nonprofit to quickly conduct these meetings without having to take a lot of time consent health insurance is in the works and should be announced in the middle of the month.

According to him, maintaining mental health should be more active during pregnancy to reduce postpartum depression.

“I honestly think this is one of the biggest areas where we are unfortunately failing,” Daneshmand said, looking at conditions across the country. “They talk about it, but they’re not always ready to do anything about it.”

But the need to do better, he added, goes beyond mental health and childbirth. Women who experience significant complications during pregnancy face a much worse chance of complications later in life. It has been shown that women who develop gestational diabetes before childbirth are 50 percent more likely to develop type 2 diabetes later in life. And those who have had premature births, as well as a complication of high blood pressure called preeclampsia, have a much higher risk of heart disease in the future.

The industry, Daneshmand said, is moving toward a “fourth trimester” model for women to make sure they get the next care they need after childbirth.

“We need to make sure we follow them more closely to make sure we are more preventive than reactionary,” he said.

Of course, on Mother’s Day these worries can be temporarily postponed to make a lot of room for celebration.

She doesn’t know it yet, but the Athena family is especially successful in helping families grow mimosas every other Sunday in May. Her grandfather, John Gelastopoulos, is the owner of Broken Yolk Cafe, a company that started serving breakfasts and lunches in Pacific Beach and which now has 34 locations across the country.

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