Josh McMahon

Zoe Eagleton’s first ever pregnancy was going so well she would joke with her husband Alwyn about how easy it had been. The Maclean couple was happy and excited.
Even when Zoe was told at 36 weeks she may have pre-eclampsia, she wasn’t overly concerned. Labetalol was prescribed to treat high blood pressure, the main symptom, and with just a few weeks to go before the birth the couple was confident everything would be fine. After all, they were aware of any potential risks – Alwyn was a registered nurse.
The next day, a follow-up urine test detected protein in Zoe’s urine, confirming the doctor’s diagnosis. Bed rest was added to the doctor’s orders.
“I was pretty cool, I had only three weeks to go and was okay with the fact I had pre-eclampsia. I wouldn’t have expected what happened in the next 48 hours,” Zoe said.
Later that afternoon Zoe was told to come to the Grafton hospital the next morning for more tests, and was told to bring a bag as it could be a long day. Little did she know what was in store.
“On arrival at the hospital on Saturday they had me in a room at 8am and by 8:15am the obstetrician was talking with us and ordering blood tests, Doppler monitoring and an ultrasound. They put me on the CTG monitor, to check my baby’s heart rate and movements,” Zoe recalled.
“The midwife didn’t seem concerned, and neither was I, telling me it all looked good on paper. Blood was taken and then in the afternoon I was taken to radiology for my ultrasound. I left Alwyn in my room as we expected the ultrasound to be quite quick like they usually were.
Turns out I knew the ultrasonographer and we chatted away jovially while he did his thing.
“He went quiet all of a sudden and had a look of concern on his face. He said whilst the gestation of 36 plus 6 was correct his measurements were showing that bub was the size of a 32 week foetus.”
Not quite able to comprehend what was going on, Zoe ‘turned to a pile of jelly’. She was taken back to her room, and a short time later the obstetrician – Dr Arvind Dougall – returned to tell the couple they had two options: deliver the baby by caesarian or to be induced. Bub had to come out as the placenta was no longer feeding him.
“By this stage I was totally thrown, my birth plan didn’t include any of this,” Zoe said.
After discussing their options, it was decided to deliver bub by caesarian. A family visit helped Zoe to feel a little calmer, and Alwyn went home to get some sleep knowing the next day could be a big one.
Zoe phoned him at 8pm to say goodnight, neither of them expecting what was about to happen.
“At 9pm I knew something wasn’t right, the pain in my chest felt like my heart was going to explode. I pressed my buzzer. The nurse thought it may be Braxton hicks so went to get a heat pack and some antacid to rule out reflux also. The pain amped up even more so I hit my buzzer again, this time I think they could see it was serious,” Zoe said.
“They quickly moved me to the acute room to be monitored while they tracked down the obstetrician. They tell me my body was moving as if I was having seizures and I was quite delirious asking for my husband.”
Dr Dougall appeared and announced an emergency caesar would be carried out immediately. Alwyn was called, and he rushed to Grafton from Maclean to be at his wife’s side.
Zoe was rushed to theatre, just as Alwyn arrived. He scrubbed up, ready to enter theatre with Zoe.
“Something must have went pear shaped quickly as he was then told to stop, he could no longer come in that I had to go under general anaesthesia. I can still remember every little detail of what was being done to me before they knocked me out. Whilst it was all very quick the playback in my head is all in slow motion now. People say I will eventually forget the details but I honestly don’t think I will,” she said.
At 11:42pm Harrison was born weighing four pounds two ounces. Artificial respiration kept him breathing for the first seven minutes, before he gained the ability to do so for himself.
Zoe came out of post-op at about 3:30am where hospital staff wheeled her bed to the special care nursery to see Harrison and have some skin contact with him. To her frustration, Zoe struggles to remember this, and only has photos to recall the special moment.
Alwyn then went home yet again as Zoe was taken back to her room for monitoring, with Harrison staying in the nursery.
This is when things continued to get worse for Zoe.
“Over the next nine days my body deteriorated even more, leaving me weak, breathless and very pale,” she said.
“My obstetrician advised that I had developed HELLP Syndrome. My red cell count dropped to 2.15 (should be between 3.80-5.20) and my platelets had dropped to 43 (should be between 150-400). The headaches and dizziness were that bad I had to send Harrison back to the nursery to be cared for as I couldn’t trust myself to be fine. I was so emotional and disengaged from everything and everyone.”
Magnesium sulphate helped stop seizures, and Klexane thinned Zoe’s blood to prevent clots. OxyContin was used to control her severe pain, and ongoing high blood pressure required continued Labetalol. Zoe also had several blood transfusions.
Her physical health improved, and Zoe and baby were discharged from hospital 10 days later. In appreciation of the life-saving work of the obstetrician, little Harrison took on the middle name ‘Dougall’.

Harrison Dougall Eagleton is now five months old, weighs 12 pounds, and is hitting all his important developmental milestones.
Zoe, however, is experiencing ongoing impacts from her traumatic experience. She has been diagnosed with post-natal depression, as well as post-traumatic stress disorder.
You wouldn’t guess it by her cheerful face and ability to work full-time, but inside she is suffering.
“While I look happy, I do put a face on – you don’t see past that. Only hubby gets to see that,” she said.
“But when I was sitting on the flood at home bawling my eyes out for no apparent reason, I realised it was not just baby blues.”
Zoe has been taking medication to help treat her depression, and has plucked up the courage to begin counselling.
She hopes one day to be able to have another child.
“I would love another child, physically I will be ready in 12 months, but it is going to be a long time before, mentally, I am prepared to take the risk and have another child,” she said.
“Hopefully one day I will come to accept what happened and stop blaming myself, and find the courage to go on to have another child in hope that HELLP does not strike again.”
She said she wanted to share her experience to raise awareness of HELLP Syndrome and post-natal depression, and let others know they are not alone.

What is HELLP Syndrome?

HELLP syndrome is a life-threatening pregnancy complication usually considered to be a variant of pre-eclampsia. Both conditions usually occur during the later stages of pregnancy, or sometimes after childbirth.
HELLP syndrome was named by Dr. Louis Weinstein in 1982 after its characteristics:
H (hemolysis, which is the breaking down of red blood cells), EL (elevated liver enzymes), and LP (low platelet count).
A suspicion of HELLP syndrome can be frustrating to the physician when all requirements for its certain diagnosis are not apparent. In some patients who are developing HELLP syndrome the primary pre-eclampsia indicators of high blood pressure and protein in the urine may not be present, and its symptoms can be mistaken for gastritis, flu, acute hepatitis, gall bladder disease, or other conditions. While some of these other conditions may also be present, there is no evidence they are related.
Symptoms may include headache; nausea/vomiting/indigestion with pain after eating; epigastric (abdominal) or sub-sternal (chest) tenderness and right upper quadrant pain (from liver distension); shoulder pain or pain when breathing deeply; bleeding; visual disturbances; swelling.
Early diagnosis is critical because the morbidity and mortality rates associated with the syndrome have been reported to be as high as 25 per cent. As a result, patient awareness of HELLP syndrome, and how it relates to pre-eclampsia, is helpful to ensure optimal and timely medical care for mother and baby. For more information visit www.preeclampsia.org

Symptoms of Postnatal Depression

The severity of PND depends on the number of symptoms, their intensity and the extent to which they interfere with normal functioning. PND tends to be characterised by a combination of the following symptoms. The combination and severity of symptoms will be different for every woman, resulting in many different appearances of PND.
• Sleep disturbance unrelated to baby’s
sleep needs
• Appetite disturbance
• Crying or not being able to cry
• Inability to cope
• Irritability
• Anxiety
• Negative, morbid or obsessive thoughts
• Fear of being alone or fear of being with
others
• Memory difficulties and loss of concentration
• Feeling guilty and inadequate
• Loss of confidence and self-esteem
• Thoughts of harm to self, baby or suicide
Some women sum it all up by saying
“There is no joy in anything anymore”,
and “I feel like I have lost myself”.
For more, visit www.panda.org.au