A love story, an answered prayer and a sad ending

Sulemann* sat on the deck on a swing chair, lost in thought. It was a balmy Saturday afternoon in June and the coastal temperatures were a tad lower than usual.

His knee was drawn up to his chest while the other leg hung over the seat. His chin rested on his drawn knee and he stared into the distance at the rolling waves of the ocean, completely oblivious of the merry giggles all around.

Exactly one year ago, on this day, Sulemann went through the most tumultuous day of his life. The happiest day of his life turned into the most sorrowful experience.

Sulemann recalled the day he met Farhiya*. She stole his heart. His mother was in hospital while he was away at work. Farhiya was her primary nurse. He headed straight to the hospital from the airport, with a pack of his mother’s favourite chocolate. He had no idea his mother had just been diagnosed with diabetes. Farhiya gave him a look of utter disdain.

They got married a year later. However, despite their intense love, babies were not forthcoming. Farhiya suffered countless miscarriages, each time, fragmenting Sulemann’s heart to see his wife so devastated. He insisted that she quit her extremely demanding job and focus on herself.

When lady luck finally visited, the blessings came in doubles. Sulemann was head hunted for a better job, Farhiya’s father beat prostate cancer and the couple were pregnant again, only this time, they went past the dreaded week 27. As if that was not enough, they were expecting twins.

Calm before the storm

She stayed active, swam every day to keep fit, religiously took her medication.

Farhiya was scheduled for a caesarian section delivery at 38 weeks. She could not wait to meet her babies. Sulemann paced outside the operating room like a soldier on patrol. Seeing his babies in the incubator being wheeled to the newborn unit was overwhelming. Zohra* and Habib* were finally here.

An hour later, he was called to see his wife. The surgery had ended well and she was at the post-anesthesia care unit being monitored. The two shed tears of joy as Sulemann showed Farhiya pictures of the healthy twins.

This was the calm before the storm.

One minute Farhiya appeared drowsy and the next, she was having a full blown cardiac arrest. Things went south rapidly and Sulemann was ushered out of the unit as the curtains were drawn behind a battery of doctors and nurses. Within 25 minutes, Farhiya was in the intensive care unit fighting for dear life.

She went into post-partum haemorrhage. She had developed a complication called disseminated intravascular coagulation and her blood was unable to clot.

The next 36 hours were the longest in Sulemann’s life. Doctors and nurses fought to save her life. She was taken back to surgery to remove her uterus with the hope of stopping the bleeding but it did not. She received 17 units of blood and blood products but her body just would not reset. It was nerve-wracking for the whole family as they kept vigil outside the ICU and prayed.

Brain dead

Eventually Farhiya’s obstetrician spoke the dreaded words. It was time for the family conference. Sulemann knew exactly what that meant. There was little hope of Farhiya. She was already brain dead. It was time to say goodbye and release her to rest.

Despite the obstetrician being convinced of the cause of death, he recommended that a postmortem be done, to eliminate any doubt. Farhiya had suffered a very rare pregnancy complication known as amniotic fluid embolism.

This is a highly unpredictable and catastrophic event where the baby’s amniotic fluid enters the mother’s bloodstream, resulting in a violent response by the mother’s body causing difficulty in breathing, circulatory collapse and disseminated intravascular coagulation.

The rarity of the complication means there is limited data on it but it all points to a very high mortality rate of over 85 per cent, in the best of hospital settings. Essentially, surviving it is a rare miracle. Diagnosis is usually done conclusively at postmortem.

There is no treatment for it. The care given is to support the body systems with the hope that they shall heal themselves.

It may happen following a normal delivery, caesarian section or even a miscarriage. There are no clear risk factors but older mothers, those carrying multiple pregnancies, those carrying a boy and those requiring complex procedures during deliveries appear to be at higher risk.

One year later, Sulemann is still yet to come to terms with the loss of the love of his life. However, he is deeply thankful as he celebrates his babies’ first birthday. They may never know the love of a mother but together they shall heal.