Mystery

today we are meeting J's primary doctor at the hospital. we might get some answers, or we might not. it's pretty nerve wracking. we saw about 12 different doctors while we stayed at the hospital and there is no way i can even remember all of their names. our primary doctor is one of the specialists in their high risk Ob/Gyn group. she performed the confirmatory ultrasound and helped deliver Soren. she stayed an extra shift with J the first night in the ICU and did her best to comfort our fears in the first few hours.

according to the information we have, the current theory is that J had asymptomatic preeclampsia, the kind that doesn't manifest itself in high blood pressure, swelling, proteinuria, or the other typical signs. all of J's prenatal appointments came out fine. there was one appointment where she had elevated blood pressure and a trace of protein. but she had complained of dehydration that day and everything was fine afterwards. it wasn't enough for anyone - our midwives or the OBs who looked at our charts - to suggest that something was wrong.

even today's appointment isn't the end. they will need to follow up in six weeks to do some additional bloodwork after J's postpartum hormones have settled down. also the autopsy and karyotype results will take extra time to come back. it's like a replay of our infertility treatment, where we went for test after test only to get a trickle of information and few conclusions until the end.

all this creates a huge cloud of my doubt in my mind about the state of medicine and midwifery. what other undetectable problems might affect J or any future pregnancy? if they can't detect preeclampsia reliably should we be paranoid and demand all precautions next time? if we had gone with an OB instead of midwives would they have found it? if we had known we might have been able to save him. and i trusted our midwives completely to tell us if anything was wrong. and they said everything was fine until the very end.

Update: the appointment didn't shed a ton of light on things. the doctor thinks that there were underlying problems in the development of the placenta, and that J had an infection when she went into labor, which may have contributed to her seizure. the good news is that they took her off one of her blood pressure medications. i was hoping they would take her off all three but i guess they are playing it safe.