St. Patrick’s Day 2017 was a day worth celebrating for Priscilla and her husband Philip: Their daughter Nyla was born at Mount Sinai Hospital, weighing 5 lbs 9 oz.
Nyla’s arrival was especially cherished because Priscilla’s previous pregnancy, in 2015, sadly resulted in a stillbirth at 28 weeks due to severe preeclampsia, a rare but deadly complication of pregnancy that is characterized by high blood pressure and can only be fully-reversed by delivering the baby.
When Priscilla, also mom to a four-year-old son, Kaiden, developed high blood pressure during her previous pregnancy, her doctor referred her to Mount Sinai, where she saw Dr. Greg Ryan, a perinatologist and Head of the Fetal Therapy Program at Mount Sinai. Priscilla’s blood pressure was brought under control, but Dr. Ryan explained that the baby was not growing well, due to extensive damage to the placenta. Too small to survive, the baby sadly passed a few days later. After delivery, Priscilla’s placenta was tested at Mount Sinai and showed all the features of severe preeclampsia. She also learned there had been some warning signs that she was at risk of developing the disease.
Despite this devastating outcome, Priscilla says she “couldn’t believe the level of care” she received. When she became pregnant again, in 2016, she told her family doctor she wanted to be cared for exclusively at Mount Sinai.
Dr. John Kingdom, a perinatologist colleague of Dr. Ryan and Associate Member of the Lunenfeld-Tanenbaum Research Institute (LTRI), became her doctor. A specialist and researcher in preeclampsia, Dr. Kingdom explained to Priscilla how the history of her previous pregnancy could impact her current one: Having had preeclampsia before, she was at higher risk of getting it again. But he also reassured her.
“He said, ‘We’re going to help you have a healthy baby.’ That’s what kept ringing in my head the whole time,” says Priscilla, cuddling a sleeping Nyla against her chest.
Dr. Kingdom and his colleague Dr. Rory Windrim monitored Priscilla closely throughout her pregnancy, giving her resources to learn more about preeclampsia and daily low-dose aspirin to prevent or delay its onset. Then, 35 weeks into her pregnancy, Dr. Kingdom was able to offer Priscilla and other expectant moms at high risk for preeclampsia a breakthrough new blood test called the Placenta Growth Factor (PlGF) test, which can determine if a woman has preeclampsia in the absence of obvious symptoms. The PIGF test emerged directly from Dr. Kingdom’s research between his LTRI lab and Mount Sinai’s Placenta Clinic, and Mount Sinai is the first hospital in Canada to offer this test in real time. Priscilla was among the very first patients to benefit from it.
Dr. Kingdom called Priscilla the night of the test to share her results: She was “in the zone” for preeclampsia. Dr. Kingdom had originally scheduled her for a C-section on March 22, but decided to move up her surgery date. He also reviewed the critical warning signs of preeclampsia with Priscilla, since these can develop rapidly, particularly later in pregnancy.
“Priscilla was the perfect candidate for this newly developed screening test,” explains Dr. Kingdom. “It tells us very specifically what the risk is so we can determine the right level of care. When we can rule out preeclampsia, we’re able to send the patient home instead of admitting her to hospital and we can avoid inducing an early birth unnecessarily. And if there is a real risk, as in Priscilla’s case, we can act quickly.”
“The test was very reassuring,” says Priscilla. “Knowing that you fall in the range gives you a guideline to watch out for. Even though I wasn’t showing the typical symptoms, it was there, and having that knowledge behind you helps you understand what to look out for.”
The day before Nyla was born Priscilla noticed some of the troubling signs Dr. Kingdom had warned her about. Nyla wasn’t moving around as much as usual a symptom she had also experienced in her previous pregnancy but hadn’t recognized as a problem. Concerned, Priscilla came in to Mount Sinai on March 16, and delivered Nyla via Caesarean section the following morning, just shy of 37 weeks’ gestation.
“I can’t say enough about this experience. It’s been amazing,” says Priscilla. “I would recommend Mount Sinai to anybody, any time.”