the life in between...: A mother's heart

A week ago I could have told you there was something called a molar pregnancy. I could also have told you its classical appearance on ultrasound: a cluster of grapes. This week I can tell you about Rachel. She is 24 and fairly well to do by Zimbabwe standards. She has 1 child and has been expecting her second child in May. At her recent 28 week check-up they noticed that her belly was measuring significantly larger than 28 weeks and they couldn't hear baby's heart sounds.

  I found Rachel lying on the ultrasound table on Wednesday afternoon waiting for me to tell her when her baby would arrive. I began to look around her belly with the ultrasound probe, but found nothing that looked like a baby. Just a uterus full of something. I called Sekuru (the seasoned surgeon) to have him look also. And he agreed: full uterus, no baby.

  I broke the startling news to Rachel who nodded and agreed to have surgery in the morning to clean out her uterus. I took her outside to get on the schedule and then caught a glimpse of her face, stoic moments earlier, now awash in silent tears. For 6 and a half months Rachel had been waiting for this little one. Everything had seemed ok. Her belly grew. She had no bleeding. She kept her appointments with the antenatal clinic. Perhaps she wondered that she didn't feel the baby move much. Now all those efforts and hopes were gone and she needed surgery.

  The next morning I did the surgery and found a placenta and tissue consistent with a molar pregnancy. There never had been a baby, just a mass of cells. But for Rachel there was a baby, the one in her mind that she was expecting.

  I know a lot more about molar pregnancy now. Rachel is at risk for cancer. She needs to have close follow up to make sure her "pregnancy hormone" levels go down to normal. It is important that she not get pregnant again for a year while her hormones are monitored for a rise in the hormone that could signal a cancer. I also know that a mother's heart was broken this week and that I don't have a medicine for that. So I'll ask you to pray for Rachel.

  I have some pictures of Zimbabwe that I have been wanting to share with you. This is a beautiful place.