Comprehensive Care for Complex Pregnancies: Chioma’s Story

After a high-risk pregnancy with her daughter, Chioma didn’t expect to have another child. Then, she discovered she was expecting again.

As a 34-year-old with diabetes, Chioma knew another high-risk pregnancy was possible. Her obstetrician referred her to Martina Badell, MD, a maternal-fetal medicine specialist and director of the Emory Perinatal Center.

“I struggled with my diabetes during my first pregnancy,” Chioma says. “My obstetrician knew I would need more specialized care. She also knew that I like consistency and would need someone who is very thorough. That’s why she handpicked Dr. Badell for my second pregnancy.”

Through a complicated pregnancy, she knew she was in the right place to get the care she needed.

First, Chioma and Dr. Badell partnered to help control Chioma's diabetes throughout the pregnancy. Their efforts were successful.

“We know that insulin demands and glucose metabolism are different during pregnancy. Chioma did a good job managing her diabetes,” she says. “She came to all her appointments and brought her logs. That made it easier for us to increase her insulin when she needed it.”

Then, an 18-week ultrasound revealed Chioma’s baby — a little boy she named Phoenix — had caudal regression syndrome (CRS), a disorder that affects fetal development. CRS is a rare condition that impacts how a baby’s lower body forms, and can lead to lifelong challenges with walking and bladder/bowel control.

“Caudal regression syndrome can be a tricky diagnosis because we rely on ultrasound images. We look for abnormal formations of the spine, differences in how the legs are shaped, and abnormalities with the bladder and genitalia,” says Dr. Badell. “We monitor mothers more closely when we detect CRS.”

The exact cause of CRS is unknown, but it most strongly links to genetics and when the mother has a diabetes diagnosis. CRS appears in one or two infants per 100,000 worldwide. But it affects one in 350 infants born to mothers with diabetes.

Dr. Badell says, “For babies diagnosed with this condition, meeting their needs is about getting the ground set for their lifelong care. We start that journey with our patient and their families by collaborating with our neonatologists, pediatric urologists and pediatric orthopedists."

Chioma processed this diagnosis with Dr. Badell, who answered questions and talked through what to expect. She connected Chioma with mental health counselors and offered to help her find additional resources.

“Dr. Badell knew I was under a lot of stress. At that time, I had just lost my mom and I had a 2-year-old,” Chioma says. “She was very compassionate with me every step of the way. She always made me feel that I wasn’t just another patient.”

More than ever, Dr. Badell focused on managing other factors that could negatively affect Chioma’s pregnancy — her mental health, diabetes and blood pressure.

Then, just like her first pregnancy, Chioma developed pre-eclampsia. This serious pregnancy-related high blood pressure condition can become an emergency when not treated, causing severe kidney and liver damage. Women who have already experienced preeclampsia in a past pregnancy are at high risk for developing it again.

“My blood pressure measured through the roof at one of my regular doctor’s visits,” she says. “Dr. Badell admitted me to the hospital. She wanted to protect Phoenix and make sure he didn’t show up early.”

Hospitalization was the right choice, as doctors quickly diagnosed Chioma with hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, a life-threatening version of pre-eclampsia. HELLP syndrome can cause complications for both mother and child, and delivering the baby is the only way to treat the condition.

When Chioma was stable enough, Dr. Badell scheduled a C-section. 

As HELLP syndrome typically goes away within a few days after the baby is born, mom Chioma was on the road to recovery after the C-section.

Born at 32 weeks gestation, Phoenix spent a short time in neonatal intensive care before transitioning to Children’s Healthcare of Atlanta for specialist pediatric care.

Even though he left Emory, Dr. Badell kept a close watch.

“Usually, you don’t have any more contact with a high-risk specialist after you go through labor. But that’s not how it was with Dr. Badell,” Chioma says. “After I got home from the hospital, she called to check on me and see how I was doing. But one of the most loving things she did was call my son’s hospital to check on him. It meant everything to me for her to check on him.”

Chioma needed advanced care throughout her pregnancy. This is known as maternal-fetal medicine, a subspecialty of obstetrics and gynecology that specializes in caring for women and unborn babies who are at high risk for complications.

“The Emory Perinatal Center offers a full scope of maternal-fetal medicine care,” she says. “We create an individualized plan for each patient and meet their needs where they are. That’s important for every patient, but particularly for those with the most complicated pregnancies.”

A multidisciplinary team of specialists collaborates to provide personalized care for each patient. Depending on a patient’s needs, the care team can include experts in cardiology, endocrinology, mental health and neonatology to name a few. For urgent concerns, patients can often schedule same-day appointments.

For Chioma, Dr. Badell’s diligence and the compassion of her care team set Emory apart, especially navigating a high-risk pregnancy.

“I had a wonderful delivery at Emory with my daughter. But my experience with Phoenix was even better,” she says. “In addition to Dr. Badell, every single nurse I had was very compassionate and very attentive. I gave every one of them the Daisy Award for outstanding nursing.”

Today, Chioma’s son Phoenix is vibrant and vocal, enjoying lots of love and attention from his mom, dad and big sister. A pediatric team of specialists continues to work with the family as Phoenix grows.

Specialist care for high risk pregnancy

Emory Healthcare's maternal-fetal specialists support women through every step of their pregnancy journey. Visit Emory Healthcare Perinatal Center for more information.