“We knew if we were to get pregnant again, it would be a rocky road.” Patient with rare condition thanks faculty for saving son
When Krista Verba went through her first two pregnancies, she experienced minimal complications. But when it came time for baby No. 3, things were different.
“We knew ahead of time that things would be a little bit rockier,” Verba said.
While pregnant with her second son, Hudson, Verba learned antibodies developed in her blood that could harm the baby. Her doctors recommended more frequent ultrasounds throughout the rest of her pregnancy and Hudson was monitored with a Middle Cerebral Artery (MCA) Doppler, which is a specialized scan to determine if there is fetal anemia. When Hudson was born, he spent a week in the neonatal intensive care unit, where he received intravenous immunoglobulin (IVIG) treatment, two blood transfusions and was under seven phototherapy lights. Thankfully, Hudson quickly outgrew his anemia, but making plans for the future became more difficult for the Verba family.
“The first baby is never affected, then after that, each baby gets worse and worse,” Verba said. “Some doctors said we shouldn’t have more kids. Others said you can, but it will be risky. We waited a couple of years, but my husband and I really wanted one more to add to our family.”
Verba, who lives in Huntington, Indiana, was referred to the maternal fetal medicine division at Indiana University Health University Hospital in Indianapolis. She and her husband had a preconception consultation to learn more about the antibodies Verba’s body would likely develop again if she were to become pregnant a third time.
This rare condition affects less than three percent of pregnant women worldwide. When it happens, the woman’s body develops antibodies against an antigen on her baby’s red blood cells, which can cause the baby to have anemia. Anemic babies can develop signs of heart failure and die in utero, but a fetal blood transfusion procedure called percutaneous umbilical blood sampling (PUBs) can save the baby.
“There were a lot of nerves going into it. I had done a ton of research on it and still don’t know if it was better to be knowledgeable and aware of what may be coming, or if the research and statistics made my anxiety even worse. Either way, the doctors were wonderful. We were happy with every doctor who worked with us.”
About nine months after the first consultation, Verba became pregnant with her son Max. She went through MCA Doppler monitoring again, just like with Hudson, and at 32 weeks, her doctor, Anthony Shanks, MD, who is on faculty with IU School of Medicine Department of Obstetrics and Gynecology, determined it was time for a fetal blood transfusion. That transfusion was successful and allowed her to continue her pregnancy to 36 weeks. In November 2018, Max was delivered.
“It was a month early, but I knew it was safer for him to be out at that point,” Verba said.
Max spent 10 days in the neonatal intensive care unit, where he received another blood transfusion, but he is now healthy and no longer needs to regularly see a hematologist. Verba said she is thankful for Shanks and the other doctors and fellows who cared for her and her son and helped her family get through this daunting situation.
“They were all helpful and really calmed my mind and eased our fears,” Verba said. “There was a lot of prayer and we relied on our faith throughout the entire process, and I really feel like all of that combined with the doctors’ expertise is how he was able to make it through.”
Learn more about maternal fetal medicine care and research at IU School of Medicine Department of Obstetrics and Gynecology.