I am a 29-year-old Caucasian female and a non-smoker. I take Cymbalta for anxiety. During my pregnancy, my medications included Cymbalta, prenatal vitamins, baby aspirin, omeprazole, and hydroxyzine. My medical history involves anxiety and endometriosis (confirmed by two laparoscopic procedures), and I delivered my first son at 35 weeks. That pregnancy was smooth until my water broke, at which point I developed severe preeclampsia and required magnesium.
To summarize—at my initial OB visit, my hemoglobin was 13. When I had my 26-week gestational diabetes screening, they also performed a CBC. I wasn’t aware of the results because the patient portal only stated ‘labs are WNL’ without providing specific data, so I didn’t think to ask. It turns out my hemoglobin was 7.2 and my hematocrit was 24, but no one informed me. I felt terrible, but I figured it was just part of being pregnant. My next check-up was set for mid-February. On the day of that appointment, I felt a sharp, debilitating pain (a placental abruption) and my water broke. By the time I reached the hospital, there was no heartbeat. I was nearly 31 weeks along. The attending physician noted I was anemic in my January results, which was the first I’d heard of it. I then lost consciousness. My hemoglobin had dropped to 6 and my platelets were effectively gone. I required ten units of blood products, gave birth to my stillborn son in the ICU, and experienced kidney failure. I was in DIC. After the delivery, a three-pound blood clot was removed from my uterus. My question is—do I have a valid reason to seek legal counsel?
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I am a pathologist specializing in fetal and placental health. There is no established causal link between anemia (whether managed or not) and the development of preeclampsia, placental abruption, or stillbirth.
I am deeply sorry for your loss.
Note: While there are correlations between anemia and certain negative pregnancy outcomes, no direct cause-and-effect relationship has been proven or theorized.
I’ll start by saying I am an OB-GYN. I also personally experienced severe preeclampsia and required magnesium. Your account of a sudden abruption, blood clotting complications, and the loss of your child is heartbreaking, and I am so sorry for the physical and emotional trauma you’ve endured. Throughout my 30 years in medicine, I have cared for patients facing similar crises. The sudden complications that can arise in pregnancy are terrifying, and I have felt that fear as both a doctor and a patient.
My sincere advice is to schedule a consultation with a maternal-fetal medicine specialist. You need an expert to go through your medical records to determine if anything could have been managed differently and to create a plan for any future pregnancies. They can perform specific tests that might guide your future health. They will also likely inform you that you face an increased risk of hypertension later in life.
Do I believe the unmanaged anemia led to this tragic outcome? No, but reviewing your records and undergoing further testing might provide some clarity.
Again, I am so very sorry.
The standard protocol for a blood transfusion is usually a hemoglobin level of 7, and it is very common for pregnant women to become anemic. Therefore, marking your labs as ‘WNL’ might simply mean they didn’t meet the threshold of 7 where medical intervention is required.
To answer your inquiry, I don’t believe this is a case for a lawyer, as placental abruptions are generally sudden events and likely unrelated to the anemia. I am very sorry for what you are going through.
I am a retired labor and delivery nurse. I am incredibly sorry for this experience; I know how physically and mentally traumatic it must have been.
I agree with the previous comments; anemia can develop rapidly during pregnancy. While you should have been notified of your levels, they were still above the 7.0 limit that most hospitals use to trigger a transfusion. I don’t believe there is a link between the anemia and the stillbirth. The abruption was almost certainly a result of the preeclampsia, which can appear suddenly and is impossible to predict. We can’t know who will develop it, which is why we constantly check blood pressure and ask about symptoms like vision changes or headaches. Consequently, I don’t think there is evidence of negligence or malpractice here. However, please understand that you have every right to feel hurt and angry. Those feelings are valid. I believe your best path forward, once you have healed physically, is to speak with a professional to help you navigate this trauma and begin your mental recovery. Sending you my best wishes and hugs.