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February 2010 Issue

Despite a recommendation to terminate her pregnancy due to heart failure and a number of other ailments, patient Aimee Brown stuck to her original plan to give birth and welcomed daughter, Bayleigh, now almost a year old.
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Heart Patient Risks Own Life to Have Baby

By Katie Pence
Published February 2010

The winter blues aren’t hitting Aimee Brown, 35, this year.

“I don’t let little things get me down,” says the mother of two. “What really matters is that I can sit down on the ground and play with my children. I can hear my daughter laugh and my son say, ‘I love you, Mommy.’ We are blessed.”

Although most mothers would state the obvious about treasuring parenthood, Brown really counts her blessings. At this time last year, she was given the hardest choice a mother could ever be given: saving your child’s life by sacrificing your own or giving up on your little one to save yourself.

Last January, Brown, then 19 weeks pregnant, was diagnosed with heart failure.

“I was experiencing shortness of breath, intense burning in my throat and was even having difficulty walking,” the Independence, Ky., resident remembers. “When I attended Christmas Eve Mass, it took me at least 10 minutes to walk from the car to the church because I was so out of breath.”

Although doctors thought Brown was only experiencing pregnancy-related asthma or a bad case of acid reflux, she knew something was wrong. An echocardiogram ordered by her family doctor revealed that her heart was functioning below half capacity and that she and her baby were in danger. She was admitted to UC Health University Hospital.

“I had a 20 percent ejection fraction—a normal ejection fraction is 60 percent,” she says, referring to the measure of the amount of blood pumped out of the heart’s main pumping chamber after each heartbeat. “It scared me because we tried for so many years to have children, and my first thought was that I was going to die.”

“This is a rare disorder,” says Stephanie Dunlap, DO, Brown’s cardiologist and director of UC’s heart failure program. “To be told that your heart isn’t working well is extremely scary, but to be told that you have the disorder during pregnancy, which is supposed to be a happy time in your life, is even worse. Mothers aren’t only afraid of losing their lives or the life of their unborn baby, but also of orphaning their other children.”

Brown also suffers from polycystic ovarian syndrome, an endocrine disorder which is the most common hormonal disorder among women of reproductive age and is a leading cause of infertility. She battled the disorder and was successfully able to have her first child, Brayden.

Although she was told to consider terminating the pregnancy to avoid losing the baby later due to complications of premature birth or dying herself, Brown says there was no question in her mind.

“I instantly lost about eight pounds of fluid once they put me on the proper medications, and I could breathe again,” she says. “Also, I found out I was having a girl, and girls do much better if born prematurely. Something—and I think it was my dad who passed away six years ago, who I believe still watches over me—told me that I was going to be all right.”

Brown says that with the help of Dunlap and the high-risk obstetricians at University Hospital, the rest of her pregnancy and her daughter’s delivery, although tricky and scary at times, were a success. Dunlap says Brown developed another complication at 30 weeks of pregnancy: pre-eclampsia, or pregnancy-related hypertension.

“Her blood pressure escalated dangerously, making her sick heart have to work that much harder,” Dunlap says. “In addition, pre-eclampsia is a threat to the baby’s blood supply through the placenta.”

Brown was hospitalized and a joint decision was made by James Van Hook, MD, David Lewis, MD, both UC Health University of Cincinnati Physicians obstetricians, and Dunlap to deliver the baby prematurely at 31 weeks.

Prior to delivery, two cardiac catheters were placed to help monitor Brown’s heart and to help it work better.

On April 8, 2009, Bayleigh Marie Brown was born.

“The staff recognized my concerns throughout the entire pregnancy,” Brown says. “They were open with clinical research opportunities that may provide new beneficial treatments for my condition. They listened to my fears and guided me the entire way. I was amazed at the excellent care I received and if I could have more children, I would deliver at Uni-versity again in a heartbeat.”

But Brown adds that self-education helped her as well.

“After we found out about my illness, my husband, Troy, and I immediately researched my diagnosis and educated ourselves so I could take an active role in my medical care,” Brown continues.

“I think it is very important for all patients to be advocates for themselves, even if great care, like the care I received at University Hospital, is available. I felt empowered during the appointments with the various medical teams because I was familiar with the things being discussed.”

Since Bayleigh’s birth, Brown has had an implantable biventricular defibrillator installed to protect her from possible dangerous heart rhythms. She no longer works but says she has another goal in mind.

“Things happen for a reason, and what you think may be a bad thing at the time can turn out to be positive in the end,” she says. “I believe that I am supposed to help other mothers who have been through this or have other serious heart issues. It’s such a hard journey and not many people understand what it’s like. I feel like it is my purpose to help others.”

Dunlap and others at University Hospital are in the process of forming a support group for mothers with heart-related issues.

“A support group will help patients talk to one another and voice their fears and concerns,” Dunlap says. “The women in the support group who have already delivered can provide support and inspiration for women who have yet to deliver. It is also a place to share information.”

Until the group is launched, Brown will continue to make her impact in small ways, one of which is being the best mom she can be.“I want to see my kids grow up and do all kinds of great things,” she says tearfully.

“They are special gifts to me. I am confident that with the help of the doctors at University Hospital, I will make it.”

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