Sara Nasser wasn’t alarmed by the high blood pressure problems she experienced during pregnancy: She had experienced those same symptoms as a child, and the rest of the pregnancy was fairly normal.
It wasn’t until the pain started one night, right below her ribs, that she took notice and wondered if something was indeed wrong with the pregnancy. Worried, she called her husband, Essa, at work, and then called her obstetrician. With the pain becoming more severe by the minute, they decided a trip to the emergency room was necessary.
“After a few minutes, I started getting really scared as the pain got much more intense and more frequent,” she says. “I immediately called Essa at work and asked him to hurry home. I then called my doctor, and he suggested I give it a bit more time, and if the pain doesn’t go away, go to the emergency room.”
A trip to the emergency room confirmed some of their worst fears. Tests revealed Nasser had a condition called HELLP syndrome, a variant of preeclampsia. With HELLP, there is a breakdown of red blood cells, a low platelet count and elevated liver enzymes. The condition can be extremely dangerous, as it can lead to complete liver failure in the mother, as well as premature birth and other complications in the child.
“She was a fighter.” - Sara Nasser
Nasser was transferred via ambulance to the University of Cincinnati Medical Center, where a team of specialists, led by Dr. James Van Hook, awaited her arrival. She received the news that her baby would be born extremely early, and would only have about a 40 percent chance of survival.
Pregnancy is a very normal process most of the time, Van Hook says.
“However, in a minority of cases, everything does not go as planned, and we have to prepare for that,” he says.
Before the news could sink in, Nasser was rushed into surgery, where Van Hook performed an emergency cesarean section, since lab results had indicated a critical situation.
“I still remember the tears in my dad’s eyes as he watched them take me away,” Nasser says.
Approximately 15 minutes later, baby Kaya was born at 24 weeks, weighing in at one pound, six ounces and screaming, which was both unexpected and a very good sign.
“She was a fighter,” Nasser says.
The first few days were promising, but the family was not out of danger. Nasser had been discharged from the hospital, but Kaya remained in the neonatal intensive care unit. Kaya was in what the doctors called the “honeymoon stage.” With the adrenaline and elevated hormones directly following the birth, a baby’s body tends to do well in these situations. However, after the chemical cocktail in the baby’s body wears off, a decline in condition is not uncommon.
After a week, Kaya’s condition took a turn for the worse. Her tiny lungs were retaining too much water, and it was becoming more difficult for her to breathe. Numerous calls were placed to the family over the course of a week, as Kaya would frequently stop breathing and need to be revived. Her respirator type was switched to a more powerful oscillating-type respirator to better encourage lung development and easier, less labored breathing.
Just as things seemed to be improving, Kaya was diagnosed with necrotizing enterocolitis, a serious illness common in premature infants. NEC is a digestive condition in which sections of the intestine are injured or begin to die off, which causes it to become inflamed or even perforated.
Every time Kaya’s situation began to look promising, something else would appear – infections or complications that required a blood transfusion.
Weeks later, Kaya’s ophthalmologist discovered she had retinal detachment and needed to undergo two eye surgeries to prevent blindness. Another condition common in premature infants, retinal detachment happens because the infant, no longer in the womb, is exposed to a more uncontrolled environment, so the developing blood vessels grow more sporadically, causing the retina to detach from the rest of the eye.
“Due to the nature of what I do, the families I treat have a special place in my heart,” he says. “I have a special bond with those babies.”
About Dr. James Van Hook
James Van Hook, M.D., is a 1981 graduate of Louisiana Tech University with a degree in biology. He attended medical school at Louisiana State University School of Medicine in Shreveport, and completed his internship and residency at the University of Texas Medical Branch in Galveston. He also completed a fellowship in critical care OB-GYN at Bowman Gray University School of Medicine in Winston-Salem, N.C., and another fellowship in maternal-fetal medicine at the University of Washington School of Medicine in Seattle.
After holding faculty positions at the University of Texas Medical Branch and Texas Tech University, where he was regional chair of the OB-GYN department at Texas Tech’s Amarillo campus, Van Hook joined the University of Cincinnati in 2008.
Van Hook is certified by the American Board of Obstetrics and Gynecology in obstetrics and gynecology, critical care OB-GYN and maternal-fetal medicine. Additionally, he is board certified by the American Society of Addiction Medicine in addictionology.
Dr. Van Hook is the director of maternal-fetal medicine at the University of Cincinnati College of Medicine. He’s published articles on a wide variety of topics in pregnancy. His current areas of interest are hypertensive disorders of pregnancy, women’s health and rehabilitation, physician health, and critical care OB-GYN.
In addition, Van Hook has been instrumental in helping the University of Cincinnati Health System receive Cribs for Kids National Sleep Certification, and he’s helped to develop and execute the Safe Sleep Program to help reduce infant mortality.
Van Hook was honored in November for his work with the University of Cincinnati Health Maternal Fetal Medicine Program, and his work and support of the March of Dimes mission to reduce infant mortality.
Melanie Dickman is a contributing writer. Feedback welcome at hbealer@cityscenecolumbus.com.
