Batesville Mom Well After Blood Clot in Lung While Pregnant
| June 5, 2018 | Teighler Kittler’s husband, Corey, was getting dressed for work Oct. 2, 2017, when he heard a long groan. He rushed to the bedroom and saw his wife, 37 weeks pregnant, on the bed clenching her fist and with a fixed stare.
It was over in a moment. He asked what happened and said he was taking her to the hospital. She managed to convince him she was fine.
Then it happened again.
After he saw the second seizure, he dressed her and rushed her to White River Medical Center in Batesville just seven or eight minutes away. As a cath lab nurse there, Teighler was required to live not more than 15 minutes away in case she’s needed for just such emergencies she was experiencing.
Physicians at White River Medical Center diagnosed her with a pulmonary embolism — a blood clot in the lung that was blocking blood flow to her heart. They put her on blood thinners and called for a med flight. The medical center’s helicopter was already in route with another patient, so they called for a helicopter transport from Searcy. The 24-year-old was med flighted to UAMS, arriving at 1 p.m. in critical condition and taken immediately to Labor and Delivery.
“None of us can explain it,” said Jill Mhyre, M.D., the obstetric anesthesiologist who treated Teighler at UAMS. “Most people die from this condition. It’s rare to develop this, and even rarer to live.”
Jill Mhyre, M.D
In Labor and Delivery, Teighler’s team included Mhyre; obstetrician Chad B. Taylor, M.D.; trauma surgeon J.R. Taylor, M.D.; and interventional radiologist Mollie Meek, M.D. The team faced an ethical dilemma, Mhyre said. “‘Do we save the baby and risk losing the mother, or save the mother and risk losing the baby?’”
Mhyre said
Teighler ordinarily would have been transferred to the Radiology Department to treat the blood clots, but Radiology couldn’t monitor the baby’s heart. Finally, the team decided that delivering the baby would help the mother.
They prepped her for a C-section. They decided she needed a blood transfusion because her heart was under tremendous strain. Also the baby’s heart rate began to drop, so they put her under general anesthesia and performed an emergency C-section.
Madelyn Kittler was born at 6:48 p.m. weighing 6 pounds and 10 ounces. She was perfect.
But Teighler was in serious trouble. Doctors put in catheters and gave her the blood-clot-busting drug tPA. They began chest compressions that broke up the clot. Doctors were using the catheters to pull out the blood clot from her arteries. But for every clot they pulled out, more were forming, which is usual for this condition, Mhyre said.
Anesthesiologist Nadir El Sharawi, M.D., was one of multiple doctors it took to save Teighler Kittler when she had a pulmonary embolism during pregnancy and was airlifted to UAMS from Batesville.
Teighler’s heart stopped three times on the table and three times they brought her back with chest compressions, Mhyre said.
Teighler’s family, including her mother, Carmella Phillips, didn’t get to see her until the next day. When Carmella entered Teighler’s ICU room, Teighler was sitting up on a ventilator texting.
Teighler said when she woke after surgery, her hands were tied so she wouldn’t pull the ventilator out. Her husband gave her his phone and she wrote “Untie me!” Her next message said “Where’s Madelyn?”
Five days later she went home. Her chest hurt for two months from the compressions.
“I thought I was going to lose my baby,” Carmella said of Teighler. “She’s my only child. It was a miracle.”
Mhyre directs the Division of Obstetric Anesthesia and has been named chair of the Department of Anesthesiology in the UAMS College of Medicine effective July 1. She said she’s been at UAMS since 2013 and never had a patient with a pulmonary embolism while pregnant. If it’s going to happen, it usually happens after the baby is born, she said.
Teighler was fortunate to have been brought to UAMS, the only adult Level 1 Trauma Center in Arkansas.
“We were able to mobilize resources not available at any other hospital in Arkansas,” Mhyre said. “For the C-section we gave her medication therapies that dilated her blood vessels. It took a huge team. There was medication, equipment and teams of people.”
Seven months later, Teighler said her doctors could find no genetic condition or other factor that caused the pulmonary embolism.
During a recent visit to UAMS for a checkup, as Corey holds a healthy, sleeping Madelyn with Teighler at his side, Carmella looks over at the happy family. “I’m thankful for this hospital.”