The Colette Louise Tisdahl Foundation – Q&A with Sera Prognostics

The Colette Louise Tisdahl Foundation was founded by Michelle Valiukenas in honor of her daughter Colette.  The organization not only keeps her memory alive but also helps families that find themselves in similar situations who struggle with pregnancy complications, premature birth and loss.

Q&A with Sera Prognostics Inc., The Pregnancy Company®

Michelle’s Story:

I have been pregnant twice, both via IVF. For the first pregnancy, our transfer was in April 2017 and then just shy of seven weeks, I started spotting at work. My husband and I went to the doctor, had our first ultrasound, and were told we had lost the baby since there was a gestational age but no baby. They took blood work from me and then said to come back Tuesday (the loss was diagnosed on Friday) to make sure that my numbers were lowering and that I was miscarrying naturally as they assumed I was. When they repeated my labs, my numbers had actually risen substantially and I was told to come in the next day for an ultrasound. I was told the reason for the ultrasound was to determine if they would instead have to do a D&C if my body was no longer miscarrying naturally.

At that ultrasound, the tech instead found a heartbeat and I was told, “Oh, never mind, you’re pregnant, go back on the medications we had you on previously.” I was shocked as was my husband, who almost got us in a car accident leaving the doctor. Later that evening, I bled massively, ended up in the ER, and then was told I had fully, completely miscarried–baby and gestational sac were both gone.

I got pregnant for the second time in December 2017. Other than all-day morning sickness and fatigue, as well as some pregnancy brain, it was a pretty normal pregnancy until I was 21 weeks pregnant. At a routine OB appointment, a day in which I had felt the best of my entire pregnancy, my blood pressure was reading at 188/110 and not going down. My OB calmly told me that I needed to go to labor and delivery so they could monitor me. I was not too worried because she seemed concerned but not overly so. We went to labor and delivery and I was admitted with a diagnosis of severe preeclampsia as well as intrauterine growth restriction. Colette had been measuring about two weeks behind when I was admitted, but the MFM team was hoping that once my blood pressure was under control, she would naturally catch up. The repeat ultrasound did not show any growth and the doctors recommended delivery. Colette was born at 24 weeks and 5 days and whisked off to NICU right away.

Colette spent nine days in the NICU before her little lungs could not handle it anymore and she gained her angel wings.

Sera Prognostics:  What did your obstetrician tell you with each pregnancy challenge? Were you warned about the potential for preterm birth? Were you given resources or sent to a high-risk pregnancy doctor (Maternal Fetal Medicine doctor, also known as an MFM)?

My OB was always optimistic and open about difficulties and challenges. She knew how much we had been through to get pregnant and she made it clear that it was particularly important to take care of me and reassure me. I don’t think preterm birth was ever really on the radar for me until I was hospitalized with preeclampsia, so if we discussed it, it was minimal.

I did see an MFM for the 20 week anatomy scan and I believe I knew I could always see one throughout my pregnancies, but just loved my OB and felt like she knew my history so intimately. I found the MFM to be particularly anxiety-provoking, warranting him the nickname of Dr. McScary. He spent a lot of time talking to us about the risks of being overweight pre-pregnancy, spending time on Downs Syndrome as a risk and then saying well, you genetically tested embryos so it is probably not a problem.

Sera Prognostics:  What did you know about preterm birth prior to and during your pregnancy?

Some of my first memories as a child revolved around preemies and NICUs. My sister who is four years younger than me was born eight weeks premature. She was in the NICU for about 6 weeks and then in and out of the hospital for her first two years. She went through a few surgeries and remained tiny for her size for a long time, as well as needed speech therapy for a few years due to a tongue thrust from the incubator.

Additionally, I have had many friends who gave birth early and had their babies in NICU for a time. In fact, for one of my best friends from high school, her baby shower occurred after her daughter was born, while her daughter was still in NICU care.

Sera Prognostics: How do you look back on your pregnancy and preterm birth experience? What would you want to tell expectant mothers?

I think when we are working with pregnant people, it is important to strike a balance between not causing too much panic and worry and also sharing risks and warning signs. One of the biggest things I learned in my journey is that there is so much we dismiss as just normal pregnancy issues when it might actually be more serious. For example, my feet swelled so badly just days before I was hospitalized. I knew that pregnant people did have swelling that was totally normal, but now I realize that the way I swelled at the time in pregnancy was not normal and was a total sign for preeclampsia.

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