Post-birth debrief letter causing concerns

[lifeontheup]

My little one is now 19 months old. I've been chasing a birth debrief appointment since he was 2 months old and finally had this last month. My little one was born by emergency c-section and was taken to the NICU within a few hours due to having high lactate levels when they tested the blood in his cord after birth. Whilst there he stopped breathing 4 times for around 30 seconds at a time but at the time they didn't know why, never got to the bottom of it, just said it was possibly an infection. I'd had a rough pregnancy with severe PGP from 4 months resulting in the need for crutches in the last couple of months of pregnancy. I could barely walk the length of my living room. I sadly contracted Covid when 36 weeks pregnant and nearly collapsed at a midwife appointment. There they sent me off in an ambulance for suspected sepsis - my temperature was low but my heart rate and baby's wasn't good. Once at the hospital they monitored for a few hours and sent me home saying it was just a struggle to cope with the Covid and not sepsis thankfully. Giving this context because i was severely unwell still in those final few weeks and i don't think it helped I saw a different midwife every time I had an appointment. Anyway, what's concerned/shocked me a little is that in the letter I've received which is a typed up note of what was discussed in the appointment, it says that I had late on-set pre-eclampsia (never once mentioned in the appointment or in person!) but that also my son had sepsis but responded well to treatment. The word 'sepsis' was also never mentioned in the appointment or at any time after birth, just the words 'possible infection'. I don't really know what to do now. I want to respond and ask why there is new information in the letter that wasn't mentioned in the appointment or am I being overly concerned? In truth, I've never felt happy about the care I received during pregnancy so this may be clouding my reaction. Any thoughts/advice welcome.

I'm so sorry you went through all this and hope your little one is well now. If it was me, I would follow this up as my mind wouldn't be at rest otherwise. It seems inappropriate for new information to be in a letter and I'd be wondering what else I hadn't been told. Have you been given access to the birth notes? I read through my son's as I had (many) questions - they didn't answer everything but helped me piece things together better.

a typed up note of what was discussed in the appointment, it says that I had late on-set pre-eclampsia (never once mentioned in the appointment or in person!) but that also my son had sepsis but responded well to treatment. The word 'sepsis' was also never mentioned in the appointment or at any time after birth

Given that both of these are unexpected and hadn't been mentioned, I would seriously query whether they have sent you the correct letter.

Sounds like someone's completely messed up your notes or switched them.

I can't imagine both you having pre eclampsia and your newborn having sepsis and neither being mentioned.

In the postnatal correspondence I received there were inaccuracies too, which I received an apology for and an accurately recorded replacement letter. I raised this with PALs.

it sounds like you may well have had sepsis. It's definitely worth clarifying re the PET though because that has some implications for your health and for any future pregnancies if you decide to have more children. Could be a mistake/could be that it's true - only way to find out is to ask them.

I would request a copy of your son's medical records. At our hospital i think there's a £25 admin fee. My DD1 had sepsis caused by GBS including 10days in NICU / SCBU. It was made very clear to us at the time, including her treatment plan, plus we had to give consent to a lumbar puncture to rule out meningitis. I'd be amazed if your DS had sepsis and noone ever mentioned it to you. His records should clear it up. Likewise, I had preeclampsia with DD2 and there was loads of follow up after birth, including BP meds for a while. It sounds really odd if it was never mentioned that you had it - particularly as it can be indicator of potential issues later in life so I was given advice on how to stay as healthy as possible. PALS might be able to help? I agree with pp, i wonder if your records have been mixed up with someone else?

This

If you both head sepsis what was your care after the birth?

All newborn infections are noted as 'neonatal sepsis' and treated as such
I would follow up to get clarification particularly around the pre eclampsia

At the hospital where I work, any newborn with symptoms of an infection is assumed to have sepsis because it's deemed better to err on the side of caution and potentially overtreat, than to wait for blood cultures etc to confirm a diagnosis and risk the baby seriously deteriorating in that time.
The pre-eclampsia should definitely have been discussed with you at the time. Did you have symptoms?

Thanks for the replies. I know a couple of posters queried if they could have sent the wrong letter but all the others details are correct. It's just the surprising addition of pre-eclampsia being mentioned and then the diagnosis of sepsis rather than 'possible infection' that was said at the time as the reason for being in the NICU.

Thank you @Greybeardy I intend to find out. I spoke to a couple of friends about all this and they said the same as you about future pregnancies. We plan to TTC after our wedding in the summer. Now I feel a bit uncertain so definitely need to chase this. I just want to know if that's definitely accurate and why I wasn't told but found out in a letter.

@CrispAppleStrudels I think that's why I'm just so confused! Surely it would have been mentioned at the time but honestly it never was nor after, and not even in my birth debrief, though she did repeat the possible infection explanation. I guess sepsis is an infection?

@BoysNameHelp thank you for this context

@Cvn thank you also for taking the time to reply with this context. That would make sense! In terms of symptoms of pre-eclampsia I did have high blood pressure readings. My little boy stopped growing so I had two growth scans towards the end which confirmed that, so they scheduled an induction for the following week. During that appointment they ended up keeping me in for monitoring for most of the day because of my blood pressure but it eventually normalised and I was sent home.

Did you have any neonatal outpatients follow up? DD1 had appointments every 6months with outpatients until she was 2, to check whether there was any long term developmental impacts due to her sepsis. That could also be a clue?

@CrispAppleStrudels no, no other appointments other than the normal ones in the first few weeks after birth.

@Cvn there was protein in my urine at that time too. And I had had some light bleeding

My son was born GBS positive and treated for an infection. I asked repeatedly if it was sepsis and no doctor or midwife ever confirmed it. The front page of his notes were not with the rest during the hospital stay. However, I requested post birth and it was only then that sepsis was written on the notes that I had it confirmed. Sepsis is caused by other infections, most commonly GBS in a newborn. They would have taken a blood culture that shows the growth if the bacteria causing the infection. You can also have a debrief where they will answer any questions, including why they withheld information.

@Glittersequins thank you. I'm going to make contact with them about it!