High-risk Diabetic Woman Safely Delivers Baby Thanks to High-level Care

When Michelle Price decided to try to have a second baby, the 31-year-old from Lanoka Harbor, New Jersey, knew the odds were stacked against her. Michelle, who has Type 1 diabetes, had a miscarriage at 30 weeks of a previous pregnancy because of preeclampsia, pregnancy-related high blood pressure condition that can be fatal to both the mother and baby. With her preexisting condition and history of complications, any new pregnancy would be deemed high-risk from the start.

So when she walked into the office of maternal and fetal medicine specialist Karen Koscica, D.O., at Jersey Shore University Medical Center, she immediately felt comforted by the words she heard.

“I asked her, ‘What do you think my shot is at bringing this baby home with me?’ She looked at me and said, ‘This baby’s coming home with you,’” Michelle says. “It was such a good thing to hear. I just knew I was with the right doctor.”

Dr. Koscica worked alongside Jersey Shore board-certified obstetrician and gynecologist Pamela Schultz, M.D., FACOG. Although Michelle considered changing doctors following her stillbirth, after various consultations with other medical professionals, she realized she was with the best team around. “Dr. Schultz is a top-notch doctor,” Michelle says, and she provided her the ability to deliver at a hospital near her home and at a facility with a Class IV neonatal intensive care unit (NICU).

Close Monitoring

As soon as Michelle got pregnant, she began a rigorous monitoring schedule with Drs. Schultz and Koscica. Most pregnant women come in for monitoring at 12 weeks and 20 weeks, but Michelle came in at 16 weeks as well to check for any anomalies. At 24 weeks, she began a routine of twice weekly checkups to monitor the baby’s growth and her blood pressure, which, if abnormal, can be an indicator of preeclampsia.

“Anyone with Type 1 diabetes is at a much higher risk for having a baby with a fetal anomaly,” says Dr. Koscica. “Babies can be too small or too big, premature or stillborn. It’s hard to manage their blood sugar because pregnancy raises it. Diabetes increases the risk of preeclampsia, but it’s really hard to predict. Sometimes the symptoms mimic those of normal pregnancy, such as headache, swelling and pain in the abdomen. But sometimes in patients who have preeclampsia, you’ll see signs in the baby first.”

At around 30 weeks, Michelle’s baby was determined to be growth-restricted, meaning he was a little smaller than normal for that stage of her pregnancy. Since her last pregnancy ended at 30 weeks, everyone was on high alert.

The week of Thanksgiving 2020, Michelle had seen Dr. Koscica twice and Dr. Schultz once before the long holiday weekend was set to begin. A little nervous that she was about to go four days without any monitoring, she voiced her concerns to Dr. Schultz, who insisted that she come in the day after Thanksgiving.

“With her first fetal demise, Michelle really did go from zero to 60—normal to very sick—overnight, and that was our main concern,” Dr. Schultz says. “We knew something could happen very quickly with her, so delaying monitoring over a long weekend wasn’t something we’d be tolerating.”

Game-changing Decision

Dr. Schultz’s insistence that Michelle be seen the Friday after Thanksgiving turned out to be a difference-making decision. That morning, Dr. Schultz noticed that the baby’s heart rate tracing had changed, so Michelle was admitted to the hospital and sent to labor and delivery to be induced.

On November 29, 2020, Joseph Price was born at a little less than 4 pounds. He spent his first month in the NICU, where his parents visited him every day until they were able to take him home.

“Joseph is doing so, so well,” Michelle says. “Every day there’s a positive change, and he’s smiling and laughing.”

Now with two healthy sons at home, Michelle is grateful for the doctors who kept her and her babies safe through challenging pregnancies. “I’m just so lucky to have this baby in my arms,” she says.