Dying to deliver: The race to prevent sudden death of new mothers

Four-month-old Muhsin just started laughing – and it’s brought some joy to his father for the first time in a long time.

Mustafa Shabazz is proud of the nursery he and his partner Tahmesha Dickey designed for their son, but it’s now reminders of what could have been.

“The name on the wall, the crib, everything,” Shabazz said. “Muhsin is going to miss out on having a great mother, that’s what hurts so bad about this situation.”

Dickey, 38, died giving birth to baby Muhsin.

Watch the full story on “Nightline” tonight at 12:35 a.m. ET

“If I wanted to describe her to someone, I’d describe her as all woman,” Shabazz said. “She was very generous , motivated, dedicated to her family, her work ethic was amazing… she was just a caring loving person.”

Her pregnancy had been going well, Shabazz said. She was not high risk and had been regularly going to her prenatal visits.

“I was excited… because this is what I always wanted, I always wanted a family,” he said.

But during labor, Dickey began having trouble breathing. Within minutes, she went into cardiac arrest and doctors performed an emergency c-section to try to save her and the baby.

“[I thought] this can’t be happening, it seemed like a dream,” Shabazz said. “They asked me to step out. I stepped outside of the room and I could just hear him saying … we’re trying to bring her back, trying to grab a pulse.”

Doctors delivered the baby, but for Dickey, it was too late.

“Her OB came out and told me something I just didn’t want to hear: ‘I’m sorry, she didn’t make it,’” Shabazz said. “I broke down…I witnessed her take her last breath in front of me. I was her man and I felt weak not being able to protect her.”

Dickey died of an amniotic fluid embolism – an often fatal complication in which amniotic fluid enters the women’s blood stream. It occurs in 1 out of 10,000 pregnancies and doctors are unsure why it happens or how to prevent it.

“The diagnoses are heart conditions and stroke being one of them, hemorrhages another and severe depression and suicide actually is another,” said Dr. Neel Shah, assistant professor at Harvard Medical School and obstetrician/gynecologist at Beth Israel Deaconess Medical Center in Boston. “As a mom you can be as healthy as can be can have the best prenatal care in the world… In spite of all of that, things can still go wrong because the system that’s set up to take care of you isn’t reliable.”

Despite advances in technology and medical care, the United States is missing the mark on maternal health during three critical time periods: Pregnancy, during labor and the first year after delivery.

While every other developed country has seen a decrease in maternal deaths, the U.S. has spent the last 20 years doing the opposite, according to the Centers for Disease Control and Prevention. About 700 women die each year in the U.S. due to complications from pregnancy or giving birth, according to the CDC, and some 65,000 women nearly die of pregnancy-related severe complications.

“The problem of maternal mortality was swept under the rug,” said Dr. Lisa Hollier, the president of the American College of Obstetricians and Gynecologists. “This goes back to the value of women and the value that we hold in our society.”

According to Hollier, this is a problem that the U.S. should be able to fix.

“We know that about 60 percent of the maternal mortality is potentially preventable,” she said. “It can start suddenly and it’s very important for the doctors to be able to identify the problem and initiate treatment quickly.”

Shah said there are a multitude of underlying factors for why the maternal mortality rate in the US is rising. For starters, he said the quality of care varies tremendously from hospital to hospital and there aren’t enough qualified practitioners in rural areas to care for pregnant women. Also, Shah said in the critical weeks following birth, when complications can occur, current guidelines call for too few follow-up visits.

“If you’re an African-American… your risks of dying in childbirth are three to four times higher than if you’re white,” he said. “It’s not tied to income. It’s not tied to education… It’s something about the lived experience of being African-American.”

Shah is working to find solutions to the things that can be fixed during these critical time periods for expectant mothers so they can be applied on a national level.

“Nightline” spent 24 hours with Shah and his team on the labor and delivery floor at Beth Israel Deaconess to see firsthand how they do things differently. Watch the full story on “Nightline” tonight at 12:35 a.m. ET.

Starting with communication, all the doctors and nurses at Beth Israel Deaconess met in what they call a huddle to discuss every patient on the delivery floor so everyone is accountable for everyone’s care.

“Part of our whole solution is to make sure that everyone on the labor floor has an awareness of everything else that’s going on,” Shah said. “It’s been shown across the country to make a really big difference in patient safety.”

While “Nightline” was there, Wendy and her husband John Samuel arrived. Wendy, in labor with their first child, decided to try to deliver without an epidural, something only 10 percent of women choose to do, but the team at Beth Israel Deaconess gave her time to explore this option.

Time is another tenant of Shah’s approach to fixing the system. In the medical field, it’s called watchful waiting vs. acting swiftly.

“We don’t treat women the way we would treat a middle-aged man,” Shah said. “For example, if a man walked into an emergency room with chest pain … a cardiologist would have to see that person within a defined amount of time,” he continued. “With OB emergencies, there is no equivalent. It’s very common for a woman to go into an emergency room and not see an obstetrician for many, many hours.”

Shah advised her on taking deep breaths and said she could get up and walk around or get in the bathtub they have on hand if that was more comfortable.

“For the last several decades … we thought we should just automatically do more,” Shah said. “And sometimes you can hurt people when you do too much too soon.”

When Wendy’s water broke, Shah noticed her amniotic fluid was green, which meant it contained meconium.

“It’s from the baby’s intestines. It’s sterile, but sometimes it comes with the baby being distressed,” he said. “But we will have the neonatologist here.”

Eventually, Wendy’s contractions became more painful and she decided to have an epidural. Four hours later, she started to push, with the NICU staff standing by. Wendy delivered a healthy baby girl, named Lydia. But after labor, she started to lose a lot of blood in a short period of time — a liter of blood in minutes, which qualifies as a postpartum hemorrhage.

Shah and his team acted fast to stop the bleeding.

But even when delivery is over, the mother’s life can still be threatened well after giving birth.

“One of the things I’m actually very worried about is that our whole health care system unplugs after the mom goes home until about six weeks later,” Shah said. “The plurality of American women experience some form of postpartum blues or depression.”

It’s something Eric Dyches, from Salem, Utah, and his five children experienced firsthand. Their mother, Emily Dyches, was 39 years old when she died in 2016. She had been struggling with postpartum depression.

“The most difficult thing I’ve ever had to do is to tell my kids their mom wasn’t coming home,” Eric Dyches said.

Childhood sweethearts Emily and Eric Dyches had four children together. In 2015, they welcomed their fifth child, but things were different this time.

“She would get very anxious and agitated quite easily, had a difficult time sleeping. But primarily the way it manifests itself was through anxiousness and worry,” Eric Dyches said.

Dyches said they saw her OB, who prescribed an anti-depressant, and for while he said things were better. But soon, Emily was struggling again.

“We sought help from a psychiatrist, we sought help through a therapist,” he said. “So we were doing everything … I knew that I could do to help her.”

Growing more desperate, Emily went to an inpatient psychiatric facility where she was treated for 11 days.

“She came home feeling a little bit better,” Eric said. “But in hindsight it was a two-week goodbye.”

Shortly after, while in the car with her father, the unimaginable happened. Eric said he was on the phone with her dad and he could hear his wife’s panic building.

“Then I heard, I heard her exit the vehicle and at that point I heard the phone drop,” he said, with tears in his eyes.

Emily Dyches was killed on highway I-15 in Utah after being hit by a tractor-trailer.

“It’s my belief, the panic caused her to lose all spacial awareness and drive her to a place she thought might be safe,” Eric said.

The American College of OB/GYN has begun to address the maternal mortality crisis by defining best practices to improve the safety and standards for pregnancy and postpartum care. The group is also calling for a new “fourth trimester” that extends three months after delivery, during which doctors or midwives are encouraged to see their patients sooner and more often.

These small changes towards fixing the maternal mortality crisis could help future expectant mothers, which brings some comfort to the Dyches’ children, although it won’t bring their mother back.

Eric has channeled his grief into action, starting “The Emily Effect,” a foundation that provides resources and support to women suffering from pregnancy-related mood disorders. The organization has been working with local hospitals to implement postpartum depression screening, something Dyches is hoping will spread to other hospitals across the country.

“I think it’s time now that we shine the light on what a mother goes through,” he said, “and we step up those resources to ensure that our mothers have the care that they need.”

ABC News chief medical correspondent Dr. Jennifer Ashton spoke about this report on today’s episode of ABC News’ “Start Here” podcast. Listen here:

“Start Here” is a daily ABC News podcast hosted by Brad Mielke featuring original reporting on stories that are driving the national conversation. Listen for FREE on the ABC News app, Apple Podcasts, TuneIn, Spotify, Stitcher, Google Play Music, iHeartRadio — or ask Alexa: “Play ‘Start Here.'”

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Predicting autism could be possible through brain wave patterns, study shows

Can a baby’s brain waves predict the chance of autism?

New research that looked at brain wave patterns of babies and toddlers showed the answer is likely yes.

A research group in Boston crunched data on brain activity from a group of 188 infants, between 3 months and 3 years old, to see if the reports showed what lead investigator Dr. William J. Bosl described as a “pattern of numbers that distinguished children who would develop autism from those who did not.”

The goal was to find a way to help diagnose autism spectrum disorders much earlier, by using simple and available tools to look at the electrical signals of the brain.

What is autism spectrum disorder? Autism spectrum disorder (ASD) is a developmental disorder that affects a child’s language, behavior, and social skills. Recent data from the Centers for Disease Control (CDC), estimates that 1 in 59 children have autism.

Because there is no physical “test” for autism, it can be a difficult diagnosis to make. Right now, doctors have to rely on how a child behaves and interacts with other people.

Ideally, children are diagnosed with autism before 3 years old and have already started appropriate therapies before 4 years. Unfortunately, according to that new data from the CDC, the average age of autism diagnosis is older than 4 years.

This study from Boston University, Harvard Medical School and Boston Children’s Hospital suggests that electroencephalography, or EEGs, may help doctors diagnose autism earlier.

What is EEG? An electroencephalography, or EEG, is an easy and low-cost way to measure the electricity of the brain and is historically used to diagnose seizure disorders. During an EEG, technicians fasten tiny wires all over the scalp and brain waves are projected on a computer screen. Specialists are then able to interpret the brain’s activity.

Improved technology has expanded the amount of data that scientists can extract from EEGs, which is considered a safe and painless tool.

The idea the researchers in this study had was that EEGs would be able to detect abnormalities in a child’s brain before the child started to display symptoms of autism.

“We know that any changes in behavior, emotion or cognition ultimately result from changes in the brain,” according Bosl, the director of health informatics at the University of San Francisco and visiting faculty at Boston Children’s Hospital computational health informatics program. “In general, brain changes precede changes that manifest in the symptoms that define neurodevelopmental, mental or neurological disorders.

Bosl said that part of the reason his team wanted to do this study was to discover “the neural correlates of autism behaviors as early as possible.”

What did they learn about autism and brain waves? In this study, scientists performed EEGs on 188 children between 3 and 36 months old, repeating the scans every few months. The children were divided into “high risk” and “low risk” groups, based on their presumed, underlying susceptibility to develop autism. Children were categorized as “high risk” if they had an older sibling with autism, as the disorder can run in families.

Of the 188 participants, 35 were ultimately diagnosed with autism spectrum disorder, almost 19 percent. The majority of these children had already been in the “high risk” group and diagnosed at 3 years.

All participants had a minimum of two EEGs between the ages of 3 and 36 months. Scientists conducted complex mathematical equations to interpret the EEG signals and identity patterns that might correspond to abnormal brain function. Based on these values, a computer algorithm was able to predict “ASD” or “not-ASD.”

This algorithm predicted autism in children as young as 3 months old with nearly 100 percent accuracy.

Can brain waves predict mental health? This is new and still-developing research. Children with autism typically do not display symptoms until they are at least 18 months old and many children are not diagnosed with autism until after 4 years.

“Our hope is that this approach can be developed into an early screening tool,” Bosl said. “If our results are replicated in much larger clinical studies, and can be implemented in a routine primary care setting, then the information obtained from early EEG measurements might be useful.”

With earlier diagnosis, treatment can also begin earlier. There is no “cure” for autism, however multiple randomized-controlled trials, including a recent study published in April, 2018, have shown that early language and behavioral therapy is linked to better results. Early intervention can be key to improving the quality of life for children with autism.

In this study, researchers said they were able to predict the diagnosis of autism — and also the severity of autism.

“Our approach may be useful for helping to guide the development of early interventions,” Bosl said, “by enabling continual, easy measurement of the developing brain and its response to new interventions — or ‘brain exercises.'”

In other words, regular brain monitoring could help guide therapies and help measure whether there’s improvement.

The researchers believe this sort of brain monitoring could help with not only early detection of autism, but possibly with a range of neurological or psychiatric disorders over a person’s entire life.

“Our vision is that brain measurements will be taken at every checkup, much like a blood pressure measurement,” Bosl said, “and monitored for changes that indicate that problems are developing, long before the changes become serious.”

Laura Shopp, M.D. is a third-year pediatrics resident affiliated with Indiana University who works in the ABC News Medical Unit.

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After romaine lettuce outbreak, here's what you should know about E. Coli

Concerns are rising amid the nationwide outbreak of food poisoning from E. Coli that has killed one person in California and infected 121 so far, according to official counts. 52 people have been hospitalized.

Romaine lettuce grown in Yuma, Arizona, is the culprit in these E. Coli infections, but the victims are spread among 25 states. The bacteria carried on the lettuce is a strain called E. Coli 0157:H7

What is E. Coli 0157:H7?

Escherichilia coli, or E. Coli, is a large group of bacteria with multiple strains, most of which are harmless and part of the normal “flora” of bacteria in the digestive tract.

Harmful strains of E. Coli produce something called a Shiga toxin, which can be deadly. The most common strain of deadly E. Coli in the U.S. — the one linked to multiple outbreaks and fatalities — is E. Coli O157:H7, which does produce Shiga toxin and is often found in cattle. This strain has previously infected people through consumption of undercooked ground beef, and is best known for a deadly outbreak in 1992.

This time, however, the toxic strain of E. Coli been found on Romaine lettuce, which likely became contamined from nearby cattle manure.

Who is at risk?

People at any age are susceptible to E. Coli infection, but very young children and the elderly are more likely to develop severe illness and complications.

How does it affect people?

Symptoms of this kind of E. Coli infection usually begin a few days after consuming the bacteria. The bacteria attach to the walls of the intestines and multiply, releasing the Shiga toxin. The symptoms include fever, stomach cramps, vomiting and diarrhea.

The good news: Most people recover in five to seven days as their immune systems kill off the troublesome bacteria. But between 5 and 10 percent of people develop a potentially life-threatening complication known as hemolytic uremic syndrome. This syndrome is associated with decreased urinary frequency, fatigue and kidney damage. Many of those hospitalized in this outbreak are experiencing kidney problems.

How to prevent infection

The first step is to avoid the source of the outbreak. The Centers for Disease and Prevention (CDC) recommends throwing out any romaine lettuce from the Yuma, Arizona, region. Any lettuce of unknown origin should be thrown out just in case. Since Romaine is found in some prepared salad mixes, read the labels.

In case any of the E. Coli 0157:H7 has made it into a home environment, thorough hand-washing will remove most bacterial contamination. Kitchens should be kept clean during food preparation, as well.

Though this outbreak is traced to lettuce, it’s a good idea to cook meat thoroughly, avoid unpasteurized dairy products and juices and avoid swallowing water when swimming. E. Coli 0157:H7 can be present wherever cattle have been.

Sunny Intwala, M.D., is a third-year cardiology fellow affiliated with Boston University School of Medicine who works in the ABC News Medical Unit.

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Synthetic Mouse Embryos Produced Without Egg Or Sperm Could Help Pinpoint The Cause Of Failed Pregnancies

Illustration of the process in which eggs are artificially inseminated.

A recent breakthrough in stem cell research has helped scientists create the first-ever synthetic embryos produced without eggs or sperm. By using solely mouse stem cells, Dutch researchers from Maastricht University in the Netherlands have managed to craft an embryo-like structure called a blastocyst, Phys.org reports.

Blastocysts are hollow spheres that usually form within a few days after an egg is fertilized. These spheres are made up of less than 100 cells that divide into two groups: and outer layer of cells which goes on to form the placenta and a small cluster of cells in the middle, which later develops into the actual embryo.

However, the Dutch team has succeeded in creating blastocysts in the lab without using a fertilized egg. Instead, the researchers experimented with two types of mouse stem cells: embryonic stem cells, which have the potential to form a whole embryo, and trophoblast stem cells, which can develop into placenta.

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CDC expands warning to consumers over tainted romaine lettuce

The Centers for Disease Control is expanding its warning over romaine lettuce tainted with E. coli. The lettuce is responsible for at least 53 people falling ill, including 31 hospitalizations, in 16 states.

The CDC had previously warned consumers only about chopped romaine lettuce, but is now saying anyone who purchased any type of romaine lettuce from the Yuma, Arizona, region should throw it out.

“Based on new information, CDC is expanding its warning to consumers to cover all types of romaine lettuce from the Yuma, Arizona growing region,” the CDC said in a statement. “This warning now includes whole heads and hearts of romaine lettuce, in addition to chopped romaine and salads and salad mixes containing romaine.

“Do not buy or eat romaine lettuce at a grocery store or restaurant unless you can confirm it is not from the Yuma, Arizona, growing region,” it adds.

The warning was expanded on Friday after someone at a correctional facility in Alaska reported getting sick from whole heads of lettuce.

The CDC has not listed any brand or product names affected, just the location, saying “no common grower, supplier, distributor, or brand has been identified.”

Of the 31 people hospitalized due to E. coli, five have developed kidney failure, the CDC said. No one has died. Symptoms of E. coli infections include diarrhea, cramps and vomiting, and severe infections can even be life-threatening.

States which have reported illnesses include Alaska, Arizona, California, Connecticut, Idaho, Illinois, Louisiana, Michigan, Missouri, Montana, New Jersey, New York, Ohio, Pennsylvania, Virginian and Washington. Idaho and Pennsylvania have seen the most cases with 10 and 12, respectively.

This is the second time in a week the CDC has warned consumers about tainted food. More than 200 million eggs were recalled by a distributor last weekend over salmonella concerns.

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Kelly Ripa Rocks Crop Top And Leotard On Instagram As Her Nutritionist Talks Bikini Body Backlash And Diet

Kelly Ripa credits an alkaline diet for her bikini body.

Kelly Ripa is getting raves from her Instagram followers for her new photo. Ripa posed in a crop top and leotards, showing off her amazing abs and thanking her fitness trainer in the caption. But beyond working with a trainer to tone her tummy, Kelly’s fabulous figure at 47 owes credit to her nutritionist.

Dr. Daryl Gioffre, who has taken on the role of diet guru to Ripa, talked with Page Six about the backlash that Kelly received over photos of her bikini body on Instagram. The nutritionist also clarified the details of Ripa’s diet, which he feels is often misunderstood.

Kelly Ripa Has Healthy Approach To Bikini Body Backlash, Says Her Nutritionist

Kelly isn’t stressing over the slams she got over her Instagram bikini photos, said Gioffre. He linked Ripa’s desire to follow a healthy diet to her relaxed approach to coping with the backlash, noting that Kelly just goes with the flow (even when it turns negative).

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