When Things Don’t Go as Expected, We Have the Experts

January 9, 2024

Marina Metrikin thought her  pregnancy was “pretty easy,” until  she began her third trimester.

“And then everything became an issue,” says Metrikin, who got pregnant at age 36. Prenatal testing revealed she’d developed gestational diabetes. “I was stressed because this wasn’t something I had experienced before I was pregnant.” 

That’s when Metrikin’s OB-GYN, Gil Bender, MD, referred her to Tania Esakoff, MD, a maternal-fetal medicine specialist at Providence Cedars-Sinai Tarzana Medical Center. Dr. Esakoff immediately connected Metrikin with a diabetic nurse educator and “tried to set me up for success with weekly monitoring of food choices and regular communication,” says Metrikin. “It was really easy to communicate. If it wasn’t on the phone, Dr. Esakoff was very quick to respond through the Providence Cedars-Sinai Tarzana Medical Center MyChart portal. Not only could I ask questions, but I could also see all my test results.” 

Unfortunately, the dietary changes weren’t enough to bring her blood sugar to normal levels, so insulin was added to the care plan. “That combination allowed me to get things under control,” says Metrikin.

But then another issue surfaced: high blood pressure, or hypertension, which required her to take her blood pressure multiple times a day. At night, she would see spikes that were concerning, but her care team was constantly working with her to improve her condition.

“I tried everything, even eliminating salt from my diet,” she says. “I was in my third trimester and losing weight because I was making all kinds of dietary changes to make sure my baby wasn’t affected.”

Metrikin started going to doctor appointments three times a week. Twice a week, she went to Dr. Esakoff’s high-risk maternal-fetal medicine office for non-stress tests, a noninvasive test where the mother’s blood pressure is taken at regular intervals while the baby’s heart rate is monitored. She also continued to see Dr. Bender in his Tarzana office on a weekly basis. 

“They were always checking my vitals after all the blood tests, talking with each other and deciding what to do,” she says. “It was great to have a team. They really worked well together and provided excellent care.” 

As Metrikin’s pregnancy got closer to 32 weeks—an important milestone where the baby goes from “very preterm” to “moderate preterm”—it felt like a miracle, she says. 

Yet she knew that the combination of high blood pressure and high blood sugar from diabetes increased the risk of preeclampsia, a serious and potentially fatal condition for mother and baby. Regular blood work and urine tests to check for high levels of protein showed signs of preeclampsia in her 36th week. “During my visit, Dr. Esakoff told me I should go to the hospital and be induced later that night,” Metrikin says. “I was so scared and said, ‘I’m not ready. Can I think about it?’” But Dr. Esakoff and a nurse shared the importance of being hospitalized and regularly monitored. Delivering a few days early would not be harmful, but waiting could be dangerous to both mom and baby. Metrikin says they told her, “Your health is important, your baby’s health is important, so get yourself to the hospital.”

After telling her husband and family, Metrikin went to the hospital on a Friday night to be induced into labor. “It was a smooth process, and the staff was incredible,” she says. She gave birth on Sunday morning to a healthy 5-pound, 2-ounce baby girl. “At the end it was worth it,” Metrikin says. “Because I’m healthy and my baby is healthy. I’m so grateful we had a team of doctors who truly cared about me and the health of my unborn baby.”

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