Posted by Lieutenant Commander Alexis Bonner (Assistant Chief Medical Officer) in side - sim: A Desperate Consultation (Tag Walker)

Posted by Commander Brad Walker (Chief Of Staff/Second Officer) in side - sim: A Desperate Consultation (Tag Walker)

Posted by Lieutenant Commander Alexis Bonner (Assistant Chief Medical Officer) in side - sim: A Desperate Consultation (Tag Walker)
Posted by… suppressed (1) by the Post Ghost! 👻
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“Emergency. Two weeks ago I did a prenatal open heart procedure on the fetus. The baby is Trill and Denobulan. The mother’s body simply can’t handle the demand the fetus is putting on her physiological systems. Normally we would attempt a surrogate, but no one is compatible.” The lift arrived and she stepped in calling for the deck. “Come down to my office, I’ll show you the file. The weird thing I want,” The doors to the lift closed, “is to know if you can build an artificial womb.”

Bonner, AMO

Kane looked at the deck counter as the lift started moving. “Huh.” was all he said and the rest of the trip he was quiet.

When they reached her office, he sat down and grabbed one of the many PaDDs and held it out to her. “Pull up the file, gorgeous. Let’s see what you’ve got going on.” and he sat down.

Kane, CSO / R&D

A quick tap and a swipe and the file appeared on the PaDD. The mother was Denobulan and this was her first pregnancy. Previously her health had been excellent except for a history of respiratory infections as a young child. Four years ago she fell from a cat walk and suffered abdominal trauma. Her records stated a full recovery, but Alexis had made a note that the previous doctors probably had not examined her reproductive system and injuries had been missed. She speculated it was part of the problem.

The early pregnancy progressed as expected with no issues until the 4th month when the anatomy scans were completed and it showed that there was a small hole in the heart. Nothing was done at the time because often such problems self corrected before birth. As the weeks progressed the mother presented with extreme fatigue, light headedness and vertigo. Her blood pressure was tested and came back as severe hypotension and vitamin defencies. She was treated but returned with severe contractions two days later.

At that time another anatomy scan was conducted showing the heart was worse and an amniocentesis was conducted. The fetus was suffering from the same vitamin deficiencies and blood flow through the placenta was sluggish. Correcting for that helped the baby but the mother got worse. Surgery was performed on the heart successfully. Alexis took a DNA sample at that time but could find nothing g that would indicate an obvious problem. The child was perfectly healthy in that respect.

So it went back and forth. The mother’s systems could either support her or the child, not both.

Bonner, AMO

Kane studied the file for a long time in silence. He looked at the lab results, cardiac monitoring trends, blood oxygen levels, mineral densities, fetal heartbeat monitoring… everything. He then looked at it all again, but this time he was standing up and pacing the room. His face had a look like he was fuming angry at someone, which Alexis would know was not the case… he was made at the circumstances. Finally he sat back down and said “Ok… the way I see it we have two or three ways to go. One, we supplement the uterus with a modified life support system that will ease the draw on the mother and keep the fetus healthy. Two, we do the artificial womb… but i don’t know if we have the time. Three is we do a modified hysterectomy and replace the majority of the uterus with synthetic. That last one would be really hard, and the risk is astronomical… to mom and baby. Two is risky as well, just in the time frame. I mean, I could probably have one ready and tested in a couple of weeks… but looking at these test results I dont think we have that long. I could be wrong. But if can implant a supplemental support system to the mother’s existing uterus, then we could monitor in real time and make adjustments as needed. It would be invasive, but it would probably work. Either way we go, it will be risky and it hasn’t been done before that I know of. So the real world challenges are unknown. What do you think?”

Kane, CSO / R&D

Alexis waited as he read and then paced and then finally sat and laid out his thoughts. “If we had known before she got pregnant or early in the first trimester I would say the synthetic uterus would have been the best option. Now, I don’t think either would survive another surgery. I was optimistic after the surgery, as their vitals stabilized for awhile. I am highly concerned about the delivery.” They didn’t have a couple of weeks, Alexis knew and so did Kane. Alexis would get them what time they could, but if the mother’s body gave out there was only so much Alexis could do. The parents knew it too. “How long would it take you to develop a supplemental support system?”

Bonner, AMO

“No idea, but I’ll get right on it. Send me a tissue sample from the mother and the genetic mapping for her and the fetus. And I’ll need to be there for the procedure. You might wanna have Walker and you come down to the labs in the next day or so so we can plan it out. I should have at least the rough specs done by then.” He stood up and gave Bonner a kiss. “We’ll do whatever we can, ok? You just keep ‘em stable. I’ll be in the R&D lab if you need me.” and he turned and walked out the door.

Kane, CSO / R&D

Alexis pulled up the the genetic mappings he requested. “Already at your console. I’ll get a tissue sample and have it brought down immediately.” A quick kiss in return and she nodded. “That’s the plan. We’ll be down in a couple of days. Sooner if you’re ready.” The door opened and then closed behind him and she stared at the medical records for a very long moment. Then she got up, and went into the maternity ward for the tissue sample. She sent the sample immediately down to R&D and then took the trip up to primary sickbay and knocked on Walkers office door.

Bonner, AMO

“Come,” Brad answered, surprise on his face when the door slid open to reveal Alexis.

“Dr. Bonner, I wasn’t expecting to see you until after the Ambassador’s party arrives.”

Cmdr. Dr. Brad Walker
Chief of Staff

Alexis nodded, sending him the names for the Amvassador’s care team could have been a simple memo, but the other topic could not. “You asked for recommendations for the ambassador. I was considering Dr Marshall and Dr Solal. Marshall is trained in emergency medicine and has worked in ERs. If we allow him to do the intake and process her like anyone else arriving to the ER he may catch something, and at least get a clean medical history. And Dr Solal because given what little history we know from the meeting, I feel his expertise in Immunology would be beneficial.”

“I can certainly see the benefit in that,” Brad agreed. “I think we should also consider running our initial diagnostics twice: once in our Sickbay, under Earth-normal conditions, and once in their quarters, in normal conditions for them, to see if it could be something about Earth that is causing her issues.”

Alexis nodded, “I agree. Their respiratory device may help them breath in other atmospheres but it could also not be healthy in the long term.”

“I also wanted to update you about Lt. Damu.” Damu was a Denobulian science officer who was pregnant and having severe complications. “She is nit doing well and neither is her child. I consulted with Dr. Kane because we simply don’t have the technology to do better for her. He has suggested a fetal life support unit. Not monitoring the mother and supporting the baby through her, but to monitor and support the fetus directly. It would be quite invasive, but would take the strain off of Damu. Cmdr Kane said he would have something for us to look at tomorrow.”

Bonner, AMO

“It’s a bit radical,” Brad hedged, pulling up Damu’s chart on his wall monitor to see the latest developments. “How far along is she?”

Cmdr. Dr. Brad Walker
Chief of Staff

“7 months. It is radical. She’s not doing well though. I can stabilize her but then the baby goes into distress and vice-versa. I considered a surrogate, but no one is compatible. We discussed an artificial womb as well, but Cmdr Kane didn’t think he could complete something like that in time. She’s getting worse every day. There was some improvement after the cardiac valve surgery, but it didn’t hold steady.”

Bonner, AMO

“28 weeks…” Brad mused. He’d received the required training in obstetrics and gynecology in medical school, years ago, but hadn’t had much opportunity to practice on the knowledge over the years. “Have you considered simply delivering the baby premature? It’s not ideal, but the baby should be able to survive outside the womb at this point, and we would certainly be able to provide more direct support.”

Cmdr. Dr. Brad Walker
Chief of Staff

Alexis shook her head, “If she was human maybe, but Denobulian gestation is almost a year, and the fetus is half Trill. Half Trill pregnancies are notoriously difficult and very high risk. I would like Damu to be able to carry the baby as close to term as possible. If bot we won’t have a choice but to deliver.”

Bonner, AMO

Brad nodded, studying the chart further while considering the options. “I presume this implant will be a temporary measure, and will come out after delivery?” he asked. Obviously, if the lieutenant sought another child in the future, she would likely choose a different method, as fraught as this natural gestation had been. Or, perhaps, a different father for the child that would be less complicated.

Cmdr. Dr. Brad Walker
Chief of Staff