Patient Case Review: Lea Dilallo

Lea Dilallo was a patient in episode 4×16 Dr. Ted.

Lea broke down in front of St. Bonaventure Hospital at the end of episode 4×15 “Waiting”. It’s not clear what happened immediately afterwards, as episode 4×16 picks up at least 24 hours after we see her collapse.

She had intense pain on both sides of her abdomen that lasted a few minutes but then subsided and didn’t recur. Her OB GYN had told her it was probably round ligament pain, which can occur as the fetus grows and the uterus expands. Claire examined her and found that her blood pressure was perfect and her ultrasound was normal.

Shaun insisted they run more tests to exclude potential complications. Claire noticed that the baby’s heartrate was mildy bradicardic (too slow). Claire then suggested a transvaginal ultrasound, where they found out that Lea had type 2 vasa praevia, a condition that made the fetal blood vessels vulnerable to rupturing (the fetal blood vessels were running across the cervix).

The gestational age of the baby at the time was 22 weeks, two weeks short of viability to survive outside of the womb, which is why they couldn’t do a C-section.

They performed surgery on Lea to stabilize the unstable blood vessel, which went well. They also administered steroids to help speed up the development of the baby’s lungs.

Lea then had a pulmonary embolism (a blood clot in the lung artery that had traveled there from her leg — usually a life-threatening condition), which they treated by inserting a filter in the artery. They ran pre-OP and post-OP tests, and those tests revealed that there was an additional issue with the umbillical artery that they didn’t see before (not a mistake, just something that they couldn’t detect with the tests they had run previously).

A second blot clot was lodged in Lea’s umbillical artery (the artery feeding the baby with blood). On top of that (or perhaps because of the second clot), the baby’s lungs weren’t responding to the steroids, so the baby wouldn’t survive.

Shaun and Lea made the difficult decision to abort the pregnancy, as there was nothing more than could be done to save their daughter.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s