Young mother with rare heart condition successfully delivers baby thanks to Midlands hospitals teamwork
Baby Theo at home with mum Courteney Jayne Beaman and dad Jesse Owens
Clinicians at three top Midlands NHS trusts have teamed up to help a young mother with a rare heart condition successfully deliver her baby. 24-year-old Courteney Jayne Beaman, from Meir in Stoke on Trent, suffers from a rare heart defect called CCTGA (Congenitally Corrected Transposition of the Great Arteries), meaning the lower half of her heart is the wrong way around. In a medical first at Royal Stoke University Hospital for a patient with CCTGA, UHNM doctors teamed up with clinicians at University Hospitals Birmingham NHS Trust and Birmingham Women’s and Children’s NHS Foundation Trust via video link to help Courteney deliver.
The unprecedented case presented an extra challenge to clinicians due to the ongoing pandemic, but thanks to close teamwork and collaboration between the trusts, baby Theo was born safely in November last year.
Courteney said: “I was five years’ old when I found out I had CCTGA, but my first memory of something happening is when I was seven. I had to be rushed to hospital because I had palpitations and my heart rate was more than 200 beats-per-minute. Generally it doesn’t bother me too much having the condition, but I can’t really do a lot. I can’t exercise much and sometimes I get tired just going up the stairs.
“Going into labour, I didn’t really feel nervous because I know what my body can handle. Everything felt quite calm and normal.”
In patients with CCTGA the heart’s pumping chambers and arteries are reversed, which means the main pumping chamber - the ventricle - struggles to cope with the body’s demands during normal activity. During pregnancy the heart has to work even harder, pumping blood through the placenta to provide nutrients to the baby and effectively doing double the amount of work it normally does. Whilst this does not present a problem for women with a normal heart, in patients with CCTGA the heart isn’t as strong and it can start to fail. If this happens, the supply of blood to mother and baby is reduced, which can cause accumulation of fluid in the lungs, leading to breathing problems.
Courteney was cared for at UHNM by consultant cardiologists Dr Adrian Morley-Davies and Dr Diane Barker, Dr Jules Allt, Consultant Anaesthetist, Mr Peter Young, Consultant Obstetrician and Ms Uma Bathula, Consultant in Obstetrician and Gynaecology.
On the day of delivery, teams at Stoke and Birmingham met virtually. Specialists helped to review Courteney’s echocardiogram images with the team in Birmingham so they could plan the safest care during delivery.
Dr Adrian Morley-Davies, Consultant Cardiologist, said: “When Courteney became pregnant it was recognised there would be more challenges. Many women with CCTGA are at significant risk when they go through labour and if things get out of control it can make both mother and baby very unwell very quickly. Complex obstetric cases are often managed at Royal Stoke, but this is the first time a patient with CCTGA has delivered here, principally because it’s such a rare condition. Many patients with CCTGA don’t even reach childbearing age, so it really is of very serious concern.
“Patients of this complexity would often be seen in Birmingham in the past for physical reviews during pregnancy, to allow for supported and joint care. However, with expansion of local expertise and the difficulties imposed by the Covid-19 pandemic, remote working has become possible and necessary.
“The support we have had from the Birmingham team regarding all our high risk cases over the last six years has been fantastic and the service would not be able to continue without the dedication of everyone in the adult congenital heart disease teams in Stoke and Birmingham.”
A successful delivery - mum Courteney Jayne Beaman and dad Jesse Owens welcome baby Theo into the world
Dr Paul Clift, consultant in adult congenital heart disease, Dr Lucy Hudsmith, specialist in heart disease in pregnancy and adult congenital heart disease and Dr Caroline Fox, maternal and fetal medicine specialist, helped to manage Courteney’s care at Birmingham Women and Children’s NHS Foundation Trust. Dr James Geoghegan, consultant anaesthetist at Birmingham Women and Children’s NHS Foundation Trust, advised on the anaesthetic aspects of Courteney’s care.
Dr Clift said: “Courteney’s heart condition is a very rare one and it is wonderful to know that she and baby Theo are thriving. Given the complex nature of her condition, close communication between the teams in Stoke and Birmingham helped ensure this outcome. There are increasing numbers of people surviving to adult life with complex heart conditions and we work closely with our colleagues across the region to help them successfully come through pregnancies.”
Doctors at the three trusts worked against the clock to establish a multidisciplinary team to care for Courteney, with clinicians in UHNM’s anaesthetics and intensive care teams lending critical guidance and support.
Ms Uma Bathula specialises in the treatment of complex cases and led Courteney’s delivery at UHNM.
Ms Bathula said: “We faced a significant challenge because we couldn’t work in the way we normally would due to the pandemic. All of our communication with our Birmingham colleagues had to be online, which, whilst better than nothing, isn’t the same as face-to-face contact. Multidisciplinary teams involve clinicians from many different specialties and it was difficult to get so many experts in the same room at the same time, but by everyone working together we managed it.
“Courteney was induced and she actually had a very smooth labour. The excellent outcome in this case highlights the relentless dedication of all the clinicians involved and we at UHNM were extremely proud to be involved in this unique experience.”
Courteney lives with partner Jesse Owens, 22, and baby Theo in Stoke on Trent, Staffordshire.