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She reached out her arm stiffly to touch his.
‘The strands are so fine that they can be hard to spot on ultrasound, Malachi,’ she whispered. ‘A diagnosis is usually made by observing the birth defects caused by ABS.’
He turned his head to look at her, and for a moment they didn’t feel like two strangers who had made a baby during a one-night stand. They felt like a unit. A team.
‘Like these masses on the b
aby’s left hand and foot?’
‘Yes,’ the consultant confirmed. ‘And the club foot we’ve seen today.
Malachi turned back to face the woman, away from Saskia. There was no need for Saskia to feel the loss so acutely. Yet she did.
‘We...we were intimate,’ he bit out at length. ‘Last week...’
‘No,’ the woman shook her head firmly. ‘We don’t always know what causes chorioamniotic separation, but usually—that is, in about eighty-five percent of cases—it is invasive foetal surgery. Either way, it won’t have been sexual intimacy.’
He still looked rigid, as if he wasn’t convinced that he wasn’t somehow to blame. Saskia wanted to say something but she didn’t know what. She didn’t know how.
‘So what now?’ he demanded abruptly.
Something surged through Saskia. She couldn’t have said what it was, but it lent her strength suddenly.
‘I want surgery.’
‘That’s what I would advise,’ the consultant agreed. ‘Though we need to discuss the risks.’
‘I know the risks.’
Galvanised, Saskia leaned forward, as though that would somehow better convey her desire.
‘But, depending on how tightly those bands are wrapped around my baby’s foot and hand, they could end up amputating them in the womb.’
‘So they are going to perform the surgery on you now?’ Malachi growled. ‘I realise this is something you can do—operate on babies in the womb—but this is my baby. Our baby. Talk me through it. I need to understand.’
‘There was something else I noted on the scans which we need to discuss,’ the consultant said.
Saskia blinked. ‘Something else?’
‘At one point during the scan your baby moved. It appeared as though part of it moved out of the amniotic cavity.’
‘PROM?’ She echoed in disbelief, staring at the consultant.
‘Right...’
‘What is PROM?’ he demanded.
Almost robotically, Saskia turned to face Malachi. ‘Premature rupture of the membranes. It means that a purely fetoscopic release of the amniotic bands will be impossible.’
‘However, we do have the option of surgery in a CO2-filled uterus,’ the consultant added quickly. ‘A laparotomy with fetoscopic release of the bands, along with a partial amnionectomy, likely through two uterine ports, with CO2 as distention.’
‘So you’ll cut the bands, remove them from the baby’s limbs, then what?’ she asked.
‘We’ll cut them away and remove them from your uterus, as well as any amnion.’
‘What about Saskia and the baby?’ Malachi cut in. ‘How do you monitor them to make sure they’re both okay?’
‘Normal cardiac function for Saskia will be monitored by heart rate, mitral regurgitation and motion of the heart.’ The consultant smiled encouragingly. ‘The baby’s cardiac function will be intermittently monitored by a separate paediatric cardiologist, using an ultrasound probe placed directly into the uterus to produce an image of the baby’s heart.’
