My week: Hassan Shehata, consultant obstetrician and gynaecologist
I specialise in problems in pregnancy and recurrent miscarriages. On Monday afternoon I was at my private practice. I see people from all around the world; by the time women come to see me, they are pretty desperate. One woman had had 21 miscarriages; she lost the majority of pregnancies in the first trimester, but also had about three or four in the second trimester. She was very upset, but I'm hoping to help her. Another of my patients had had eight miscarriages. She is pregnant and when she arrived, she was shaking. When I gave her a scan it was the first time she and her husband had ever seen their baby's heart beat. It was very emotional, and it made my day. I love my job because often I'm bringing good news to people for the first time.
My research is on "natural killer cells", where the body's immune system attacks the pregnancy. I estimate it could affect a fifth of women who have recurrent miscarriages.
On Tuesday morning I have a diabetes clinic. With diabetes, babies tend to become bigger in the womb. If the diabetes isn't controlled, it can cause the death of the baby. We had a woman who had been meticulous with her diabetes control and diet, but her baby was still getting bigger and we had to deliver the baby by caesarean section the next day.
On alternate Tuesday afternoons I do a recurrent miscarriage clinic or a preconception counselling clinic. We see patients from all over the country. One wanted to fall pregnant, but has systemic lupus erythamatosus (SLE), which is like rheumatoid arthritis, but can also affect the lungs and kidneys. I had to tell her I didn't believe it was a good idea to become pregnant, which is always hard. Her disease is quite active at the moment – we need to control that first. A few years ago, I advised a patient with similar problems against pregnancy. She became pregnant and by 24 weeks she had severe pre-eclampsia. We had to do a very early caesarean because we were worried about her life. Her baby didn't survive. It can be that severe.
On Tuesday night, I was on call. I'm not often called out, but the registrar had decided to do a caesarean section for a woman who had a high BMI and whose baby was stuck. It was very difficult – a routine caesarean takes 45 minutes, but I spent about three hours on this. Eventually the mother and baby were well.