A mother has gone beyond the call of duty, recently, after giving birth to her daughter’s twin children. The 53-year-old, Susie Kozisek, acted as the gestational carrier in place of her daughter, who was unable to partake in the pregnancy, due to quite a significant medical contraindication, called pulmonary hypertension.
Kozisek’s daughter, Ashley Larkin was diagnosed with pulmonary hypertension. This is a condition which increases the blood pressure within the vasculature of the lungs, forces the right ventricle of the heart to pump harder to ensure an adequate rate of oxygenation is achieved. In turn, this leads to ventricular hypertrophy, where the size of the chamber increases in response to this additional exertion. Blood is often pushed backwards, as a result, through one of the valves (tricuspid) that divisions two chambers of the heart, called the right atrium and ventricle.
Therefore, Ashley’s mother stepped up to the mark, acting as a gestational carrier. Essentially, the biological mother and father’s respective egg and sperm cells are combined, under laboratory settings. The egg and sperm cells are placed into a medium, which simulates natural conditions required for fertilization; as many are aware, this is called in vitro fertilization (IVF). The fertilized egg, called a zygote, is then placed into the uterus of a healthy carrier, who continues with the pregnancy.
The reasons for this particular case being so extraordinary is two-fold. Firstly, Kozisek and Larkin are biologically related, meaning that Kozisek had given birth to her own grandchildren. Secondly, Kozisek was reaching the upper-end of the age scale, where pregnancy starts to become riskier.
The idea came about when Ashley’s 53-year-old mother had seen the technique described on a talk show. She then decided to investigate the possibly that she could harbor her daughter and son-in-law’s children. Quite unbelievably, Kozisek remained employed during the pregnancy, continuing her duties as a legal secretary. Little did she know, prior to her offer, that she would give birth to her hypertensive daughter’s twin children.
Pulmonary hypertension can cause significant danger during pregnancy, with mortality rates estimated at between 30% and 56%. It has been suggested that the regular physiological changes observed during pregnancy cannot be withstood by pulmonary hypertension suffers. During a healthy pregnancy, the mother’s pulmonary vasculature reduces its resistance, permitting an elevation in cardiac output (the volume of blood pumped out from the ventricles of the heart). Sadly, those afflicted with pulmonary hypertension, do not experience the same decrease in pulmonary resistance, which leads to dangerously high pressure within the blood vessels of the lungs.
Ultimately, this can lead to right-side cardiac failure, increased risk of pulmonary emboli, and reduced diastolic filling of the left ventricle.
Of course, one could argue that there were still risks associated with this pregnancy, they had just been shifted. With age the risk of stillbirths increases, along with underweight newborns, miscarriage, gestational diabetes and preeclampsia (elevated blood pressure, with multi-organ damage), whilst chronic medical conditions can too exacerbate the undertaking.
However, according to the Daily Mail, Ms. Kozisek was in great medical shape, during her pregnancy. Dr. Jani Jensen, of the Mayo Clinic, who was responsible for the IVF work, states that Kozisek was a “good candidate,” based upon her fitness and after having given birth on previous occasions.
Frankly, Ashley Larkin owes her mother of 53 quite the pat on the back. Having the burden of giving birth, at such an age, and providing her hypertensive daughter with the gift of twin children is quite an astounding act of altruism, not one that many mothers would even dare consider.
By: James Fenner