MANHASSET, NY – When Kirsten Kuhn, of Huntington, NY, learned that her pregnancy was complicated by an abnormal condition known as Placenta Accreta, she and her doctor decided that the only place for her to give birth was at North Shore University Hospital in Manhasset (NSUH). That’s because the hospital is the only facility in the area that features a hybrid operating room (an OR that combines surgical equipment with the latest radiological imaging technology) that is available for high-risk deliveries such as patients with Placenta Accreta.
At the time of delivery in a normal pregnancy, the placenta separates easily from the mother’s uterine wall with minimal bleeding. In cases such as Ms. Kuhn’s, that separation is very difficult and could result in a massive hemorrhage. To minimize that risk, doctors place thin catheters (immediately prior to delivery) in the blood vessels that supply the uterus. These catheters can be used to significantly decrease the uterine blood supply (after the delivery of the infant) and therefore the risk of hemorrhage to the mother. Placement of these catheters requires specialized imaging equipment available in radiological suites.
In most hospitals, high-risk maternity patients are taken to Radiology to have the catheters inserted and are then moved to the OR for the Cesarian-section (C-section) delivery. After delivery, these catheters are used to decrease the uterine blood flow. Depending on the type of procedure, the mother may have to be moved back to Radiology if more images are required. Moving patients from Radiology to the OR and possibly back again risks displacement of the catheters and a delay in controlling the bleeding, which could be dangerous.
According to Adiel Fleischer, MD, chair of obstetrics and gynecology at North Shore-LIJ and the physician who brought Ms. Kuhn’s son Kellen into the world, a hybrid OR used for such high-risk deliveries is “the wave of the future” especially considering the dramatic increase in the number of patients with Placenta Accreta. “The hybrid OR approach allows us to combine high-resolution radiological equipment with a fully-equipped operating room,” Dr. Fleischer said. “This enables us to perform the radiological intervention on short notice, change catheters if necessary and that allows the surgery to continue while minimizing the risk of hemorrhaging and creating the best outcome for our patients. This approach has resulted in a significant improvement in our management of this life-threatening obstetrical complication.”
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