Obstetricians. Obstetric anesthesiologists. Trauma surgeons. Neonatologists. Urologists. Oncologists.
A small army awaited a terrified Emrys Hamidi as she was wheeled into a trauma operating room at MUSC for a C-section that would hopefully save her and her baby from a life-threatening condition, placenta accreta - a condition where the placenta attaches too deeply to the uterine wall and can actually grow through the uterus and attach to a nearby organ, often causing the mother to hemorrhage during delivery. It can be deadly, and there haven’t been many options for obstetricians who confront a massive hemorrhage during C-section.
But in a fortuitious bit of timing, Trauma surgeon Evert Eriksson, M.D. and Trauma program manager Shawn Crowley, RN, MSN had recently introduced REBOA (Resuscitative Endovascular Balloon Occlusion of the Aorta) at MUSC Health to use in the Emergency Department for patients bleeding in the abdomen.
The device cuts off blood flow from the aorta into the lower portion of the body, giving doctors time to track down and repair the source of the hemorrhage.
After success in the Emergency Department, they decided to call their colleagues in OB-GYN to see if they might be interested in using the new device for pregnant women who hemorrhage during C-sections.Dr. Scott Sullivan, director of the Division of Maternal Fetal Medicine, and his team began to research the use of REBOA during C-sections to deliver patients with placenta accreta.
After several months, they were ready to move forward, and Emrys was one of the first patients to benefit.
The Trauma team preps the patient with the hope that the REBOA won’t need to be deployed. But after Emrys’ son Abbas was delivered, her blood pressure began to drop dramatically. The Trauma team quickly stepped in to deploy the REBOA, stabilizing her blood pressure and allowing surgeons to repair the damage. All of that was forethought as much as it was medical prowess,” said her husband,
Amid Hamidi, who was in the room during delivery. “Had they tried to place it emergently, once things were going sideways, it would have been too late. She would have probably bled out in two minutes. There wouldn’t have been enough time to place it.”