28 March 2017

Northside Team Saves Mother, Baby in Complicated Delivery

Air Force major Jerry Gay and his pregnant wife, Mary, were looking forward to the expected February 9 arrival of their new daughter. Mary was at home in Georgia and Jerry was deployed in Qatar, in the Middle East. But the couple’s joy became tempered with fear when Mary’s ob-gyn, Dr. Alex Eaccarino, noticed a spot that didn’t look quite normal during Mary’s 30-week checkup, per a recent story on Fox 5 Atlanta

The spot turned out to be uterine scarring from Mary’s prior cesarean-section deliveries. The scarring increased her risk for a placenta accreta, a potentially life-threatening obstetric condition that occurs when part or all of the placenta invades the uterine wall and is inseparable from it, preventing the placenta from detaching as it should during birth. "The biggest risk factor to the mom would be the risk of post-partum hemorrhage or uncontrollable bleeding," Dr. Eaccarino told Fox 5 Atlanta. Mary was told that she would need a C-section and that it was likely she also would need a hysterectomy to remove all or part of her uterus. Jerry immediately rushed home from the Middle East on emergency leave and was with Mary at Northside Hospital’s Forsyth campus on January 4 for her surgery.

Mary’s three surgeons and the anesthesia team from Sheridan practice Northside Anesthesiology Consultants (NAC) were extremely experienced in dealing with this type of complicated, high-risk delivery. Northside has the busiest obstetric practice in the country, delivering more than 25,000 babies and performing roughly 7,000–8,000 C-sections each year, according to John Kimbell, CAA, MMSC, NAC’s administrative chief anesthetist. 

Anticipating the possibility of hemorrhage, the anesthesia team placed invasive monitoring lines pre-operatively, and a large supply of blood products had already been cross-matched and were available, if needed—preparations that helped saved Mary’s and her unborn daughter’s lives.

The C-section went better than expected, with minimal bleeding, and it appeared that the placenta accreta was not as extensive as the surgeons had originally thought, Dr. Eaccarino told Fox 5. At that point, he said, they agreed it would be best to preserve Mary’s uterus and decided against performing a hysterectomy. Jerry told the reporter that while he was in the NICU with newborn daughter Sinclair, he was ecstatic to receive a call from Mary's surgical nurse, who told him that she was doing well and was being moved to the recovery area.

Unfortunately, this best-case scenario didn’t last long. When Mary woke up from the anesthesia, she was in severe pain and her nurse quickly realized Mary was bleeding excessively. The nurse "got my doctor back in there really quickly and the anesthesiologist back into the OR,” she recalled to the reporter. By then, Mary was hemorrhaging and needed more than 30 units of blood to replace the blood she was losing.

The anesthesia team, which included Stephen Grice, MD, Jeff Mims, CAA, Jeff Thomas, CAA and Patty Flaherty, CAA, among others, activated its Massive Transfusion Protocol that allows quick coordination with the blood bank and enables predetermined packages of different blood products to be delivered quickly and constantly. Thanks to that team’s prior preparations and the Massive Transfusion Protocol, the surgeons were able to stop the bleeding and remove part of Mary's uterus. Jerry told Fox 5 that it "the longest hour and a half of my life." 

When Mary woke up in the ICU, on a ventilator, she immediately asked to see her baby, Sinclair. "I don't think you can go through things like that and have it not change you,” she told the reporter. “I appreciate things a lot more."

In their interview with Fox 5 Atlanta, Mary and Jerry expressed their gratitude for Dr. Eaccarino and the entire Northside team, whose skill and alertness helped save both Mary’s and Sinclair’s lives, and for the dozens of strangers whose blood donations helped make the life-saving surgery possible.