Hybrid Operating Room at North Shore University Hospital Uses Imaging to Aid in High-Risk Deliveries

by faithgibson on February 27, 2013

in Contemporary Childbirth Politics

Synopsis of comments about this article by Linda B, a retired midwife, who originally posted this link on a California midwives’ email group:

Because…there are fewer vaginal deliveries…. because we put more scars on more uteri… because just doing that increases the risk of mothers dying of a placenta accretas or percreta (most sever form abnormal placentation) the next time they have babies… we now have a LOT of high risk deliveries.

But NOT to worry! The obstetrical profession, who created the problem in the first place with its 33% Cesarean section rate and substantially increased maternal mortality rate, has had its bacon saved by the high tech medical imaging industry. They are now advertising a hot new “hybrid” operating room with all the usual surgical equipment (and unusually expensive bells and whistles!) to which they’ve added the latest radiological imaging technology so they can SAVE YOU as a high-risk patient with a placenta accreta/percreta.

That, of course, closes the obstetrical circle — the gift that keeps on giving!. Abnormal placentation is well-known downstream complication of the C-section they were so anxious to do because your labor was going a little slower than usual, or the EFM indicated the maybe your baby getting a little tired.

Source: PRWeb – Thu, Feb 21, 2013

North Shore University Hospital in Manhasset (NSUH) 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.  Manhasset, NY (PRWEB) February 21, 2013

With increase in Cesarean deliveries, doctors consider hybrid OR to be “wave of the future” in high-risk cases.

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 imagingtechnology) 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.”

{Editor’s Note on this comment:With increase in Cesarean deliveries, doctors consider hybrid OR to be ‘wave of the future’  in high-risk cases”

Those who have read Steven Brill’s recent article “Bitter Pill” (TIME Magazine March 4, 2013) will realize the delayed and downstream complications of the already more expensive Cesarean surgery (twice the cost of a normal vagina birth) will only sky-rocket with this super-sizing of medical interventions.

Hospital charges and doctors’ bills for the use of this hybrid operating room will be $100,000 at the very least. And that $100,000 birth assumes neither mom or baby spends any time in an intensive care unit @ 13,500 a day (daily charge for our local hospital’s NICU). If they do, it can turn into a quarter million dollars in no time flat.

But instead of looking for ways to reduce the risk of these complications by working to lower the number of Cesarean surgeries, the ‘system’ is programed to ramp up its billable units.

In addition to the hospital’s standard charges for the operating room and radiology department’s imagining equipment, there are all the professional fees generated by its team of a half-dozen specialists — at least 2 obstetricians, 2 radiologists, a hematologist and at least one perinatologist, plus nurses and technicians.

Then there will be dozens of inflated charges for single-use disposable supplies, like $40 patient gowns or a $77 strap to keep the mother from falling off the OR table! These arbitrary fees are taken from the hospital’s mysterious charge-master list, which is used by hospitals to systematically overcharge as a regular, daily aspect of their business model.

This tradition began as an institutional decision to pump up the fees for thousands of ordinary items on their chargemaster list as a way to inflate the bills of uber-wealthy patients who pay out-of-pocket (ex. Arabian sheks who come to the US for medical care).

Unfortunately the chargemaster list generates the same nonsense charges when billing all the rest of us. If you don’t have an insurance company to that has pre-neigotiated a more reasonable fee, the uninsured get taken to the cleaners first, then turned over to bill-collecgtors and eventually wind up in bankruptcy court.}


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