Dr. Tomasz Waśniewski, MD, is a gynecologist and has already proven that he knows his profession well. Dr. Grzegorz Wasilewski, MD, is also a respected radiologist. Both of them are proven practitioners, because apart from working at the University of Warmia and Mazury, they also work at the Voivodeship Specialist Hospital in Olsztyn. At the end of January, they conducted a Caesarian section surgery in pregnancy with placenta previa, which was a pioneering surgery in Poland.
Placenta previa is a very serious complication in pregnancy. It is based on an improperly low placement of the placenta in the uterus. In this situation, it often grows into the uterus and the mother has no way of giving birth to a child in a natural way. A Caesarean section is needed. After removing the child, the doctor must remove the accrued placenta. This results in a serious hemorrhage. Within a dozen or so seconds a woman can lose even 3 liters of blood. However, very often physicians must remove the entire placenta. Therefore, a woman will never give birth to a child again. After this procedure each patient is transferred to the intensive care unit and heals for a long time. Currently, placenta previa is also the main cause of perinatal death.
A few months ago, the voivodeship hospital in Olsztyn launched a hybrid operating room. It is a room in which physicians of various specialties, such as radiologists, cardiologists and oncologists, can perform procedures simultaneously or one immediately after another on the same operating table. However, there had never been a radiologist and a gynecologist on the team.
Dr. Waśniewski and Dr. Wasilewski decided to change this. They began preparing to make this decision for some time by following professional literature and the achievements of Elżbieta and Marek Stefanowicz from the voivodeship hospital, who had laid the groundwork for their plans. The super-modern X-ray machine at the operating table gave them self-confidence. It not only provides impeccable image quality but also video which physicians see on the big screen at the operating table. In addition, this machine can smoothly show the inside of the body as seen from below, from the side or from above. This allows physicians to see the area of the body’s inside that interests him/her. Dr. Waśniewski selected a patient with placenta previa at the end of last year, and when her fetus reached 36 weeks, he started his work. He waited so that the child would be able to live without artificial support. The team of Dr. Wasilewski, i.e. the radiologists, commenced their work first. They inserted catheters into the femoral arteries in both groins, which then they pushed to the iliac arteries into the immediate vicinity of the uterus supplied with blood by them. It was not an easy task, because at some point the arteries separate and the catheter had to change direction by almost 360 degrees.
“A catheter is a flexible plastic tube terminated with a hollow bubble in the initial phase. Its introduction into the arteries resembles the introduction of a spiral into sewer pipes by a plumber. Only what I do is much, much smaller. The iliac arteries have a diameter of 6-7 mm inside and everything I do I see in a large magnification on the monitor screen, not directly. This is possible thanks to this modern X-ray machine”, Dr. Wasilewski explains.
Once the catheters were in place, Dr. Waśniewski with his team, i.e. gynecologists, commenced their work. Dr. Waśniewski performed a Caesarean section and removed a healthy child.
This is when the most important part of this surgery begins. Previously, Dr. Waśniewski would have started to remove the placenta grown into the uterus. The blood would flood, the patient would fade away and despite the efforts of the entire team of obstetricians - no one could guarantee her survival. But this is the now the past. When the placenta was empty, Dr. Wasilewski inflated the bubbles at the ends of both catheters. The bubbles blocked the arteries. The blood stopped reaching the placenta. Dr. Waśniewski calmly removed the placenta and sewed the uterus and the belly of the patient.
“This method gave us time to precisely complete all activities. We used only 600 ml instead of 3 liters of blood. The patient after the operation was in very good condition, and most importantly, she will still be able to give birth in the future”, Dr. Waśniewski informs.
This was the first surgery of this type in Olsztyn and the second one in Poland.
Both physicians announced that they would apply this procedure in cases of placenta previa. Thanks to the knowledge and skill of university specialists, deliveries in Olsztyn will be even safer and women will have the opportunity to have more children.