Hackensack University Medical Center Surgeons Successfully Preserve a Woman’s Uterus Despite Possible Life-Threatening Complications from Placenta Accreta

August 5, 2019

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Abdulla Al-Khan, M.D., director of the Center for Abnormal Placentation (CAP) and vice chair, Department of Obstetrics and Gynecology at the Donna A. Sanzari Women’s Hospital at Hackensack Meridian Health Hackensack University Medical Center and Jesus Alvarez-Perez, M.D., senior maternal fetal medicine specialist and director, Perinatal Diagnostics at the Donna A. Sanzari Women’s Hospital, successfully saved the uterus of Marleen Tawadrous.  Physicians in Boston, Massachusetts referred Marleen to Dr. Al-Khan and his team because of their groundbreaking work for patients with the most challenging cases, including placenta accreta.

When 29-year-old Marleen Tawadrous learned she was pregnant with her second child, she and her husband Ehab Tosa who live in Weymouth, Massachusetts were ecstatic.  The couple had been planning to give their six-year-old daughter a sibling.

“It was a very happy time for our family and we looked forward to a new addition,” recalls Marleen.

But, their happiness soon turned to sadness.  During an ultrasound in her 17th week of pregnancy, Marlene learned her unborn son had severe fetal anomalies, including the absence of kidneys and his prognosis for a live delivery was grim.  Marleen was advised by her doctors to terminate her pregnancy.  Instead, Marlene wanted to let nature take its course in hopes that he would be delivered full-term and she would be able to at least see her baby before he passed.  But, it was soon discovered that Marleen had a condition called placenta accreta, which occurs when blood vessels and other parts of the placenta grow too deeply into the uterine wall and can lead to life-threatening complications, including severe blood loss.  In Marleen’s case, the placenta was completely covering her cervix and invading her uterus and most likely her bladder.  Marleen was told her only option was to have a hysterectomy. Marleen was devastated and sought a second opinion.

“I wanted to preserve my womanhood and perhaps be able to have more children,” said Marleen.  “In my Egyptian culture, if you don’t have a uterus, you are no longer alive spiritually. I was told by my doctors that I could go to 20 other physicians, but I would be told the same thing, that saving my uterus was not an option.”

Marleen’s physicians ultimately referred her to a major academic medical center in the Boston area where she was evaluated by specialists, who then referred her to physicians at yet another major academic medical center in Boston, who once again told Marleen she needed a hysterectomy to save her life. Understanding Marleen’s strong desire to preserve her uterus,  she was referred her to Abdulla Al-Khan, M.D., director of the Center for Abnormal Placentation (CAP)  and vice chair, Department of Obstetrics and Gynecology at the Donna A. Sanzari Women’s Hospital at Hackensack Meridian Health Hackensack University Medical Center. Dr. Al-Khan has successfully performed uterus-sparing surgeries.  Marleen and her husband traveled to New Jersey to meet with Dr. Al-Khan in hopes they would be presented with more options.

“Marleen was devastated because she only has one child and now she was faced with losing not only her unborn child, but also her uterus,” said Dr. Al-Khan.  “This news was catastrophic for her.  When I met with Marleen and her husband, she said to me ‘I’d like everything done to save my uterus, if possible.’  I understood how much this meant to her.  I told her that we would do what we could and perform this very complicated surgery. I had all of the strategies in mind to execute a safe surgery trying to save her uterus, if feasible.”

On Monday, July 15, Dr. Al-Khan began the task to save Marleen’s uterus during a seven-and-a half hour surgery, which included delivering the fetus.

“We were able temporarily to cut off blood supply to the pelvis and with innovative techniques, we were able to remove all of the placenta accreta, which had invaded the uterus and cervix,” said Dr. Al-Khan. “We reconstructed her uterus completely and saved it.  We are proud to be successful. This is only possible because of the extraordinary physician and nursing staff who seek out innovative solutions for patients.”

The Center for Abnormal Placentation performs the most placenta accreta surgeries in the country, with 250 surgeries since the CAP program was established 12 years ago. As a result, Hackensack University Medical Center has become an active referral center for mothers in special situations.

“Hackensack Meridian Health is committed to maintaining a culture of quality and safety and providing exceptional outcomes for our patients,” said Ihor S. Sawczuk, M.D., FACS, regional president, Northern Market, Hackensack Meridian Health.”  Congratulations to the Division of Maternal-Fetal Medicine and Surgery for the outstanding services they provide every day to transform health care for our patients, their families and the communities we serve.”

“Congratulations to Dr. Al-Khan and his team at the Center for Abnormal Placentation for their tireless work to find innovative solutions that ensure the best care for our patients,” said Mark D. Sparta, FACHE, president and chief hospital executive, Hackensack University Medical Center and executive vice president, Hackensack Meridian Health. “It’s the courage, collaboration, creativity and compassion of our team, which creates a lasting impact on the lives of our patients and their families.”

“Major academic medical centers across the country are referring the most challenging cases to us,” said Manuel Alvarez, M.D., chair, Department of Obstetrics and Gynecology at the Donna A. Sanzari Women’s Hospital at Hackensack University Medical Center. “I am extremely proud of our committed team in the Division of Maternal-Fetal Medicine and Surgery for the groundbreaking work they do every day to deliver the best patient-and family-centered care.”

“Dr. Al-Khan and his team are incredible and I am so grateful for their efforts,” said Marleen.  “We now have hope that we can potentially have another baby in the future.  I owe my life and my uterus to the amazing doctors and nurses at Hackensack University Medical Center.”