How UC Davis Surgical Team Saved Mom, Baby’s Life Without Blood Transfusion

Karine Petrosyan visits her daughter, Abigail, in the UC Davis Neonatal Intensive Care Unit.

“At UC Davis they were so good taking care of me. All of this group of people provided such great support for me like a family. My whole life is thankful to them for what they did for me. And God blessed them to do a good job.”

During Karine Petrosyan’s pregnancy, she developed a series of very rare and serious conditions, which threatened both her and her baby’s life.

Her placenta began growing through the wall of her uterus and had attached to her bladder in a condition called placenta percreta. She was also diagnosed with placenta previa, in which her placenta obstructed the birth canal.

Add to that one more complication: Her water broke when she was only 24 weeks’ pregnant, due to preterm premature rupture of the membranes, which occurs in 3 percent of pregnancies.

A plan was needed – and fast.

Five surgical teams at UC Davis – obstetrics and gynecology, gynecologic oncology, vascular surgery, trauma and acute care surgery, and urology – met with Petrosyan and planned the complex operation to save mother and baby. Physicians would deliver her baby by cesarean section and then remove Petrosyan’s uterus in a procedure known as a cesarean hysterectomy.

But the biggest and most common risk of this procedure is blood loss. Petrosyan, a practicing Jehovah’s Witness, refused any blood transfusions due to her religious beliefs so the team needed to find a solution that wouldn’t require blood transfusion.

UC Davis has been a leader in bloodless surgery for heart surgery patients and is one of the leading centers to use TXA (tranexamic acid) to prevent blood loss. But this was an opportunity for the UC Davis team to leverage its expertise and apply it to obstetrics.

The answer — their only chance — came in the form of a device called an ER-REBOA catheter, which looks like a small plastic tube with a balloon attached to it.

From war zones to surgical settings

The ER-REBOA is an intra-operative balloon occlusion device developed by the U.S. Air Force as an internal tourniquet to stop major intra-abdominal and pelvic bleeding in war zones in Iraq and Afghanistan. It was approved for non-military…

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