—Complex high-risk surgery saves mother and baby as hospital successfully uses Cell Saver system in rare obstetric procedure
GUYANA continues to strengthen its position as a regional leader in healthcare, most recently with the Georgetown Public Hospital Corporation (GPHC) achieving a significant milestone in maternal care through the successful completion of a complex, life-threatening obstetric condition using advanced blood conservation technology.
The landmark procedure resulted in the safe delivery of a healthy baby, the recovery of the mother, and marked one of the few successful uses of Cell Saver blood salvage technology in a high-risk obstetric surgery within the region.
The achievement, according to GPHC, demonstrates the hospital’s growing capacity to provide specialised care in complicated maternal cases through the combination of advanced medical technology, early diagnosis, and the expertise of a multidisciplinary healthcare team.
Dr Rafi Rozan, Head of the Department of Obstetrics and Gynaecology at GPHC, described the procedure as a major accomplishment for the institution, noting that the case involved two serious conditions identified during antenatal care, placenta previa and placenta accreta spectrum.
“It was basically about a patient who was with a late pre-term pregnancy and she was a previous caesarean section by one; however in this case during antenatal we diagnosed her with two special conditions,” Dr Rozan explained.
He said placenta previa occurs when the placenta develops in the lower section of the uterus, blocking the area where the baby would normally pass during delivery, while placenta accreta spectrum occurs when the placenta grows abnormally into the uterine wall.
He explained, “Placenta previa is where the afterbirth usually is located in the lower aspect in the lower segment of the uterus so it occupies that area where the baby now cannot pass through in order to have a normal vaginal delivery,” he explained.
He was keen to note that such cases are considered among the most dangerous complications in obstetrics because they can result in severe blood loss and require careful preparation before surgery.
Dr Rozan noted that placenta accreta spectrum is often associated with previous caesarean sections, as scars left on the uterus can affect the normal attachment of the placenta.
As he explained, “Placenta acreta spectrum is now a condition in which the placenta basically invades into the muscular layer of the uterine wall and that usually happens when there is a scar in the uterus and in this case, it was because of the previous caesarean section that would have created a scar that basically distorted the normal borders of the placenta when it actually adheres to the uterus,” he said.
A defining feature of the procedure was the use of GPHC’s Cell Saver blood salvage machine, an advanced technology that allows blood lost during surgery to be collected, processed, purified, and returned to the patient.
The technology was especially important in this case due to the risk of catastrophic haemorrhage associated with placenta accreta spectrum. Instead of relying solely on donor blood, the medical team was able to recover and reuse the patient’s own blood during the procedure.
The use of the Cell Saver technology follows GPHC’s first successful application of the advanced blood recovery system earlier this year during a high-risk emergency surgery.
On June 12, GPHC’s Vascular Surgery Division, in collaboration with the National Blood Transfusion Services (NBTS), utilised the Cell Saver system during the emergency repair of a ruptured abdominal aortic aneurysm (AAA) in an 85-year-old woman.
Building on that achievement, the technology was used during the most recent complex maternal procedure, allowing doctors to recover, process, and safely return the mother’s own blood during the surgery.
Dr Rozan explained that the technology played a key role in reducing the amount of blood loss experienced by the patient, noting, “The fact that this is a complication that is associated with catastrophic haemorrhage, do note that we use the cell saver machine so when we aspirated the blood it basically went to this machine which processed the entire blood products, it reprocessed it, purified it and we were able to salvage units of blood which were then re-transfused into the patient,” he said.
Moreover, Dr Rozan said the use of the technology represented a significant achievement for the hospital and greatly contributed to the successful outcome of the surgery.
As he highlighted, “This was a novelty thing that we were able to do for this patient. Patient had a successful surgery, there was no damage to any pelvic or abdominal organs, baby was delivered with an excellent Apgar [appearance, pulse, grimace, activity (tone), and respiration] and we proceeded to do the obstetric hysterectomy with the cell salvage machine.”
Dr Rozan added that the patient did not require additional blood transfusions and continues to recover well following the procedure, “Patient did not receive any other blood transfusion and currently recovering awesome,” he said.
The successful surgery also highlights the importance of early diagnosis and consistent antenatal care in managing high-risk pregnancies.
According to GPHC, advances in prenatal imaging allowed doctors to identify the conditions before delivery, giving the medical team adequate time to plan and assemble the specialists needed to safely complete the surgery for both baby and mother.
The achievement reflects the importance of continued investment in specialised healthcare services and innovative medical advancements. The successful implementation of Cell Saver blood salvage technology during this complex procedure represents a significant step for GPHC and reinforces the institution’s place among other leading healthcare facilities in the region.
