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Cesarean Delivery in the Hybrid Operating Suite: A Promising New Location for High-Risk Obstetric Procedures
Abstract Number: S 8
Abstract Type: Original Research
Introduction: The rising cesarean delivery rate, attendant placental implantation abnormalities, and increasing general medical complexity in the obstetric population has driven innovation to optimize the care of parturients during delivery. Novel and multidisciplinary approaches and locations may enhance the options available for care (1-7). Increasingly, surgical or other interventional care during pregnancy and delivery may be seen in settings outside of the traditional labor and delivery environment.
Methods: After Institutional Review Board approval, the medical records of 10 patients who underwent cesarean delivery in our hybrid operating suite between December 2007 and May 2012 at Brigham & Women’s Hospital were reviewed. Procedural details and outcome data including demographics, comorbid conditions, delivery indication, type of anesthesia administered, intraoperative interventions, estimated blood loss, transfusion requirement, intensive care unit (ICU) admission, and length of stay were recorded.
Results: The results are listed in Table 1. The most common indication for the use of the hybrid operating room was an increased risk of hemorrhage most commonly owing to abnormal placental implantation. Other indications included intracranial pathology and significant cardiac disease.
Conclusion: The hybrid operating room has demonstrated significant utility in interventional and surgical disciplines in which a combination of minimally invasive and open surgical procedures are required, along with the ability to perform advanced imaging techniques and interventions. Cesarean delivery for some high-risk parturients may best be facilitated in this setting where surgical conditions, imaging quality, and immediate availability of interventional equipment are optimized.
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2. Angstmann T, et al. Am J Obstet Gynecol 2010;202:38.e1-9.
3. Mok M, et al. Int J Obstet Anesth 2008;17:255-261.
4. Kodali B. Int J Obstet Anesth 2010;19:131-2.
5. Miller T. Health Facil Manage 2012;25:23-7.
6. Ramakrishna H, et al. J Cardiothorac Vasc Anesth 2012;24:7-17.
7. Iihara K, et al. J Stroke Cerebrovasc Dis 2012 Aug 29.