HackensackUMC Receives Federal Grant to Improve Maternal Outcomes in At-Risk Pregnancies

On Sep 28, 2015

Hackensack University Medical Center’s (HackensackUMC) Department of Obstetrics and Gynecology has received a $3,316,475 grant to measure pregnancy complications involving the placenta in real-time, using automated 3-D ultrasound tools.  The grant, from the National Institute of Child Health and Human Development (NICHD) and the National Institute of Health’s Human Placenta Project, will be used to enhance HackensackUMC’s innovative collaborative research program with University of Oxford physicians in the United Kingdom for the early detection of at-risk pregnancies.

“I am so proud of our brilliant and committed team and their tireless work to find innovative solutions that ensure the best care for our patients,” said Robert C. Garrett, president and CEO of Hackensack University Health Network. “Our Division of Maternal-Fetal Medicine and Surgery is dedicated to the well-being of the mother and child, and this grant will further enrich the groundbreaking work they are doing to protect the families in our care.”

HackensackUMC plans to use the grant to develop a four-year program that will test ultrasound techniques in the first trimester of pregnancy in an effort to better diagnose an increasingly common, life-threatening complication called Abnormally Invasive Placenta (also known as placenta accreta).  Placenta Accreta occurs in about one out of every 2,500 women.   Kelly Pfeiffer of Mt. Olive, New Jersey, was one such woman.  Mrs. Pfeiffer came to HackensackUMC’s Center for Abnormal Placentation (CAP) after she was diagnosed with placenta percreta, the most severe form of placenta accreta in which the placenta fully invades the uterine wall and attaches itself to other pelvic organs like the bladder.

Earlier this month, Pfeiffer endured a five and a half-hour-long surgery including a complete bladder reconstruction and blood transfusion, and gave birth to her daughter.  Pfeiffer and her daughter are both expected to make a full recovery and are enjoying their time at home with their family.   Pfeiffer donated her placenta to the CAP team to assist their research and help save more women and children suffering from placenta accreta.

“Dr. Al-Khan and his team are incredible.  I couldn’t have asked for a better experience in what was one of the most stressful times of my life,” said Pfeiffer.  “I had been to other doctors after being diagnosed with placenta accreta who did not make me feel better about my situation.  As soon as I met with Dr. Al-Khan and his team, I knew I was in good hands.  I constantly felt reassured that my baby and I were going to be okay.  Even though my daughter was born six weeks early, Dr. Al-Khan and his team took every precautionary measure to make sure she was able to come home with me.  I used to cry because I was under such stress that my baby and I wouldn’t make it.  Now I cry because I am sitting at home holding my daughter and she’s happy and healthy, and I owe that to the amazing doctors and nurses at HackensackUMC.”

Dr. Abdulla Al-Khan, director of the CAP and section chief, Maternal Fetal Medicine and Surgery will lead the program as senior clinical investigator, along with Dr. Stacy Zamudio, Dr. Jesus Alvarez-Perez, Dr. Manuel Alvarez (co-investigator) and Dr. Nicholas Illsley. Dr. Ciaran Mannion and Dr. Christopher Koenig in the Department of Pathology are also collaborators in this effort.

“It is so important to gain a better understanding of maternal health and life-threatening complications like placenta accreta,” said Dr. Al-Khan.  “This grant will allow us to further expand our program and invest more deeply in innovative practices we have established so that we can decrease maternal complications and in turn greatly improve outcomes for mothers and babies.  I would especially like to thank Dr. Stacy Zamudio at HackensackUMC and Dr. Sally Collins at the University of Oxford for their tireless work on this project.  Without them, this would not have been possible.”

There has been a significant increase in cesarean deliveries in recent years, which disrupts the integrity of the uterus and contributes to issues with placental formation in future pregnancies.  Mothers who have undergone cesarean sections are at greater risk for developing placenta accreta (about one in every 500 women), which is one of the leading causes of maternal death in the United States.  There are three stages of placenta accreta:

·         Placenta accreta occurs when less than 50 percent of the placenta invades the uterine wall

·         Placenta increta is when more than 50 percent of the placenta invades the uterine wall

·         Place percreta is when the placenta fully invades the uterine wall and attaches itself to other pelvic organs

If the placenta invades more than 50 percent of the uterine wall, it triggers a process known as neovascularization or an excessive formation of blood vessels around the affected area.  These blood vessels can cause life-threatening hemorrhaging during delivery, threatening both the lives of the mother and baby.

HackensackUMC was the first hospital in the nation to identify the neovascularization process thanks to the CAP, led by Dr. Al-Khan.  Dr. Al-Khan has grown CAP over the last five years into an internationally-recognized program that has developed strategies to better diagnose placenta accreta, decreased surgical ICU admissions, decreased the number of blood transfusions, all of which have led to more positive maternal outcomes. CAP provides much-needed comprehensive services to women who currently have few alternatives for expert care. This groundbreaking program has been developed and designed to serve as a template for regional, national and international institutions.

HackensackUMC has the largest volume of deliveries as a single institution in the tristate area, with more than 6,300 births in 2011 alone. The hospital has become an active referral center for mothers with special needs.

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