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Advanced Obstetric Surgery Center

Doctor speaks to patient about ultrasound
 
The Advanced Obstetric Surgery Center is proud to provide patients at risk for complications like placenta accreta spectrum, placenta previa, prior hemorrhage and other complex conditions with specialized care. Our physicians are equipped with the expertise to assist patients with sonographic and imaging management throughout pregnancy and perioperative and surgical management through delivery and postnatal care.
 

 

 

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Why Choose Johns Hopkins for Advanced Obstetric Surgery?

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Collaboration and Expertise

Our center combines the multidisciplinary expertise of maternal-fetal medicine, imaging specialists, and anesthesia care. We also have access to specialized surgeons and care throughout the Johns Hopkins Healthcare system in order to provide critical care directed expertise.

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One Care Team

A surgical specialist in maternal-fetal medicine will lead your care from our outpatient practice and imaging center to the operating room. Our MFM surgeons are board certified in surgical critical care, allowing them a full understanding of maternal perioperative care.

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Comprehensive Care for Mother and Baby

We offer preterm counseling including lactation consults for preemie moms, recovery in labor and delivery among your peers, and the option for care partners to stay with you during birth and recovery.

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Shared or Dual Care Models Available

For patients who live far away from Baltimore, we offer the option to work with your primary OB/GYN throughout your pregnancy, delivery, and post-op care. Telemedicine options may be available prior to delivery.

Conditions We Treat

Conditions We Treat and Specialized Care We Provide:

  • Placenta accreta spectrum is a spectrum of disease where the placenta grows into the uterus during fetal development, invading into the muscles of the uterus or sometimes other organs. Placenta accreta can be fatal, but the survival rate is drastically improved with fetal monitoring and management combined with surgical intervention in the form of a cesarean hysterectomy (a c-section and hysterectomy) upon delivery.

    Why Choose Johns Hopkins for Placenta Accreta Spectrum Care?

    We are ready to help you make a treatment plan with:

    • Preterm birth management - we prepare our patients for the likelihood of late preterm birth with lactation and NICU consultations.
    • Faster recovery - get out of the hospital sooner thanks to excellent anesthesia and perioperative care.
    • Excellent outcomes - placenta accreta conditions can be fatal. At Johns Hopkins we have a low ICU admission rate as well as very low intraoperative and postoperative complications in patients treated for this condition.
    • Time sensitive care - we understand the urgency of treating a diagnosis of placenta accreta and are ready to work with you to make a care plan as soon as possible.
  • Placenta previa is a condition where the placenta grows in a location which blocks the cervix, the opening through which the baby must pass to reach the birth canal during delivery. Placenta previa can cause bleeding throughout pregnancy and typically causes heavy bleeding during birth due to tearing as the cervix naturally expands to allow for the baby to pass through. This expansion can cause the placenta to tear away from the uterus putting both mom and baby at risk. Monitoring and surgical intervention may be necessary to achieve the best possible outcome for both mom and baby during delivery.

    Why Choose Johns Hopkins for Placenta Previa Care?

    • Time sensitive care - we understand the urgency of treating a diagnosis of placenta previa and are ready to work with you to make a care plan as soon as possible.
    • Multidisciplinary care - your maternal-fetal medicine specialist will work with other experts at Hopkins to provide you with the best possible care.
    • Preterm birth management - we prepare our patients for the likelihood of late preterm birth with lactation and NICU consultations.
  • Vasa previa is a condition in which the blood vessels that connect the placenta and the fetus (to allow nutrients to reach the fetus from the placenta) grow over the opening of the cervix, blocking it. The cervix is the the opening through which the baby must pass to reach the birth canal during delivery. With vasa previa those blood vessels blocking the cervix can tear during birth, causing heavy bleeding which places both mom and baby at risk. Monitoring and surgical intervention may be necessary to achieve the best possible outcome for both mom and baby during delivery.

    Why Choose Johns Hopkins for Vasa Previa Care?

    • Time sensitive care - we understand the urgency of treating a diagnosis of vasa previa and are ready to work with you to make a care plan as soon as possible.
    • Multidisciplinary care - your maternal-fetal medicine specialist will work with other experts at Hopkins to provide you with the best possible care.
    • Preterm birth management - we prepare our patients for the likelihood of late preterm birth with lactation and NICU consultations.
  • Patients with a history of prior hemorrhage, or excessive bleeding within the first twenty four hours to two weeks after birth, may be at higher risk for hemorrhage in later pregnancies. Monitoring and surgical intervention may be necessary to achieve the best possible outcome for both mom and baby during delivery.

    Why Choose Johns Hopkins for Surgical Obstetric Care With a History of Prior Hemorrhage? 

    • Multidisciplinary Care - we work with care teams across Johns Hopkins medicine including the adult and pediatric hematology, adult and pediatric cardiology and cardio obstetric care teams to provide our patients with the best possible outcome.
    • Fetal Monitoring - with options for advanced fetal monitoring throughout your pregnancy
  • Patients with a history of abdominal surgery, especially in cases of multiple surgeries, may be at higher risk for heavy bleeding during a traditional delivery. Monitoring and surgical intervention may be necessary to achieve the best possible outcome for both mom and baby during delivery.

    Why Choose Johns Hopkins for Surgical Obstetric Care  With a History of Multiple Abdominal Surgeries?

    • Multidisciplinary Care - we work with care teams across Johns Hopkins medicine including the kelly gynecologic oncology service to provide you with the best possible care.
    • Fetal Monitoring - with options for advanced fetal monitoring throughout your pregnancy
  • Team surgeries are available for patients that require dual or multiple surgical specialties for the safe delivery of their baby. For example, patients who have undergone complex urologic surgeries may require a team delivery - with both a maternal-fetal medicine surgeon to help safely deliver baby and a urological surgeon to address any urologic concerns that may arise with mom during delivery.

    Why Choose Johns Hopkins for Team Surgeries?

    •  Expert Care - Johns Hopkins Medicine is home to some of the top specialists in their respective areas. You can expect the surgeon working with your maternal-fetal medicine surgeon to be a qualified expert.
    • Know Your Options - your maternal-fetal medicine specialist will work with you throughout your pregnancy and help you to create a plan ahead of time for the safe surgical delivery of your baby.
  • For patients who have received prior surgeries where inserting a mesh was necessary, for example for certain pelvic floor disorders, there may increased risk of tearing or bleeding during delivery. In some cases surgical intervention may be necessary in order to achieve the best possible outcome for both mom and baby.

    Why Choose Johns Hopkins for Surgical Obstetric Care with a History of Prior Mesh Surgeries?

    • Patient Tailored Care - your maternal-fetal medicine specialist will work with you to develop a care plan that meets your specific needs.
    • Multidisciplinary Care - this includes expert care in partnership with other Hopkins specialty areas including imaging and anesthesia care.
  • Patients with a history of surgery for Crohn's and ulcerative colitis or for inflammatory bowel disease may be at an increased risk for complications during pregnancy and delivery. These patients may benefit from additional monitoring throughout pregnancy as well as surgical delivery.

    Why Choose Johns Hopkins for Surgical Obstetric Care with a History of Prior Ulcerative Colitis or Inflammatory Bowel Disease Surgery?

    • Patient Tailored Care - your maternal-fetal medicine specialist will work with you to develop a care plan that meets your specific needs.
    • Multidisciplinary Care - this includes expert care in partnership with other Hopkins specialty areas including imaging and anesthesia care.
  • An abdominal cerclage is an advanced surgery that can help achieve a successful pregnancy when other options have not been beneficial, or prior surgeries have affected the cervix substantially. It involves placement of a suture around the cervix, at its highest point where it meets the uterus ("womb"), which is best approached via an abdominal surgery. In appropriate candidates, this surgery can be a significant aid towards achieving a live birth.

    Why Choose Johns Hopkins for Abdominal Cerclage?

    • This is an uncommon surgery that is best performed by centers such as ours with robust numbers of cases for the appropriate experience and expertise to handle placement of the cerclage, as well as care throughout pregnancy and delivery.
    • Our team performs these surgeries in patients before, as well as during pregnancy as appropriate.
    • Our care for abdominal cerclage patients is overseen completely by our team from start to finish, with availability at all times for any questions or concerns. 
    • We create a multidisciplinary care team for both the patient and the expected newborn(s).
  

Advanced Obstetric Surgery: Collaborating Programs

The Advanced Obstetric Surgery Center leverages the expertise of care across Johns Hopkins. Should you require additional testing or care, our program works with:

 

Meet Our Team of Experts

 

Maternal-Fetal Medicine Experts

 

Gynecologic Oncologists

 

MRI Imaging

 

Interventional Radiology

 

Obstetrics Anesthesia

 

Nurse Manager – Labor and Delivery

Tanesha Stokes, RN, MSN, MBA

Perinatal Nurse Manager

Tanesha Stokes
 
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