6 • SUMMER 1993 ISSUE
New Procedures Provide
very year, some 750,000 American women undergo
1Li a hysterectomy, the partial or complete surgical re-
moval of the reproductive organs. Although a tradition-
al hysterectomy may sometimes be needed, it comes at a
high price pain, four to six weeks of recovery and ear-
ly menopause. Thanks to revolutionary developments in
gynecology, a growing number of women are learning
they have choices when a hysterectomy seems inevitable.
Sinai's Section Chief of Gynecology Milton Goldrath,
M.D., developed laser ablation of the endometrium in
1978, a major breakthrough in the prevention of hys-
terectomies in women who bleed excessively. Prior to Dr.
Goldrath's pioneering work, women suffering from pro-
longed difficult menstrual periods were forced to have a
hysterectomy or endure their symptoms. With this pro-
cedure, a laser is used to destroy the uterine lining there-
by eliminating the menstrual period.
"The procedure is 96 percent effective," says Dr. Gol-
drath, and with a shorter recovery period, less post-sur-
gical bleeding and less pain. "Patients come in, have it
done, go home the same day and back to work the next,"
Dr. Goldrath advises that any woman suffering from
unresponsive excessive menstrual bleeding for benign
causes consult with a physician able to perform en
dometrial ablation before resorting to a hysterectomy.
An adaptation of this hysterectomy alternative is ab-
lation of the endometrium by electrocoagulation, com-
monly known as "rollerball." Sinai obstetrician/
gynecologist Donald R Blitz, M.D., was the first physi
cian at the hospital to perform this procedure in which
an instrument is rolled along the uterine lining to elim-
inate it This procedure is also done on an outpatient ba
imder local anesthetic, and the patient typically returns
to work the day after surgery.
To keep southeastern Michigan women informed about
their hystenactomy alternatives, Sinai Hospital has spon-
sored two recent panel discussions an this important top-
ic. Sinai obstetrician/gynecologist Seymour Ziegehnan,
M.D., a national consultant for the Hysterectomy Edu-
cation Research Services (HERS) Foundation, and Chair-
man of Obstetrics and Gynecology David B. Schwartz,
M.D., joined Drs. Blitz and Goldrath to present these op-
tions for women. Women have the right to question their
physicians about alternatives, they noted, especially when
Watch for notices on future panel discussions on "Al-
ternatives to Hysterectomy."
Sinai Hospital is centrally located in metropolitan Detroit
on West Outer Drive just north of West McNichols / Six Mile
Road and two blocks east of Greenfield. The main entrance
is on West Outer Drive, and valet parking is available.
The Sinai Women's Center is conveniently located in Farm-
ington Hills on Orchard Lake Road between Twelve and Thir-
teen Mile Roads in Suite 201 of Sinai's Berry Health Center.
\ Maple Road
High Hopes for High-
igh hopes. It's
when she finds
out she's pregnant. High
hopes for a relatively wor-
ry-free pregnancy and a
For many women, how-
ever, there are several con-
ditions which can often put
a damper on these high
hopes. In the past, condi-
tions such as a previous
miscarriage, diabetes, high
bloOd pressure or a preg-
nancy after age 35 may
have prevented women
from having a healthy preg-
high-risk mothers. "Not
only do we have some of the
most highly trained mater-
nal-fetal medicine sub-spe-
cialists, neonatologists and
on staff, we have nurses,
technicians, genetic coun-
selors, psychologists and
support staff who are sec-
ond to none," says Dr.
Sinai's Maternal-Fetal Medicine specialists perform state-of-the-art test-
ing on expectant mothers including amniocentesis.
ment, consultations or di-
rect management, mothers "We sit down with the fam- cause time is of major
who select Sinai for their ily and let them know what essence," says Dr. Levinson.
pregnancy care are sure to the risks and choices are.
Its designation as a Lev-
A Team of
get the personal and pro- Once they have all this in- el III NICU nursery means
fessional care they deserve. formation, they can make Sinai can handle acute
A World of Care
"In all that we do," says Dr. an informed decision," says emergencies in the labor
room and the nursery. The
At Sinai Hospital and the Schwartz, "our attention Ms. Gold.
result is that Sinai's mor-
Sinai Women's Center, a never drifts from personal-
tality and morbidity statis-
team approach to caring for ized service and striving for Special Care for
tics are at or below —
high-risk mothers means the highest quality."
As explained by Director
usually below — those ex-
women can depend on com-
pected nationally for sick
prehensive care throughout of Maternal-Fetal Medicine
their pregnancies. And Gregory Goyert, M.D., cial care after birth, Sinai newborns.
"Parents who deliver a
while Sinai's High-Risk "Sinai's team approach to offers a Level III Neonatal
Care Unit baby at Sinai find their
Pregnancy Team can't caring for high-risk moms Intensive
(NICU). The 20-bed unit is chances for a good outcome
guarantee that mothers will includes state-of-the-art
be worry-free during their testing procedures like ul- staffed by six neonatologists are maximized," Dr. Levin-
pregnancies, they can pro- trasound, non-stress tests, and an expert nursing staff son states. "In addition to
vide the medical services amniocentesis and bio- that includes neonatal expert medical care for new-
borns, we also offer a great
and support to assist them physical profiles which in- nurse clinicians.
deal of support to family
members. It's special care
that extends beyond the
baby's hospital stay."
Through Sinai's Devel-
opmental Assessment Clin-
ic (DAC), a team of
specialists which includes
physical, occupational, and
speech therapists, nurse
clinicians, physicians and
gists follows the progress of
NICU infants. Children are
tested at six, 15, 30 and 48
months to determine spe-
cial needs. Parents receive
education, support and hos-
with the school system.
"It's definitely a team ef-
Sinai Chairman of the Department of Obstetrics and Gynecology David B. Schwartz, M.D., directs a highly-
fort," says Dr. Levinson.
skilled team of care-givers.
"Together, we offer sick
newborns a fighting chance
for a bright, healthy future."
with the problems. Once corporate
of Sinai's De-
women have experienced measurements of fetal be- Chairman
partment of Pediatrics is ex-
the personalized care of havior and activity."
tremely proud of the
Sinai's team, they'll never
go anywhere else for their also part of Sinai's compre- department and the ser-
hensive approach to caring vices it offers. "Sinai's De-
for women. Genetic Coun- partment of Pediatrics is at
A Master Builder
selor Robin Gold, M.S., en- the forefront in creating an
Since he became Direc- courages couples to be environment where high-
babies can flourish. We
tor of Maternal-Fetal Med- tested even before preg- risk
were the first hospital in
icine in 1984 and then nancy. A family history of Detroit to have a neonatol-
Chairman of the Depart- Down Syndrome, Tay-
ment of Obstetrics and Gy- Sachs or Sickle Cell Ane- ogist in the hospital 24
Newborns requiring special care
a day. Things that go
necology in 1986, David mia, is cause for concern, hours
are treated in Sinai's 20-bed Lev-
Schwartz, M.D., has care-
el III Neonatal Intensive Care Unit
fully assembled a staff of mean a woman can't carry can go wrong quickly. You
highly-qualified care-givers a pregnancy successfully need someone on the spot
to meet the unique needs of