6 • SUMMER 1993 ISSUE ■ SINAI HOSPITAL rmkompwwwwwwww New Procedures Provide Hysterectomy Alternatives 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," he says. 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 facing hysterectomy. 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. WEST BLOOMFIELD \ Maple Road BIRMINGHAM ROYAL OAK HealthNews High Hopes for High- Risk Pregnancies H igh hopes. It's what every woman has when she finds out she's pregnant. High hopes for a relatively wor- ry-free pregnancy and a healthy baby. 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- nancy. high-risk mothers. "Not only do we have some of the most highly trained mater- nal-fetal medicine sub-spe- cialists, neonatologists and obstetric anesthesiologists on staff, we have nurses, technicians, genetic coun- selors, psychologists and support staff who are sec- ond to none," says Dr. Schwartz. Coordinated, Comprehensive and Compassionate Sinai's Maternal-Fetal Medicine specialists perform state-of-the-art test- Through co-manage- 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 Specialists — 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." Special Infants As explained by Director usually below — those ex- women can depend on com- For babies who need spe- 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 developmental psycholo- 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- pital-based communication 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 Martin Levinson, M.D., ultrasound 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 Genetic counseling is 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- obstetric needs. 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- wrong with sick newborns but it doesn't necessarily 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 (NICU) highly-qualified care-givers a pregnancy successfully need someone on the spot with special training be- and have a healthy baby. to meet the unique needs of