Salisbury resident Kerri Madero had a bad feeling when she and her partner, Lindsay Tortorella, left for the hospital on the morning of January 11, 2024, for a routine birth induction at the Birthing Center at University of Maryland Shore Medical Center at Easton. Tortorella hoped that Madero’s apprehension was due to anxiety or fear and tried to think positively about the imminent birth of the couple’s first child.
On their way to the hospital, neither had any idea just how right Madero’s initial feeling was, or that a clinical team from University of Maryland Shore Regional Health (UM SRH) would employ a state-of-the-art medical device that would save her life in the next 24 hours.
Madero’s prenatal care was provided by UM Shore Medical Group-Women’s Health at Easton (UM SMG). During a routine appointment on January 9, when Madero was nearly 39 weeks along, Audrey Drummey, MD, expressed concern about her high blood pressure. Concerns about gestational hypertension led to Madero being quickly scheduled for an induction two days later.
Madero and Tortorella arrived at the Birthing Center for the induction on January 11, and at 11:25 p.m. the following evening, UM Shore Medical Group certified nurse midwife Sunny Granger, CNM, helped the couple welcome their daughter, Koda, to the world at a healthy 7 pounds, 10 ounces, and 20 inches long.
What came next was a nightmare the new family never thought they would experience. “It was such a beautiful moment, and then it crumbled,” Tortorella said.
Following the birth, Madero’s bleeding did not subside as expected, and when bleeding worsened in frequency and heaviness, the situation was deemed an obstetric emergency. The UM SMG-Women’s Health provider and surgeon on call was OB/GYN Palak Doshi, DO, who rushed to assess Madero’s bleeding and quickly determined that surgery was needed.
“I remember hearing ‘Code White, Room 570’ over the loudspeaker and realizing that was our room; that was me,” Madero said. “The bleeding wasn’t stopping, and though I was aware of that, I wasn’t really aware of the severity of the situation until the code was called.”
At 12:30 a.m., Madero was on her way to the operating room, with Dr. Doshi and a team of nurses by her side.
“Sunny (Madero’s midwife) never left my side until I was wheeled out of the room,” Madero said. “I remember, I was scared to close my eyes because I was floating in and out of consciousness and I thought if I closed them, I wouldn’t open them again. But Dr. Doshi made me feel so comforted in a time that was terrifying for me, to say the least. She was a true angel, and I am thankful she was there. She held my hand and gave me the emotional support I needed at that time. I cried to her, ‘Please don’t let me die.’ And I recall her saying, ‘I’m not going to let you die’ and she held my hand until the anesthesia put me to sleep.”
Granger said the patient experienced partial placenta accreta, which means the placenta did not detach as expected after giving birth, which led to excessive bleeding.
“After surgery, Dr. Doshi explained to me that in addition to stopping the bleeding, they had given me 5 units of blood, 3 units of plasma and 3 bags of fluid, and that I had lost more than 3,000 milliliters of blood, which is well over half of the volume in a person’s body,” Madero said. “I realized the gravity of the situation and how poorly the outcome could have been without the quick actions of my clinical team — the nurses, Sunny and Dr. Doshi.”
How did Dr. Doshi and the surgical team stop Madero’s bleeding?
“Abnormal postpartum uterine bleeding occurs fairly commonly after birth, with an incidence of two to four percent of vaginal deliveries and six percent of cesarean deliveries complicated by postpartum hemorrhage. It can quickly become an obstetric emergency,” said Javier Cajina, MD, Chair of the Obstetrics and Gynecology Department at UM Shore Regional Health. “Postpartum hemorrhage is the leading cause of maternal mortality, accounting for 11 percent of maternal deaths due to obstetric complications, so there’s a critical need for effective and easy to use treatment options. That’s where the JADA System comes in.”
The JADA System is a hemorrhage control device that provides rapid and effective treatment for abnormal postpartum uterine bleeding and postpartum hemorrhage.
Dr. Cajina was a key advocate for the introduction of the JADA System to the Birthing Center and in 2021, UM SRH became the first affiliate hospital within UMMS to add this technology.
“It’s been a definite game-changer when it comes to our management of postpartum hemorrhage,” Dr. Cajina said. “JADA increases the speed and effectiveness in our treatment of this potentially catastrophic condition. Many of our obstetric patients have benefited from this novel device and our obstetrical providers’ quick decision-making in utilizing it to its full potential.”
“I can’t even begin to say how grateful I am that UM Shore Regional Health has the JADA System,” Madero said. “If this device were not available, I could have died or would have had to undergo a complete hysterectomy to stop the bleeding.”
Instead, the new mother’s recovery time was quick.
“It was a complete miracle. I was up and walking 12 hours later,” Madero said. “Without this device, I may not have been able to see Koda, Lindsay or my older daughter, Gia, again. And also, because I didn’t have to have a full hysterectomy, we can look forward to having another baby someday.”
“Because we live in Salisbury, we traveled an hour each way to every (prenatal) appointment at UM Shore Medical Group-Women’s Health, and knew we wanted to deliver at UM Shore Medical Center at Easton,” Madero said. “Easton provides such a high standard of care. It was absolutely worth the drive.”
“We are eternally grateful that we chose to go with the inconvenience of a longer travel time for quality health care,” Tortorella said.