Doctors at Jackson Memorial Perform First In-Utero Laser Ablation Surgery in South Florida on Pregnant Woman with Rare Condition

By: Krysten Brenlla

Carolina Alejandra Marcano de la Rosa has always dreamed of being a mom. For years, the 41-year-old tried to conceive and carry a baby full-term, but suffered two miscarriages.

That’s why when she found out she was pregnant for a third time, she knew it would be her miracle baby.

“I didn’t think it would come,” she said. “I couldn’t believe I was pregnant.”

Throughout her first trimester, Marcano experienced a normal pregnancy.

However, at week 18, after what seemed like a routine ultrasound appointment, she received concerning news.

“I was diagnosed with vasa previa,” Marcano said. “It was definitely very scary to hear this – I never experienced any symptoms.”

Vasa previa is a rare but serious pregnancy complication where some of the baby’s blood vessels run too close to the cervix (the opening to the birth canal), instead of inside the umbilical cord or placenta. With a vasa previa complication, the blood vessels, which are extremely delicate, run the risk of tearing when the water breaks, or during labor, which can cause severe and dangerous bleeding.

If the blood vessels were to rupture, it could pose life-threatening risks for both mom and baby.

“When I was diagnosed with vasa previa, my gynecologist told me that I would be transferred to Jackson Memorial Hospital, where they had the best doctors and equipment to treat high-risk pregnancies,” Marcano said. “I knew I would be in the best hands.”

At Jackson Memorial, Marcano met her new team of maternal-fetal experts, including Rodrigo Ruano, MD, PhD, fetal surgeon, director of the UHealth Jackson Fetal Care Center, and division chief of UHealth Jackson Maternal-Fetal Medicine.

“Vasa previa is a very interesting condition because, in a normal pregnancy, you have the placenta with natural fluid, and the baby attaches to the placenta by the umbilical cord,” Dr. Ruano said. “But, with Carolina, she had blood vessels in the middle of her cervix. And, in reality, there’s no symptoms – the only way to diagnose is through an ultrasound. That’s why, when you’re pregnant, it’s important to have consistent ultrasounds to check the structure of the baby and the placenta.”

To correct the issue, Dr. Ruano recommended a new technique not offered in many centers – in-utero telescopic laser ablation, a procedure where a tiny camera and laser are used to find and seal off the problem blood vessels.

Once the blood vessels are sealed off, patients can continue their pregnancy normally, with the potential to even deliver their babies vaginally.

“At Jackson, we have amazing operating rooms, the necessary equipment, and the resources to offer these unique procedures for our patients,” Dr. Ruano said. “Patients can expect to see a full, specialized team that can manage their conditions with different options to ensure the best care for the mother and the baby.”

After conducting her own research, Marcano decided to go through with the in-utero telescopic laser ablation 32 weeks into her pregnancy.

Four weeks later, her son, Christian, was born via C-section.

“When my water broke, I felt scared, but excited to finally meet my son,” Marcano said. “Everything went great with the pregnancy and labor.”

After just a few days in the NICU, Christian was ready to go home – healthy and happy.

“My hope for any of my high-risk mothers and their babies is for them to have a successful pregnancy and birth,” Dr. Ruano said. “Our fetal care center at Jackson strives to reduce the risks for all of our high-risk patients, so they can go on to live happy, normal lives.”

“Thank you to Dr. Ruano and his team for being so attentive and responsive,” Marcano said. “I’m so grateful to them for giving me the opportunity to have a healthy, perfect son.”