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In what can be described as a highly unusual surgery, Dr. Peter Sipos, Consultant Obstetrician-Gynaecologist at the Cayman Islands Health Services Authority (HSA) led the successful effort that saved the lives of a mother afflicted with uterine fibroids and her baby.

Members of the team consisted of Consultant Obstetrician-Gynaecologist Dr. Iulia Irimia, Obstetrician-Gynaecologist Dr. Christina McLean, and Anaesthetist Dr. Rachel Gooden.

The mother, Ms. M. Brown, noted, “I knew the pregnancy was high risk but was not aware of the true level of how serious things were until after my c-section.”

In relating the rare and complex medical case, Dr. Sipos explained that “the baby was in the body of the uterus. The body was folded backwards behind the lower part of the uterus where a fibroid fixed the uterus in that awkward position as it was stuck in the lower pelvis. We were not expecting this very unusual situation, especially with the mother presenting with underlying conditions. We, therefore, had to improvise and make decisions in the patient's best interest.”

Uterine fibroids, also called leiomyomas or myomas are benign (non-cancerous) growths that develop from the muscle tissue of the uterus.

In cases of women suffering from uterine fibroids, the uterus, with the fibroid on top of it, normally resides in the lower pelvis (true pelvis). However, in the case of Mrs. Brown the growth of the fibroid resulted in her uterus being bent in a complete U-shape.

“The fibroid which was on top of the uterus was so big that it could not come out of the lower pelvis through its brim when the uterus started growing to accommodate the baby. This resulted in it being stuck in the lower pelvis causing the rest of the uterus to grow out of the pelvis,” explained Dr. Sipos.

The five-hour-long surgery to rectify these complications led to Dr. Sipos and his team gaining access to the fetus by conducting a cross-sected procedure to the lower part of the uterus which permitted access to the back wall at the top where the baby was positioned. The fibroid was removed in order to prevent this from happening again, and to reduce the blood supply the uterus needed.”

The procedure, which Dr. Irimia found only one similar case through research, not only facilitated the safe delivery of Mrs. Brown’s baby but allowed for her uterus and fertility to be preserved. Both mother and baby are doing well and are on the path to recovery.

In expressing gratitude for the treatment received at the HSA, Mrs. Brown noted that, “Dr Sipos was very kind and gentle. He was professional and I had confidence that he was able to take care of my operation as I already prayed that God would choose the right person for the job. We are doing great. I am still undergoing recovery, but I am strong enough to overcome.”

Dr. Sipos joined the HSA in 2019. He is Head of the Women’s Health Department and specialises in angiogenic fetal stem cells in the mother, fetus, and ovarian cancer. His experience includes being a researcher and lecturer at the universities of Manchester and Sheffield in both fetal medicine and gynaecological oncology. He also served as a visiting researcher at the universities of Cambridge and Alberta.