Pre-Consultation
Prior to your visit, your doctor will communicate with us regarding your suspected diagnosis and possible treatment options. If you may be a candidate for fetal surgery, we will work with you to set up an ultrasound and consultation with Dr. Chmait. Please bring your I.D. and insurance card with you to your appointment.
If you have any questions prior to your office visit, please feel free to call our office 213-469-6277.
Consultation and Ultrasound Assessment
Upon arrival, please park in the parking lot and proceed to 1300 N. Vermont, Suite 905 in the Doctors Tower. You will first meet with Kris Rallo, RN, Fetal Surgery Clinical Nurse Coordinator and Arlyn Llanes, RN, Fetal Surgery Program Coordinator. They will answer any immediate questions that you may have regarding your suspected diagnosis.
You will then meet Stephanie Loew, RDMS, BS, Fetal Surgery Sonographer, who will perform your ultrasound evaluation. This exam may take up to two hours. Following the ultrasound, Dr. Chmait will discuss all findings and will review the treatment plan (which may or may not involve surgery), prognosis, and recommended follow-up care. He will be able to answer your questions and concerns at this time.
You may then discuss any further questions with Kris or Arlyn. They may reiterate the treatment plan and answer any questions you may have. If surgery is needed, the surgery consent form will be given to you for review. It explains the surgery in detail in terms that are easy to understand. This is in addition to the hospital consent form. Both consent forms will need to be signed prior to surgery. Arlyn will answer all questions regarding the consent forms that you may have.
Pre-Admission Testing
If you desire to proceed with fetal surgery, you will be scheduled for a pre-op appointment either the same day or the day of surgery. You will register as a patient and blood will be drawn for various tests that are necessary prior to surgery.
Preparing for Surgery
Before surgery, you will not be allowed to eat or drink after midnight on the night before your surgery. This is to prevent the risk of vomiting during surgery. In medical terms, this is known as “NPO” (nothing by mouth). You may have a regular diet at dinner the night before surgery.
Please remove all jewelry except wedding ring if applicable.
Before Surgery
You will present to the Hollywood Presbyterian Admitting Department prior to scheduled surgery time on the day of surgery. An intravenous line (IV) will be inserted by needle stick to give fluids and medications during surgery. A blood draw may occur if not done the day before. A brief ultrasound will be done prior to you going to the operating room. One of the specially trained nurses that will be assisting in surgery will then accompany you to surgery.
During Surgery
When you arrive in the operating room you will be moved to the operating table. You will be covered with a warm blanket and a pillow will be placed under your knees to keep you comfortable during surgery. Medication will be given through your IV tubing to relax you. A catheter will be placed in your bladder to drain urine and will remain in place until later that evening. Surgery is performed under IV sedation, meaning you are awake but relaxed, and local anesthesia, meaning your abdomen is numbed where the instrument is inserted. The Anesthesiologist stays with you throughout the procedure. You will be given additional medication as needed.
During surgery, one or two small incisions, approximately 1/10 inch long, are made on the abdomen. The incision(s) are small and will only require a band-aid dressing.
In most cases, surgery lasts one to two hours, but this can vary depending on a number of factors.
After Surgery
Following surgery, you will be taken to the recovery room where you will be monitored for at least one hour. Medication may be given after surgery to relax the uterus and stop any contractions. Pain or discomfort after surgery is usually minimal. If needed, pain relief medicine is available. If you will stay the night for observation, then you will be moved to a private hospital room.
The catheter will be removed from your bladder about four hours after you arrive to your room. Your husband/significant other, or other support person may remain with you in your room. There is a bed available for his/her comfort.
Following surgery, you usually may have food as tolerated. That night, activity is restricted to bathroom privileges only, but this depends upon your specific condition.
The day after surgery, a follow-up ultrasound will be performed at the bedside. Most patients are discharged following their ultrasound.
You should plan on being in the Los Angeles area for approximately 2-3 days. One day is required for ultrasound and consultation. Surgery is usually performed on the second day. You will then spend the night of surgery in the hospital. Most of our patients are discharged home the following morning. You may travel home in an automobile or airplane, as necessary.