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How HackensackUMC Doctors Saved Mom's Fertility

MaryBeth Stancato of New Milford holds her son, Francesco Valentino, who was born a year after she underwent a non-invasive procedure to treat her cervical fibroid. John DeMeritt, M.D.
MaryBeth Stancato of New Milford holds her son, Francesco Valentino, who was born a year after she underwent a non-invasive procedure to treat her cervical fibroid. John DeMeritt, M.D. Photo Credit: Contributed

MaryBeth Stancato of New Milford always knew she wanted several children.

At the age of 37, the mother of three children and her husband wanted a fourth child.

But, she wasn’t sure if she would be able to have another baby.

“Two years ago, my cycle was changing in that both the duration and frequency of my period had increased,” Stancato said.

“I was getting my period almost every two weeks and it was lasting for two weeks. I constantly felt as though I had my period. And, it was very heavy.”

The bleeding was so heavy that Stancato was given a blood transfusion. It was determined that she suffered from a cervical fibroid, which is a benign tumor. When symptomatic, cervical fibroids can cause various clinical problems including infertility and most commonly, excessive vaginal bleeding.

Cervical fibroids are relatively rare as opposed to the more common locations in the uterus. In addition to bleeding, cervical fibroids can also block the endocervical canal (birth canal), cause recurrent pregnancy loss and obstruction of labor (dystocia) leading to high rates of cesarean delivery, cesarean hysterectomy, postpartum hemorrhage and blood transfusion.

Stancato's gynecologist referred her to John DeMeritt, M.D., assistant director of Interventional Radiology at Hackensack Meridian Health Hackensack University Medical Center.

DeMeritt specializes in minimally invasive endovascular techniques including fibroid and enlarged prostate (BPH) embolization.

“I came to his office looking for options in treating my fibroid. I knew that I wanted something non-invasive. When I met the team, I knew it was a perfect fit for me.”

Cervical fibroids, which are supplied by small arteries that arise directly from the main uterine artery, are the most difficult to treat conservatively with either surgery (myomectomy) or a procedure known as uterine artery embolization (UAE).

“While uterine artery embolization is a very effective alternative to myomectomy or hysterectomy for fibroids in the remainder of the uterus, it rarely works for cervical fibroids,” DeMeritt said.

“We devised a new and innovative approach, which included using a micro-catheter to deliver much smaller particles than are typically used directly to the artery that feeds the cervix. Advanced imaging techniques, including Cone Beam CT, were used to ensure the particles were delivered to the proper location.

"Selecting the cervical arteries directly also spared the remainder of the uterus to the potentially injurious effects of the much smaller particles.”

During the procedure, Stancato was awake and watched the entire process on a monitor.

“The procedure was painless,” she said. “They inserted a catheter into my leg and located the fibroid and blocked the blood flow to it with very small particles.

" I watched Dr. DeMeritt and his team perform the embolization procedure in real-time. I felt very safe and calm the entire time.”

“Cervical fibroid embolization is yet another demonstration of Hackensack Meridian Health’s commitment to innovative medicine and the enhancement of quality patient care,” said Michael Horton, administrative director, Clinical Operations at Hackensack University Medical Center.

After the embolization procedure, Stancato vaginal bleeding immediately stopped and she was discharged from the medical center the following day. Three months later, MaryBeth discovered she was pregnant. In February 2017, gave birth to her fourth child, Francesco Valentino.

“When I was told of my options, the possibility of not having any more children was scary,” Stancato said.

“I didn’t want to have a hysterectomy. I wanted to have a large family. Dr. DeMeritt gave my husband and me an opportunity to have another baby. I will be forever grateful to Dr. DeMeritt and his team.”

“Not only was this procedure the most minimally invasive of our options, but it also preserved MaryBeth’s fertility,” DeMeritt said.

“In addition, she had no complications during her pregnancy and was able to deliver a healthy baby vaginally. What’s more, the final fibroid volume reduction of 96 percent was beyond all expectations.

"We couldn’t be happier for MaryBeth and her family and look forward to offering this novel treatment to more patients.”

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