From ICU to the Delivery Room: How Innovative AVM Surgery Saved a Pregnant Mother

For Melanie Hart, the fall of 2024 was going well.

She was continuing in a job she loved teaching third graders. At home, she had a loving husband, a rambunctious preschooler, and another daughter on the way.

That all changed in late October.

After attending a school function, Melanie went to bed as usual. At 26 weeks pregnant, waking up in the middle of the night was nothing new. But this time, she knew immediately that something was wrong.

Her whole left side felt heavy and foreign, as if her arm and leg were no longer part of her body. Her head throbbed unlike ever before. As Melanie slid to the floor, her husband bolted awake and called 911.

An ambulance rushed her to Overlook Medical Center, where an emergency scan revealed a large dark spot in her brain: a pool of blood caused by a ruptured arteriovenous malformation (AVM). Though she had likely been born with the AVM, the physical stress of pregnancy may have contributed to the rupture.

Just one week before everything changed.

Facing the Unknown

Days of uncertainty followed as Melanie drifted in and out of awareness while her family gathered around her bedside. Her parents flew in from Trinidad, her brother came from New York City, and her sister, a physician, traveled from California. It was Melanie’s first time away from her young daughter, and that separation added emotional weight to an already overwhelming situation.

Shortly after Melanie was diagnosed, Dr. Kyle T. Chapple, a neurosurgeon at Atlantic Brain and Spine specializing in AVMs, met with her family to discuss the path forward.

His combination of technical expertise and calm, compassionate communication quickly gave them confidence.

“Dr. Chapple’s approach immediately gave our family confidence. Everyone thought he was personable and knowledgeable.”

Dr. Chapple recommended an advanced approach to relieve the pressure in Melanie’s brain and treat the AVM itself. But because she was pregnant, the stakes were even higher. If complications arose, her baby might need to be delivered early and transferred to the NICU at Morristown Medical Center while Melanie recovered at Overlook.

A Novel Procedure with Promising Results

Melanie remembered crying on the phone with her husband as she was wheeled into the operating room. But by the time the surgical team began introducing themselves, her sense of humor had returned.

“Hi, my name is Melanie. I’m the patient and I’m here for surgery.”

Dr. Chapple, who is dual-trained in both endovascular and open neurosurgery, performed a carefully coordinated two-part procedure.

First, he performed an embolization to block the abnormal blood vessels feeding the AVM. He then followed with a craniotomy to remove the malformation and evacuate the blood clot. This combined approach relieved dangerous pressure on Melanie’s brain and significantly reduced her risk of another bleed.

From ICU to motherhood—Melanie now gets to enjoy life with both of her daughters.

The Long Road to Recovery

Fortunately, the procedure went smoothly, relieving the bleeding while keeping Melanie’s baby safe.

But surgery was only the beginning.

Melanie still had to relearn how to use her left arm and leg. She spent two long weeks in the ICU at Overlook, willing her limbs to move while managing excruciating headaches. One of the only things that helped was an improvised solution: surgical gloves filled with ice, tied together and draped over her head.

“It looked like an octopus on my head, but it worked.”

Through it all, she was surrounded by family, friends, and a dedicated team of medical providers. When her left leg remained especially difficult to wake up, her sister stepped in to help with stretches and massages. Dr. Chapple and Lauren Eskuchen, an Advanced Practice Nurse at Atlantic Brain and Spine, visited every day to monitor her progress and support her recovery.

“Dr. Chapple always made the time for my questions, answered them in terms I could understand, and was there when I needed him. Everyone in the ICU, including the nurses and other doctors, were amazing.”

Rehabilitation and Resilience

Once she was strong enough, Melanie was transferred to rehabilitation, where a new phase of recovery began.

While there, she experienced two vasovagal episodes, causing concern that she could be having seizures and sending her back to the hospital for evaluation. Once she was cleared, she resumed daily occupational therapy and physical therapy, relearning how to walk and how to reconnect with the left side of her body.

“It felt like my leg wasn’t working in unison with the rest of my body. I had to consciously tell myself, ‘Okay, left foot, heel to toe.’”

Although Melanie wished she could speed up the process, she kept reminding herself how far she had already come. Eventually, she was able to return home using a walker for support. Throughout it all, Dr. Chapple and Lauren continued checking in, offering steady encouragement and support.

Post-Surgery Milestones

By the time of her final post-surgery appointment, Melanie found herself unexpectedly emotional. After everything she had been through, the idea of not seeing Dr. Chapple and Lauren regularly felt difficult.

She had grown especially close with Lauren, who had been there from the very beginning.

“I would be lost without her. Lauren sends me texts checking in and always bridges the gap if I need anything. She’s phenomenal.”

In January, Melanie and her family welcomed a healthy baby girl, Kylie Charlotte. Dr. Chapple and Lauren came to celebrate with them. The similarity between Kylie’s name and Dr. Chapple’s was simply a happy coincidence, but to Melanie, it reflected the closeness she felt with the team who had helped carry her through the hardest chapter of her life.

From ICU to motherhood—Melanie now gets to enjoy life with both of her daughters.

Nearly a year after her collapse, Melanie reached another major milestone: returning to her classroom.

She still experiences some lingering symptoms, including light sensitivity, occasional brain fog, and headaches, but she is well on her way to recovery and deeply grateful for the care she received.

“I have nothing but gratitude and appreciation for everything Dr. Chapple and his team did. All the people surrounding me were angels.”

Melanie’s story is a powerful reminder that advanced neurosurgical care is not only about technical skill. It is also about timing, judgment, coordination, and compassion.

At Atlantic Brain and Spine, patients with complex cerebrovascular conditions like AVMs have access to highly specialized care designed to meet critical moments with expertise and humanity.

Request an appointment to learn more about neurovascular care at Atlantic Brain and Spine.