At 18:12 on January 15, at the Airport District Hospital of the First People's Hospital of Zhengzhou City, the designated hospital for the treatment of new crown pneumonia in Henan Province, accompanied by the cry of a newborn baby, a 41-year-old pregnant woman diagnosed with new crown pneumonia gave birth to a baby boy by caesarean section, 6.6 kilograms, and the newborn score was full. With the concerted efforts of the medical staff of the Provincial People's Hospital, it took only 3 minutes from the beginning of the operation to the birth of a new life.
Caesarean section surgery for pregnant women diagnosed with new crown is completed in 3 minutes
At about 17:00 on the afternoon of January 15, obstetrics, pediatrics, anesthesiologists and operating room nurses, midwives and neonatal nurses were fully armed in the negative pressure operating room of the designated hospital for the treatment of new crown pneumonia in Henan Province, waiting for the arrival of a pregnant woman.
This is an elderly pregnant woman who is 38+5 weeks pregnant, accompanied by progressively low platelets, anemia, and may initiate contractions at any time. Because the patient's platelets are less than 50,000 and the function is low, once the contractile weakness, it will face heavy bleeding, endangering the safety of the patient's life, increasing the exposure opportunity of medical staff, and after obstetric evaluation, it is necessary to perform a caesarean section immediately.
At 17:40, the pregnant woman was escorted to the operating room with mobile ultrasound equipment under the escort of nurses and doctors in the ward.
Preoperative anesthesia begins. Intubation of the endotrachea in patients diagnosed with COVID-19 is a very high risk of exposure, and the anesthesiologist must also wear a positive pressure hood in addition to the protective clothing, which makes the ordinary operation difficult. Not only that, but general anesthesia means that once the delivery time is too long, the likelihood of neonatal asphyxia will be greatly increased. This is a challenge for the medical staff on site.
The three-level protection of the whole process makes the doctor's once unfavorable feel strange. Bulging protective clothing, fogging goggles, and three layers of gloves failed to stop the professionalism and efficiency of the surgical team. With a wealth of surgical experience and surgical procedures that have formed muscle memory, just 3 minutes after the operation officially began, a baby boy was successfully removed.
"Wow..." As a loud baby cry echoed through the room, the dangling heart finally came down.
The baby boy is healthy and strong, weighs 6 pounds and 6 pairs, and the newborn score is 10 points!
To avoid cross-infection, the baby is quickly transferred to a specific room after delivery, where he is cared for by a neonatal team health care worker.
On the operating table, the test faced by medical staff and pregnant women has just begun - to get through the bleeding barrier.
In order to prevent intraoperative bleeding, the expert team made a detailed and perfect plan from intraoperative blood preparation to rescue plan. Fortunately, except for a slight bleeding from the surgical wound, none of the emergency situations in the plan occurred.
At 19:25, the operation was successfully completed. At this time, under the heavy protective clothing, everyone's surgical gowns have long been soaked with sweat.
At present, the situation of the mother is normal and she has been sent back to the isolation ward for further treatment.
More than 30 medical staff prepared for three consecutive days
Behind the rapid and efficient operation and the safe and healthy mother and child, the strength of multi-departmental and multidisciplinary coordination and cooperation of Henan Provincial People's Hospital is condensed. Among them, it involves the careful deployment of surgery, the transfer of patients and newborns, the purification and preparation of the operating room, the selection and operation of anesthesia methods, the preparation of obstetric surgical personnel, the rescue of newborns, the cooperation of blood transfusion departments and laboratory departments, the design and elimination of transfer routes by hospital sense, the support of logistics departments, and so on.
In order to ensure safety, Henan Provincial People's Hospital set up a special working group to organize multidisciplinary consultations, formulate surgical plans, conduct practical exercises, fully consider the high-risk factors of pregnant women, and strengthen hospital guidance to ensure the safety of medical staff. The caesarean section operation working group for patients infected with the new crown virus is composed of more than 30 people, including the Medical Department, the Nursing Department, the Surgical Department, the Anesthesia and Perioperative Medicine Department, the Hospital Sense, the Obstetrics Department, the Pediatric Critical Care, and the Logistics Support.
The First People's Hospital of Zhengzhou Sent Senior Nursing Experts to Reinforce, Assist in Surgical Preparation, and Provide Strong Support in Logistical Support.
Wu Haiying, director of the obstetrics department of Henan Provincial People's Hospital, recalled that 3 days ago, she received a call from Wang Li, a doctor who was supporting the airport area hospital, immediately reported the news to the hospital, and led the team to conduct the first consultation with Wang Li and Wang Qiuming through video, and formulated a detailed perioperative plan.
At 5 p.m. on January 14, the last 24 hours before the pregnant woman gave birth. In the conference room of the Airport District Hospital, a three-party remote consultation is being carried out intensively. This is the third consultation conducted by a multidisciplinary team of experts in 3 days.
Advanced age, new crown pneumonia, thrombocytopenia, gestational diabetes; epidemic, prevention and control, medical staff... Every difficulty needs to be overcome urgently.
The experts have finally sorted out the surgical methods and procedures to make sure that nothing goes wrong.
After the establishment of the Caesarean Section Operation Working Group for Patients Infected with Covid-19, a number of management plans such as surgical plans, procedures for COVID-19 patients and medical staff to enter and exit the operating room, and a list of emergency abdomen and caesarean section items were produced, so that all work could be based on evidence.
The operating room in the port area has prepared common surgical supplies and protective equipment such as positive pressure hoods and isolation gowns. In order to ensure the safety of medical staff during the operation, the provincial medical headquarters has deployed anti-penetration surgical gowns, caesarean section dressings, and hole towels with pockets (intraoperative amniotic fluid can flow into the pockets to avoid soaking the doctor's clothes). The logistics department of the port hospital deployed newborn incubators, milk powder, and small quilts.
Sun Jing, chief coordinator of the operating room, and Liu Yunhong, the infection prevention and control team, repeatedly designed the process and planned the route to ensure that the pollution surface was minimized.
The team also conducted two on-site drills on the 14th and 15th, carefully considering each link and continuously optimizing the process.
At 15:00 p.m., the relevant personnel entered the operating room according to the drill process. The surgical, anesthesitic, and surgical nurses are divided into 2 groups, one group enters the negative pressure operating room, and one group is on standby in the adjacent operating room.
At 17:50, the pregnant woman arrived at the operating room.
At 18:12, the baby is born.
Subsequently, the medical staff evacuated the operating room in batches and escorted the mother and son to the ward and the intensive care unit respectively.
After the patient left, the nurse in the operating room carried out follow-up work such as instrument disinfection, environmental disinfection, and terminal disposal, which was not completely completed until 21:18.
After the baby was born, a special team composed of PICU doctor Cheng Dongliang, anesthesiologist Wu Jiangxia, midwives Jin Weiwei and Yuan Shuhui, and NICU nurses Zhao Xin and Gao Guangqin was responsible for ensuring the safety of the newborn.
Next, the newborn will be cared for by professional doctors and neonatal nurses in the one-person, one-room intensive nursing ward prepared for him by the medical staff, who will establish a feeding mechanism for the newborn and continuously monitor various indicators.
(Zhengguan News Reporter Wang Hong)