"We can't wait any longer, we must terminate the pregnancy immediately..." Liu Ying, deputy director of the obstetrics department at Tianjin Central Obstetrics and Gynecology Hospital, said emphatically on the phone that she was a medical worker who was assigned to support Jinnan Hospital during the current round of the epidemic.
On the evening of 21 January, shortly after she returned from the hospital, colleagues reported to her about the emergency of a pregnant woman who was hospitalized. With years of experience, Liu Ying judged that this pregnant woman had complications such as HELLP syndrome, and if the pregnancy was not terminated, the consequences would be unimaginable... In the end, through surgery, the newborn was successfully delivered, and then was quickly transferred to the Municipal Children's Hospital for further treatment, and the mother also spent a dangerous period in the intensive care unit of Jinnan Hospital, and the mother and child were safe.
This is a precise relay to protect life. With the sudden outbreak of the epidemic, Tianjin coordinated multiple medical resources to rush to jinnan, enriched the medical force, straightened out the diagnosis and treatment mechanism, timely treated various critically ill patients, and guarded the life safety and health of the people.
Liu Shaoxia (first from left) and other medical staff were interviewed
Decisions at critical moments
Late on the night of January 10, Wang Xiaolan (pseudonym), a pregnant woman living in Xinzhuang's mother's house, suddenly felt a headache and found that her blood pressure was high after self-testing. In the past few days, she has been treated in the downtown hospital and has been relieved. This time, the blood pressure rebounded, and at this time, her community Xinwangli has been sealed, and Xinzhuang is the key area of this round of epidemic.
What to do? The family quickly contacted Jinnan Hospital and learned that they could be admitted, and in the early morning of the 11th, they came to Jinnan Hospital. "At that time, I was so nervous, I was afraid that something would happen to the child!" Wang Xiaolan recalled.
The hospital arranged for her to be admitted to the buffer ward, which is a special ward for critically ill patients in Jinnan Hospital during the epidemic period, and those patients from the sealed community who do not have a nucleic acid negative certificate in a short period of time can be admitted to this ward and receive timely treatment.
Wang Xiaolan suffers from hereditary hypertension and is heavier, and when she is admitted to the hospital, her pregnancy is only more than 31 weeks, which is a high-risk pregnant woman who needs to pay attention to. Within 10 days after admission, experts and medical staff from medical institutions such as Tianjin Central Maternity Hospital, Tianjin Third Central Hospital and Tianjin Children's Hospital, together with colleagues from Jinnan Hospital, carefully formulated a diagnosis and treatment plan for Wang Xiaolan and paid close attention to her physical progress. In her own words, sometimes when she moves herself, doctors and nurses ask if there's anything uncomfortable.
After a course of treatment, Wang Xiaolan's blood pressure stabilized, and the discomfort was gradually eliminated. However, at 8 p.m. on January 21, her blood pressure suddenly rose sharply again, reaching a maximum of 199/120mmHg, accompanied by epigastric discomfort and fetal heart rate abnormalities. At this time, Liu Shaoxia, administrative director of the Obstetrics and Gynecology Department of Jinnan Hospital, could not sit still, and she dialed Liu Ying's phone.
Liu Ying just returned to the station, after listening to Liu Shaoxia's description, combined with the laboratory results showed elevated aminotransferases, thrombocytopenia and other indicators, Liu Ying judged that Wang Xiaolan was a typical sign of HELLP syndrome. This is a common comorbidity in pregnant women with high blood pressure, which is more dangerous, and if the pregnancy is not terminated by surgery, adults and children will be at greater risk.
However, they will face resistance from their families to take further measures. Since admission, because of concerns that the fetus may be immature and the survival rate is low, the family has been hoping not to terminate the pregnancy too soon. But on the night of the 21st, Liu Ying and others, out of professional judgment, decided that they must persuade Wang Xiaolan's family to agree to the operation.
"When it comes to the safety of pregnant women, we try to extend the gestational age as long as possible, and if something happens, it must be terminated immediately." Liu Ying said. The final result was good, and after the medical staff informed the patient of the condition, the family learned of the seriousness of the situation and happily agreed to carry out the caesarean section.
Not a second was delayed
This is no ordinary caesarean section. Pregnant women are only 32 weeks and 6 days pregnant, more than 7 weeks earlier than the expected date, and all professional medical staff understand what a newborn will be like after giving birth, immature development, various unexpected conditions... Most importantly, Jinnan Hospital does not have a neonatology department, and premature babies can only be properly treated in large general or specialized hospitals in the city. And the transfer is not so easy, at this time, Jinnan, or the center of this round of epidemic...
"After knowing that the mother was in a situation, our string was stretched!" A health care worker recalls. Next, a race against the clock, seamlessly, and closely coordinated life guarding operation began.
While preparing for Wang Xiaolan's operation, they carefully planned the emergency treatment after the birth of the newborn, according to the plan, the child will be transferred to the Municipal Children's Hospital at the first time. Nie Yanyan, a neonatologist at the Children's Hospital of Jinnan Hospital, coordinated with the department and the director in charge of the unit, and the hospital immediately launched the emergency process of referral during the epidemic period, and after assessing the risk of the epidemic, decided to open a green channel for newborns, eliminating the need to go to the fever clinic first.
The neonatology department of children's hospital is busy with the upcoming little life, the incubator is warmed up in advance, the ventilator is ready for standby, and the monitoring and rescue equipment is in place...
On the side of Jinnan Hospital, Liu Shaoxia and others are also busy, preparing for surgery, while coordinating the hospital's medical office to handle referral procedures, and applying for a permit from the Municipal Epidemic Prevention and Control Command. When everything was ready, the hospital's emergency vehicles came to the emergency building to stand by.
At 21:41, the child was successfully delivered. As the medical staff expected, the developmental maturity is low, the weight is only more than 1500 grams, cyanosis, bruises on the skin... At this time, they did not delay for a second, and the child was transferred to the ambulance and drove to the children's hospital.
In less than an hour, the child was lying in an incubator in the neonatal department of children's hospital.
The child is safe, and the medical staff has also made careful arrangements for the mother. Before the operation began, the critically ill maternal treatment team of Jinnan Hospital took action, preparing blood and formulating a large blood transfusion plan. After the operation, the maternal blood pressure continued to be at a high value, and the respiratory recovery was not good, and she was transferred to the intensive care unit of the hospital for the first time, and was personally treated by the medical force from the third central hospital of the city.
Wang Xueyao, director of the obstetrics department of Jinnan Hospital, who performed the operation for Wang Xiaolan, said that the operation did not take long, but the difficulty was not low, the maternal weight was heavier, and there was high blood pressure, as they expected, they found that the placenta had been half prematurely peeled during the operation, if not operated in time, there was a high probability that there would be serious consequences such as fetal stillbirth and heavy bleeding.
Over the past few days, after careful care, the child's condition in the ward of the children's hospital has gradually improved, and the indicators have stabilized. The child's mother, Wang Xiaolan, after 28 hours of intensive care, passed the dangerous period and was transferred to the general obstetric ward.
Obstetrics and Gynecology Ward of Jinnan Hospital
There is no "nucleic acid" to be treated
At noon on the 24th, when answering the reporter's phone, Wang Xiaolan was in a good state. She thanked the medical staff for their help and care for herself and her children. She said she was very nervous when she first entered the hospital, but after being hospitalized, she felt more and more relaxed, and she had complete trust in the medical staff. "Every doctor who came to check the room first asked me about my condition, asked me how much blood pressure I had and whether I was uncomfortable."
After the child was born, she was transferred to the hospital, she has not seen the child yet, and even at first she did not know that the child was a boy and a girl, and the nurse inquired and told her that it was a son. "I want the child to grow up over there now and come back soon!" Wang Xiaolan said.
The epidemic has suddenly hit Jinnan, and the whole district has been classified as an epidemic prevention and control area, and Jinnan Hospital, which originally rarely received critically ill pregnant women, has become the first choice for pregnant women in the district. Liu Shaoxia said that since the current round of the epidemic, more than 150 pregnant women have successfully given birth in Jinnan Hospital, and nearly 10 newborns have been successfully transferred to other hospitals.
Since the outbreak of this round of local epidemics, the municipal party committee and the municipal government have attached great importance to the medical needs of the people in southern Jinnan, and sent a working group to enter Jinnan to coordinate the scheduling of medical resources in the city and do a good job in ensuring the medical treatment of the masses in Jinnan District. At the same time, we will coordinate the city's specialized medical resources to support the oncology department, obstetrics and gynecology department and nephrology department of Jinnan Hospital to improve the specialty diagnosis and treatment capabilities. These medical forces, together with the medical staff of Jinnan Hospital, have jointly undertaken the arduous task of protecting the safety and health of the masses during the epidemic period.
Li Xiaoye, an obstetrician of the third center, has been in Jinnan Hospital for half a month, and she has also come with colleagues from orthopedics, intensive care and other departments, who have formed a strong team of 21 people and rooted in the frontline of the fight against the epidemic in Jinnan.
The medical force is stronger, the referral channels are smoother, and Jinnan Hospital has also formulated a new set of medical procedures according to the characteristics of the anti-epidemic period. They transformed the emergency department into two areas, one for receiving patients in the sealing and control area, one for the treatment of patients in the control area, and the prevention area for patients in the general outpatient clinic.
Jinnan Hospital has also set up a special buffer ward in the Department of Obstetrics and Gynecology to admit inpatients from the sealed area who cannot provide nucleic acid negative certificates in a short period of time. In the buffer ward, patients are admitted to a single room, and patients who are negative at a 24-hour interval between nucleic acid singles can be transferred to the general ward.
"In our case, patients don't go untreated because they don't have a negative nucleic acid certificate." Liu Shaoxia said.
Protecting the health of the masses, epidemic prevention and control and treatment work are not wrong, these days, Tianjin has been working hard.
Jinyun News reporter Chen Qingpu Zhao Yingyan