Cover news reporter Zhou Jiayi
Recently, in the operating room of Chengdu Shuangliu District Maternal and Child Health Hospital, a thrilling rescue version of "Fast and Furious" was staged...
Finally conceiving her first child at the age of 40 is undoubtedly great news for Yingying (pseudonym) and her family, who have been waiting too long for this day with her family. But what makes the whole family uneasy is that Yingying in the 20 weeks of prenatal examination B ultrasound prompted the placenta previa, the doctor repeatedly told her: "The rate of various diseases in advanced pregnancy is 2-4 times that of pregnancy of the right age, and the placenta previa is a very dangerous pregnancy complication, the possibility of major bleeding is very high, it is recommended that Yingying pay more attention to the importance of prenatal examination in the third trimester of pregnancy, strictly implement each prenatal examination, and give her health and fetal health more protection." ”
In view of Yingying's high risk factors and the maturity of the fetus, the doctor decided to end Yingying's pregnancy by caesarean section at 38 weeks of pregnancy. Finally waited for the time of surgery, everything was carried out in an orderly manner, but when the doctor entered the abdomen, the surgical field of vision was occupied by the thick earthworm-like blood vessels densely packed in the lower part of the uterus, and with rich clinical experience, the chief surgeon immediately judged the possibility of "placenta implantation".
Although it is said that the preoperative preparation has been made, the chief surgeon is still surprised by such a patchwork of blood vessels, in order to ensure the safety of the mother and baby, the chief surgeon immediately made a suspension of surgery and re-evaluation. At the same time, the surgical team immediately sounded the "postpartum hemorrhage" prevention and treatment "alarm" - starting the obstetric and pediatric emergency plan in the hospital, adding a lifeline infusion channel, delivering the prepared blood to the operating room, and explaining the condition again... In the normally run hospital, a terrifying "battle" quietly kicked off in the operating room...
Precise caesarean section is performed to deliver the baby quickly
"Report the main knife, ready to go." "Go!" Everyone performed their duties, at the moment when the chief surgeon took the knife and cut the uterus, all the team held their breath, accompanied by the first cry of life, the pregnant woman was cut open uterus surging bleeding, in the report chengdu Shuangliu District Obstetrics and Pediatric Emergency Management Office at the same time, the surgeon immediately took squeezing, tethering, hand removal of the placenta, suture wound, pelvic vascular ligation, uterine balloon packing... In one fell swoop, the team members worked together, and after a series of measures such as hemostasis and transfusion, the patient's condition was temporarily stable, with a total of 3200ml of bleeding. The uterus is temporarily preserved, the newborn is lively and lovely, and the doctors and patients work together to achieve a stage victory!
According to the doctor, under the opening of the blood sinus of the placenta attached to the face of pregnancy at term, the amount of uterine bleeding per minute is about 500 ml, and the blood volume of a pregnant woman is more than that of non-pregnant, depending on the weight, about 5000 ml. So estimate, 10 minutes will run out! The amount of bleeding in patients with placenta previa and placenta implantation is often more than 2000ml, which is equivalent to half a circulating blood volume, and the surgical process is very thrilling.
Rescue War Emergency The illness has reversed
Although the "war" has achieved a stage victory, due to the special condition of the mother, the team does not dare to relax at all, and still guards the patient on the operating table with full armament and always pays attention. During this critical monitoring period, it was found that the patient's uterine floor was gradually moving upwards, vaginal bleeding was gradually increasing, the patient's heart rate was gradually increasing, and the blood pressure was gradually decreasing...
"The situation is critical" "Immediately report to the Municipal Maternity Emergency Office..." The commander-in-chief of the rescue team issued an order on the spot, and the Municipal Maternity Emergency Office immediately launched the municipal emergency treatment for critically ill pregnant women...
According to reports, the "Municipal Maternity Emergency Office" is the abbreviation of the Chengdu Obstetric Emergency Office, located in the Chengdu Municipal Health Commission Maternal and Child Department, Chengdu Women and Children's Central Hospital is responsible for the daily transactional work of the Maternity Emergency Office, which is a team that guards the health of pregnant women in our city by rapidly coordinating the city's obstetric medical emergency forces 365 days a year.
First aid is command Life is responsibility
At this time, the leaders of the Shuangliu District Health and Health Bureau and the president of the Shuangliu District Maternal and Child Health Hospital personally came to supervise the battle, the district obstetric emergency office coordinated on the spot, the Chengdu Women and Children's Central Hospital was suspended from the Shuangliu District Maternal and Child Health Hospital, and the vice president in charge of the Shuangliu District Maternal and Child Health Hospital, Charlie, personally took command, and the obstetrics director and gynecological director went into battle... Faced with the preservation of the reproductive capacity of women of childbearing age on the one hand, and the risk of losing their lives on the other hand, in critical moments, the team collectively decides: life is supreme, "cutting the uterus, saving life"!
After obtaining the understanding and consent of the family, all the "fighters" launched the fiercest attack.
At this time, the laboratory department reported urgently: "Abnormal blood clotting, platelets are significantly reduced!" ”
This means that the mother may have diffuse intravascular coagulation (DIC), due to the large consumption of platelets and coagulation factors, which will cause extensive bleeding, thrombosis and microthrombosis, resulting in a series of serious complications... This is a critical moment for life.
"Clamping, detaching, moving down, ligating, suturing..." Under the command of Charlie, the deputy director of Chengdu Women and Children's Central Hospital, the obstetrics and gynecology team skillfully cut off the uterus and cut off the source of the bleeding. At this time, Chengdu Women and Children's Central Hospital, Chengdu First People's Hospital critical care medical experts and Chengdu Fifth People's Hospital hematology experts have also been in place to join the rescue, a number of experts on-site research and judgment, correct the internal environmental disorders, to ensure the function of various organs... Erythrocyte suspension 28 units, platelets, autologous blood transfusion, fresh frozen plasma, albumin, prothrombin complex, human fibrinogen, cryoprecipitated geng that is, into the body... The vital signs gradually stabilized, and at this point, a "blockade battle" that lasted for more than 5 hours was won with the trust and close cooperation of doctors and patients! The total bleeding is about 6280 ml.
Recently, Yingying and the baby have been safely discharged from the hospital. This is a pregnant woman with the most bleeding since the history of maternal and child health work in Shuangliu District, and it is also another list of critically ill pregnant women who have successfully rescued the city's medical resources in a timely, accurate and effective manner by the Chengdu Obstetric Emergency Network.