Born to be human.
A person's birthday is also a mother's Good Friday.
It is often said that maternal love is great, and the pain of childbirth reaches level 10. Behind every new life is a mother's thrilling battle.
How did we come to this world before we came into this world? How much hardship has my mother gone through?
A mother is in labor stills from the second episode of "The Human World 2"
Placenta previa, heart disease, thrombocytopenia, pulmonary hypertension... In the episode "Birthday", several sad and happy "desperate" stories that take place in the obstetrics and gynecology department of Shanghai Renji Hospital give you the truest answer.
One operation produced 10,000 milliliters of blood, which is equivalent to three times of blood in the body
Lin Qin, 38, already has two daughters, the first two of which were caesarean sections. She knew that pregnancies were dangerous at an advanced age, but she also wanted to have a son and was looking forward to welcoming her upcoming third child.
Unfortunately, the placenta position of this pregnancy is not good, and the risk of surgery is very high.
In general, the placenta position should be at the bottom of the uterus, far from the cervix. If it happens to grow into the muscle layer of the cervical orifice, it belongs to the dangerous placenta previa, and the process of stripping the child from the placenta is like vigorously uprooting the tree, and the probability of major bleeding is very high. Obstetric bleeding is the first cause of maternal mortality.
Director Lin Jianhua said that in the normal placental stripping process, the uterine muscle layer can contract, and the blood vessels in the uterine muscle layer can be closed. But if the placenta is previa, cannot be peeled off, and the lower blood vessels of the uterus are very rich, the open blood vessels cannot be closed, just like the dragon head cannot be closed, and there is heavy bleeding.
Stills from the second episode of "The Human World 2"
To this end, Renji Hospital prepared sufficient blood for surgery in advance and performed balloon preset surgery for Lin Qin to control intraoperative bleeding.
When the son was removed from the body and the placenta was stripped off, the danger that could not be avoided came as scheduled, and a fierce battle began.
Massive hemorrhage!
"Like a fountain, it can be described as a spray, that is, a stream of blood is directly sprayed out, and it is such a thick column of blood, thousands of milliliters of blood in a few minutes, immediately gone." Lu Xuan, attending physician of the Department of Obstetrics and Gynecology of Renji Hospital, described the heavy bleeding that occurred during the operation this way: In just 10 minutes, Lin Qin lost 3,000 milliliters of blood, while the normal blood volume of an adult was about 4,000 milliliters. The worst thing is that the blood can't be stopped.
After the transfusion of 6,000 ml of blood, Lin Qin's blood still could not be stopped, and the only option was to cut off the uterus and completely lock off the bleeding point of the uterus, and it needed to be decided immediately.
"Take the womb stuff, hurry up, fast. End it, end it, and then don't end this behind the life, life is more important. Director Lin Jianhua is Lin Qin's chief surgeon, and seeing Lin Qin's heart beating faster on the operating table and her blood pressure was still very low, she made the decision to remove the uterus.
After the uterus was removed, Lin Qin's heavy bleeding stopped. Mother and child are safe.
On this day, Lin Qin's caesarean section surgery produced a total of 10,000 milliliters of blood, which is equivalent to three times of blood in the body.
Between life and death, there is only a fraction of a centimeter.
"In fact, I think that if you are still a good man, you don't have to suffer so many sins." Lin Qin, who was pulled back from the brink of life and death, said.
Knowing the danger of life under the taboo, I still want to fight for the sake of "consummation"
Fertility brings hope, but for mothers with serious diseases, it is a life adventure, and even life hangs in the balance.
In addition to placenta previa, advanced women and scarred uterus are potential risk factors for pregnancy, and some women who have underlying medical conditions before pregnancy and those who have comorbidities during pregnancy are also high-risk women.
Director Lin Jianhua introduced to Tencent Medical Code that the current classification and management of pregnant women adopts a color warning classification similar to meteorological warning, which is mainly divided into green, yellow, orange, red and purple. Except for green, which is a woman without any high-risk factors, the remaining four categories have different levels of risk factors, all called high-risk mothers.
But high risk is a general definition, with some severity and constantly changing with the changes in pregnancy. Among them, yellow is relatively light, basically does not affect fertility, and basically does not pose a danger to life; orange and red are through pregnancy tests, predicting that there will be more and extremely serious impact on pregnancy, affecting the presence of maternal and infant health diseases, these two types of women are usually defined as critically ill pregnant women.
There are five critically ill maternal consultation and rescue centers in Shanghai, and the Obstetrics and Gynecology Department of Renji Hospital undertakes about 40% of the critically ill maternal rescue tasks in Shanghai. "In Renji Hospital, basically orange and red women account for more than 50%. In general, tertiary hospitals will have more pregnant women with orange and yellow grades. Lin Jianhua said.
Rao Meiling is going to have a second child, and she is 7 months pregnant. But her hydrocephalus occupies a third of the brain. Before giving birth, she had to have a craniotomy.
Yang Caili has a serious heart condition and is not suitable for pregnancy. But in order to have a offspring with her husband, she was desperately prepared.
After Zhang Li became pregnant, the number of platelets was only more than 10,000, far below the minimum value of 100,000 for normal people. This can cause bleeding or even death in the organs at any time.
By five months, you already have that perception, and then if you know that you are in danger, you still want to fight, just such a feeling.
In their view, if life is to be complete, it is necessary to have a child, even if the disease they suffer from does not allow this, they still want to fight, gamble with their lives, and take an adventure.
A 25-year-old pulmonary hypertension mother desperately wants a child of her own
Having children is really nine deaths for some people, and it is not far from death. Wu Ying, 25, gave birth to a child, but lost her life, and did not even meet the child.
Wu Ying suffers from severe congenital heart disease with severe pulmonary hypertension, which is an absolute contraindication in medicine for pregnancy. But stubbornly, she ignored the desperate objections of doctors and family members and wanted to have a child of her own.
Wu Ying said: "I also know the risks, the doctor has also spoken, I am willing to fight." ”
"Fifty percent, now say nothing." Wu Ying's husband has been with her bedside, although he is afraid, he can't do much, he can only pray that his lover can survive this upcoming test of life and death.
Director Lin Jianhua told Tencent Medical Code that patients with pregnancy and heart disease are clinically divided into five categories, some patients are mild heart disease, and general doctors still agree to become pregnant, but if they reach the fifth level, it is very serious, it will be life-threatening, and they should not be pregnant.
For example, if congenital heart disease is a severe atrial defect that stimulates pulmonary hypertension and hypoxia, then the heart load is aggravated by the enlarged uterus of pregnancy and the increased blood volume demand of the fetus. In particular, the heart load is aggravated during childbirth and within the first week after childbirth.
The operation began, considering Wu Ying's dangerous condition, Renji Hospital concentrated the best obstetric team and anesthesiologists in the hospital to ensure that Wu Ying could survive the operation.
It went well at first, but the experts were well aware that the key challenges lay ahead. Once the fetus is taken out, the blood circulation in Wu Ying's body will change greatly, her original fragile heart will bear more pressure, and if the blood pressure is not well controlled, Wu Ying may not be able to get off the operating table. The risk of pulmonary hypertension and premature beats at any time is an absolutely tricky challenge for anesthesiologists.
"This kind of desperation is not the meaning of hard work, it is really desperate to fight for this child." Zheng Xiuge, attending physician of the Department of Obstetrics and Gynecology of Renji Hospital, said that the doctors knew that Wu Ying's physical condition was not suitable for childbirth and repeatedly advised her, but because of her persistent will, they could only choose to continue, "We strive to let them achieve the best outcome, otherwise it is really too pitiful."
On the eighth day of the son's birth, his mother died and was never separated by a distance of only a few hundred meters
The operation ended smoothly. The "son of Wu Ying", who was born prematurely for more than 7 months, 1005 grams, was sent to the Shanghai Children's Medical Center next door to Renji Hospital, and Wu Ying was pushed to the intensive care unit, hundreds of meters away from the newborn child.
The day after the operation, Wu Ying woke up. However, her vital signs are extremely unstable, ordinary people's blood oxygen saturation is more than 95%, and her blood oxygen saturation is only 81% because of pulmonary hypertension, and it is still declining. This directly leads to a drop in Wu Ying's blood pressure, an acceleration of her heart rate, and even death.
On the eighth day of the intensive care unit, Wu Ying's blood oxygen saturation had dropped to 59%, only 60% of ordinary people. Moreover, she had a serious infection in her lungs, and the hemodynamic changes were severe, and a pulmonary hypertension crisis occurred.
The biggest risk of pulmonary hypertension is infection, Wu Ying's body temperature of 39 degrees 4, has been very high can not come down, blood oxygen saturation may fall lower and lower at any time, the value of heartbeat monitoring is lower and lower, has been fast to the limit.
Why is pulmonary hypertension an absolute contraindication to pregnancy?
Director Lin Jianhua explained:
"Pulmonary hypertension causes blood to fail to enter the pulmonary circulation, can not exchange oxygen, there will be hypoxia, and there is no blood in the left heart, which leads to hypotension." Hypoxia and hypotension, so that the whole body perfusion without oxygen supply, especially the heart coronary veins and other organs of the blood supply, slowly will appear problems.
"Because of low blood pressure and low oxygen, doctors have to find ways to raise blood pressure and give oxygen, and patients must get ventilators and intubate tubes, which is easy to cause secondary infections in the lungs." If a severe lung infection occurs, it affects lung oxygen exchange, a vicious cycle that makes blood oxygen lower.
Therefore, severe pulmonary hypertension secondary to lung infection is equivalent to entering a dead cycle, and the final outcome is often not good. ”
Doctors from all departments of Renji Hospital were mobilized and desperately rescued. "Adrenaline to give again, 5 mg, give again, two mg, come and come, change people to press, change people ..." After the medical staff rescued with all their might, Wu Ying still could not wake up, her husband and family forcibly suppressed the sadness in their hearts, watching Wu Ying's rescue bed sent to another room, and will never come back again...
Tried my best, and that's the result of disobedience.
After Wu Ying left, her husband hid in the corner, flipping through the sweet photos of the past while wiping tears
"Everyone's mood is also quite painful, so young, and left this kilogram of children, this is definitely a pregnancy contraindication, should not be pregnant at all, really to be strictly grasped, after this disease severe pulmonary hypertension, really have to talk repeatedly, talk to death, talk to her about this serious consequence, to keep telling them the tragic case." A day after Wu Ying left, Director Lin Jianhua reviewed the case that had just been experienced with a little excitement at the regular case meeting of the department.
Wu Ying's son is growing up healthily, and the new life is desperately absorbing nutrients, which is the fastest stage for him to grow. His bones, heart, and muscles were all rapidly developing to adapt to this new world.
It is believed that when he grows up, his father will tell him what his deceased mother has experienced the moment he fell to the ground.
Outside the window, a round of slanting sun sprinkled on the Renji Hospital building, the sunset set, and there will be a rising sun.
May everyone, when celebrating their birthday, be accompanied by their mother.
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
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