Original title: Sudden amniotic fluid embolism, pregnant mother's life hanging in the balance! The multidisciplinary collaboration of the Third Affiliated Hospital of Zheng University has turned the danger into a disaster
It was an extraordinary day for the family of Lily (pseudonym) and the medical staff of the Third Affiliated Hospital of Zhengzhou University (Provincial Maternal and Child Health Hospital, Provincial Women and Children's Hospital). On the same day, after more than 4 hours of rescue, the medical staff successfully pulled Lily back from the "ghost gate".
This thrilling treatment occurred at 4 a.m. that day.
The rescue team of more than 20 people from obstetrics, anesthesiology, ICU, operating room, pediatrics and other multidisciplinary departments of Zhengda Third Affiliated Hospital successfully "snatched" the life of the mother and fetus from the hands of the serious complication of childbirth, "amniotic fluid embolism", which has a mortality rate of up to 80%.
Lily, 34, a second-born mother who is also a doctor at a hospital in Zhengzhou, chose to come to Zhengda Third Affiliated Hospital to give birth out of trust in the obstetrics department of Zhengda Third Affiliated Hospital.
When Lily gave birth, the first stage went well. But at 3:55 a.m., when her uterine opening was complete, she suddenly appeared coughing, irritability and suffocation, followed by sluggishness, impaired consciousness, inability to monitor the fetal heartbeat, etc., the blood pressure fell down, the life monitor showed that the blood pressure dropped to 70/50mmHg, and the blood oxygen saturation dropped to 80%...
With years of clinical experience, doctors and midwives preliminarily judged that patients were likely to have amniotic fluid embolism, and then activated the amniotic fluid embolism rescue emergency plan. Under the guidance of the hospital-level multidisciplinary rescue team led by Xu Yajuan, director of the Obstetrics Department of the Third Affiliated Hospital of Zheng University, Wang Wentao, chief physician of the Obstetrics Department, and Zhang Huifang, deputy chief physician, immediately performed emergency caesarean section operations, and a life-and-death rescue was launched.
After a short but long 9 minutes, at 4:04, a baby boy was delivered. After the rescue and recovery of pediatricians and midwives, the newborn let out a loud cry, and everyone breathed a sigh of relief.
However, after the delivery of the fetus, the maternal uterus contracted poorly, the wound bleeding was surging, the surgical field was bleeding in a large area, the blood pressure continued to decline, the bleeding in a short period of time exceeded 3000mL, and continued to increase rapidly, the blood did not coagulate, the hospital-level multidisciplinary rescue team considered that the mother had diffuse intravascular coagulation (DIC) and refractory postpartum hemorrhage, in order to save the young woman's life, the rescue team decisively decided to remove the uterus.
On the operating table, several medical staff cooperated skillfully, carefully operated, and strictly stopped the bleeding. Under the operating table, the rescue team performed its duties in an orderly and orderly manner. Hu Mengcai, director of the obstetric ward of the hospital, Han Ning, director of the delivery room, and Wang Lu, the chief nurse, calmly communicated, the administrative general duty, Lin Jing, director of the party office, and Xu Yunfei, deputy director of the medical department, coordinated and organized the delivery of emergency drugs, blood products and cooperation between multiple departments, Jiang Lihua, director of the anesthesia department, and Wang Lixin, chief nurse of the operating room, participated in maintaining blood pressure, heart rate, and breathing at the scene, and carried out the implementation of central intravenous catheterization, tracheal intubation, etc., and the departments of critical care medicine, blood transfusion, laboratory, pharmacy and other departments gave full support.
Finally, after more than four hours of thrilling rescue, with the joint efforts of medical staff, the maternal surgical wounds completely stopped bleeding and the vital signs tended to stabilize.
During the operation, the cumulative maternal bleeding volume reached 5500mL. For Lily, who weighs less than 60 kilograms, this amount of bleeding is equivalent to a blood exchange throughout the body. After her vital signs stabilized, they escorted her to the intensive care department for further treatment, and the newborn was transferred to the neonatal department for observation and treatment after resuscitation. All the paramedics present stayed up all night.
At present, after careful treatment and care in neonatology, intensive care medicine and obstetrics, Lily and the child have recovered and been discharged from the hospital.
It is understood that amniotic fluid embolism is in the process of childbirth, amniotic fluid suddenly enters the maternal blood circulation to cause acute pulmonary embolism, anaphylactic shock, disseminated intravascular coagulation or sudden death, etc., which is a rare and extremely critical complication in obstetrics. Subsequent DIC, severe shock and multi-organ failure, clinical management is very difficult, the development is particularly rapid, the mortality rate is relatively high, and the treatment is very difficult. The incidence of amniotic fluid embolism is about 4/100,000 to 6/100,000, and the mortality rate can reach up to 80%, which is one of the main causes of maternal death, and there is no complete prevention method.
The success of this rescue is inseparable from the early identification ability of the obstetric department of the Third Affiliated Hospital of Zheng University for acute and critical illness, the effective implementation of the emergency plan, and the full cooperation of the team. (Liu Yanxing, Lu Jingjing)
(Big River Network)