On February 6, 2022, the sixth day of the Chinese New Year, Ms. Ma, who lives in Bin County, gave birth to two cute babies by caesarean section in the local hospital due to "twins, IVF, preeclampsia", and a large amount of vaginal bleeding occurred about 20 minutes after the operation, after symptomatic treatment, the blood routine and fibrinogen continued to decline, and after the cesarean section 9 hours later, Ms. Ma, who was dying, was urgently transferred to the obstetrics department of the First Hospital of Harbin Medical University overnight for rescue.
Ms. Ma, who was sent to the emergency room of the First Hospital of Harbin Medical University, was in a very poor state, indifferent expression, pale conjunctival eyelids, severe anemia appearance, abdominal bulging, uterine body tension, pressing the uterine floor to see the vagina continued to bleed in large quantities, bright red color, the doctor on duty Cao Shan, deputy chief physician, Dr. Liu Fangqun quickly judged that the patient now had a large amount of blood in the uterus, and there was active bleeding, there had been hemorrhagic shock, coagulation dysfunction, there was a risk of cardiac arrest at any time, the patient's vital signs were not stable, and the blood pressure was as low as 70/40mmHg. With a heart rate of 160 beats, life is at stake.
Professor Huang Mingli, director of the obstetrics department, rushed to the hospital in advance after learning about the patient's situation, and led the obstetric team to immediately carry out a rescue of "life and death speed". During the laparotomy, Professor Huang Mingli found that the tension of the uterine body is extremely high, the suture of the uterine cesarean section incision is cut open, a large amount of blood and clotting clots gush out from the uterine cavity, the total amount of blood and coagulation clots in the uterine cavity is about 1500ml, and there is a serious placental implantation in the uterus, a large amount of blood in the uterine cavity has caused severe secondary contracture weakness in the uterus, and severe coagulation dysfunction leads to extensive bleeding from the wound, and it is necessary to stop the bleeding immediately for Ms. Ma, otherwise cardiac arrest may occur at any time.
Director Huang Mingli of obstetrics and deputy chief physician Cao Shan immediately gave uterine B-Lynch pressurized binding and uterine cavity stuffing gauze to stop uterine bleeding. With the cooperation of anesthesiologists, blood transfusion technicians and operating room nurses, Professor Huang Mingli led obstetricians to quickly stop bleeding, transfuse blood, maintain vital signs and other symptomatic treatment for patients, and after 3 hours of full rescue, successfully stopped uterine bleeding, stable blood pressure, rising hemoglobin, and successfully saved Ms. Ma's uterus. After the operation, Ms. Ma recovered well, and after two days of treatment and observation in the ICU, she was transferred back to the maternity ward and was recently discharged from the hospital.
Professor Huang Mingli introduced that postpartum hemorrhage is a serious obstetric complication, every pregnant woman has the risk of postpartum hemorrhage, and it is still the primary cause of maternal life-threatening, and it is the first cause of maternal death in mainland China. Ms. Guan is a high-risk group of hypertensive diseases, IVF, and twin pregnancies during pregnancy, and belongs to the high-risk group of postpartum hemorrhage.
Professor Wong stressed the importance of understanding the causes of postpartum haemorrhage and preventing it in advance. The successful success of this rescue mainly lies in the correct assessment of the patient's bleeding volume, the timely diagnosis of the cause of blood loss, and the correct treatment of the cause of postpartum bleeding.
As a provincial critical care rescue center, the Obstetrics Department of the First Hospital of Harbin Medical University has established a rescue team that can cope with all kinds of obstetric critical and critical diseases, completes the rescue of more than 100 cases of "various diseases" every year, receives thousands of critically ill pregnant women, and uses high-level medical technology and rich rescue experience to fully protect the life safety and reproductive health of pregnant women in Longjiang.
Source: The First Hospital of Harbin Medical University
Author: Su Yao Xu Xu Yu Miao
Editor-in-Charge: Jia Yufei