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Fortunately, there was no danger, and the brothers were finally able to "get along harmoniously" after they came out.
On June 25, 2018, under the accurate medical evaluation of the obstetric department, a pair of children with twin-twin transfusion syndrome (TTTS) were delivered by emergency caesarean section, and the two brothers were admitted to the neonatal department immediately after birth, and their condition was critical, and the second son also had severe anemia, hemorrhagic shock, etc. After the active rescue treatment of neonatology, laboratory department and blood bank doctors, on the night of admission, blood transfusion was smoothly carried out and temporarily out of danger of life.
After the article was published, the fate of the twin brothers touched the hearts of readers, and everyone left messages to pay attention to the health of the brothers...
The author once again sorted out the follow-up of the two brothers' "palace fight" and reported to you on the recovery of the children.
ONE
Brother
After the two brothers were admitted to the department, the eldest son had polycythemia, excitement and irritability after admission, jaundice appeared on the 2nd day after birth (the actual daily age was less than 24 hours), the degree was severe, the progression was rapid, and there was neonatal ABO hemolytic jaundice, after positive blue light irradiation and static globulin blocking hemolysis therapy, the jaundice gradually subsided, and the biochemical return had no organ damage.
After 13 days of treatment in the hospital, the eldest son's vital signs were stable, Hb 201g/L, the milk volume was completed well, and he was discharged.
TWO
Brother
After the second son was admitted to the hospital, severe anemia, blood pressure decreased progressively, the blood oxygen saturation under high-flow oxygen inhalation could not be maintained normally, the emergency department applied for "type A, Rh(+) to de-white suspended red blood cells", the laboratory department performed a cross-matching blood test, 3 consecutive primary side agglutination, secondary non-agglutination. Contact "Maternal blood type O, Rh(+), child A, Rh(+)", consider the presence of hemolytic disease in the child, and infuse "O type, Rh(+) wash red blood cells" instead.
Because there is no washed red blood cells in this hospital, the doctor on duty of the blood bank urgently contacted the Baoding Center blood station to collect blood, and after the cross-matching test was successful, the second son was successfully infused with "O-type, Rh(+) washing red blood cells" at 00:20 (6 hours after birth).
After blood transfusion, the child's respiratory and oxygen saturation gradually improved, after the completion of the blood transfusion, the low flow of oxygen inhalation, the child's blood oxygen saturation can be maintained normal, no dyspnea, the skin color is rosier than before, the blood pressure is normal, the Hb 88g/L is rechecked, and the "O-type, Rh(+) washed red blood cells" are infused again.
1 month after birth, the left brother, the right brother.
After two blood transfusions, the child's Hb remained above 90g/L, the blood oxygen saturation was normal without oxygen, and the vital signs were stable, but the biochemistry suggested multi-organ damage (liver and kidney function, myocardial damage), and the damage was serious, and there was hypoproteinemia, the surrounding edema was obvious, and the early strict restriction of fluid and albumin supplementation were actively treated. Subsequently, the laboratory indicators of the second son were normal, there was no organ damage, and the edema subsided.
After 20 days of treatment in the hospital, Hb 114g/L can complete the milk amount of 50ml by itself and be discharged smoothly.
At the time of discharge
During the hospitalization, Bao Dad faced such a sudden and rare disease, without any psychological preparation, from the initial confusion and confusion to anxiety and helplessness. Looking at the hard-working neonatologist all the way, the family is grateful, took out 1,000 yuan to send to the doctor, in order to make the family feel at ease, the doctor accepted 1,000 yuan, and then paid the hospital deposit to the child. When you are discharged from the hospital, the doctor gives the deposit slip to Dad...
After discharge, the doctor in charge continued to follow up the child, monitored blood routine, percutaneous bilirubin, blood biochemistry, etc., guided him to feed, continued oral anti-anemia drugs, and assessed physical and intellectual development.
In the follow-up process, the brother is normal, the younger brother with a more serious condition, the weight gain is not satisfied, under the superposition of physiological anemia period, Hb is always at a low value, continuous iron, vitamins and other oral supplements, nutritional status is not very satisfactory, weight, length, head circumference and other measurements continue to be below P10 (10%). Neonatologists regularly instruct families to add low-weight formulas, help them calculate heat cards, and monitor their weight.
In the fall, my brother had a pneumonia and recovered after being hospitalized in pediatrics. After 6 months, the brothers successfully added complementary foods, and the weight of the younger brother gradually caught up, there was no repeated lower respiratory tract infection, and the intellectual development was normal. At the age of 1, the younger brother completed the catch-up growth, which was almost the same as that of the older brother. Now, the 3-year-old baby has gone to kindergarten, and like the normal twins, healthy and cute...
The brothers are 1 year old
TTTS is a serious complication of single-chorionic double amniotic sac twin pregnancy, with a incidence of 10% to 15%.
TTTS often causes complications such as uneven development of twins, abnormal amniotic fluid, anemia in one litter, or erythrocytosis in one litter. If left untreated, the perinatal case fatality rate of TTTS is as high as 80% to 100%. Although the fetal survival rate after treatment is greatly improved, children with TTTS are still prone to brain damage, cardiovascular and renal damage, resulting in a poor prognosis.
The management of TTTS is a major challenge for obstetricians and pediatricians. TTTS can be diagnosed at 22 weeks of gestational age, and if the disease is diagnosed at this time, the average gestational age of newborns at birth is about 29 weeks, and the survival rate of those with a gestational age greater than 28 weeks can reach 84.4%.
A "bloody case" between brothers caused by twin pregnancies begins with a "palace fight", and through the joint efforts of family members and medical staff, it begins with a warm "human world". As for the reader's message, Wu Song and Wu Dalang have such a big difference in physique, is it the result of twin transfusion syndrome? We have no way to verify, but our baby will not have the tragedy of Wu Dalang and Wu Song, which is a fortunate thing in the world!
Source of this article: Pediatrics Channel of the Medical Community
This article is written by Li Yuelan
Editor-in-Charge: CiCi
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