The first time the child was born, a cesarean section was chosen, and as a result the uterus was left with scars. The 26-year-old "panda blood" mother's second child encountered a huge danger: the placenta grew to the scar left by the first cesarean section, the uterus was thinner than paper, and it cracked like a "bomb" during childbirth... The obstetrics MDT team of Chengdu Integrative Traditional Chinese and Western Medicine Hospital fought against the god of death for 3 consecutive hours and successfully saved the mother and son of "panda blood".
Scars from the first caesarean section
The life of the mother and son of the second child hangs in the balance
Recently, Chengdu Integrative Medicine Hospital admitted a mother-to-be who was 34 weeks pregnant. Getting pregnant with her second child was a happy event, but things didn't go well. During her pregnancy, she had not undergone routine tests during pregnancy, but the admission to the hospital to give birth found that it was a dangerous placenta previa.
Qi Xiaoxue, director of the Department of Obstetrics and Gynecology, introduced: "After pregnancy, the blood flow in the uterus is very rich, the muscle layer of the uterine neck is thin, the contraction is poor, and once the bleeding is not easy to stop. The insidious placenta previa is one of the most frightening factors in postpartum haemorrhage, with a mortality rate of up to 20%. ”
What is a dangerous placenta previa? It refers to a previous history of caesarean section, and the placenta of pregnancy is attached to the original uterine scar site, because the blood vessels around the placenta are extremely rich like tree roots, when they are attached to the scar of the uterine incision, it is easy to implant through the uterine wall or even part of the bladder, resulting in local implantation of the placenta.
Encountering "dangerous placenta previa", it is not only easy to cause heavy bleeding during pregnancy, but also easy to cause intraoperative bleeding during caesarean section delivery, resulting in hysterectomy to save life, and may cause maternal death in severe cases, which is recognized as "the most difficult caesarean section" in the industry.
For Xiaoli (pseudonym), the mother of the second child, childbirth is not unfamiliar. But she never expected that this time she was pushed into the operating room, and she would face a thrilling "life and death disaster". Dangerous placenta previa implantation, scarring of the uterus, penetration of the muscle layer... These dangers, which could be fatal when they occurred alone, struck her one after another, constantly pushing her to the "ghost gate".
Qi Xiaoxue told the Red Star News reporter: "Xiaoli's weight is not up to standard, according to the calculation of her own blood-soluble amount is only 3000 ml, coupled with her moderate anemia, hemoglobin is lower than the normal index, once the intraoperative bleeding reaches 1000 ml, it will cause shock." The most difficult thing is that Xiaoli is still rare RH-negative blood, and the blood source is very tense. ”
"Multidisciplinary rigorous cooperation, rich clinical experience, perfect surgical plan, full emergency plan, after many consultations and discussions by the MDT team, make each step of surgery more refined and accurate, and reduce the risk of intraoperative bleeding as much as possible." The "dangerous placenta previa" MDT team led by Qi Xiaoxue quickly took action, involving 11 departments such as operating room, anesthesiology, blood transfusion, neonatology, urology, interventional surgery, and ICU... All the medical staff, ready.
Uterus suddenly "explodes" during surgery
Blood is like water that opens the floodgates...
As soon as the abdominal cavity was opened, Qi Xiaoxue, who had many years of rich surgical experience, inhaled a cool breath. Although it has been predicted, this is the most serious type of dangerous placenta previa and penetrating placental implantation. The wall of the uterus exposed to the incision, covered with angry blood vessels of varying thickness and thickness, has completely lost its normal form. The uterus is just at the scar before implantation, and the peritoneum and the anterior wall of the uterus are adhesion in a large area, leaving only a thin transparent film, almost penetrating the uterus, and there is a danger of bleeding at any time.
Although the surgical procedure minimized the risk of bleeding, it eventually happened: bright red blood was like water that opened the floodgates, and it was out of control. The rate of blood flow in the uterus exceeds 500ml-700ml per minute, and if the bleeding is not stopped in time, the patient will develop hemorrhagic shock in less than 5 minutes. Even Qi Xiaoxue, who was accustomed to seeing "big scenes", was extremely nervous. Fortunately, with his rich experience, Qi Xiaoxue found the bleeding site quickly and accurately, fine separation, compression and ligation in one go.
▲Intraoperative.
▲Maternal bleeding heavily.
The baby finally came out, a boy. Next, the neonatologist will take care of your baby's health. The obstetrician is still busy with her mother, concentrating on solving the biggest difficulty – the placenta previa.
After 3 hours of rescue, the medical staff rescued Xiaoli from the "ghost gate" to ensure the safety of the mother and baby.
In the memory of the aftermath, Qi Xiaoxue's mood still could not be calm. Almost all of the complex cases in the textbook are concentrated on Xiaoli, and they appear in turn, which is a huge challenge to the basic knowledge of medicine, practical operation, and teamwork.
Doctor's Tips:
Pregnant women should have regular obstetric check-ups
If giving birth to a child is a woman's life, then the "dangerous placenta previa" is the "robbery in the robbery".
Qi Xiaoxue said that it is necessary to advocate natural delivery of women and not blindly choose caesarean section to quickly end the pain caused by natural delivery. Caesarean section brings some secondary risks and complications, be sure to follow your doctor's advice. It is recommended that pregnant women must have regular obstetric examinations, timely discover and eliminate pregnancy risk factors, avoid going to the hospital after the occurrence of danger, and complicate simple problems that can be avoided.
Qi Xiaoxue told Red Star News that Xiaoli and the baby have been discharged from the hospital recently. Xiaoli's anemia has changed from moderately good to mild, and both mother and child are currently healthy.
It is understood that the Chengdu Municipal Health Commission, Chengdu Maternal and Child Specialist Medical Association and other departments have always been committed to ensuring the safety of mothers and babies in the city. In 2021, maternal mortality in Chengdu reached a new low, falling to 1.94/100,000, and the infant mortality rate fell to 2.15 ‰, which reached the level of developed countries in the world.
Cao Yisha Red Star News reporter Wang Tuo
Edited by Peng Jiang
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