In March, Ms. Liu, who was about to reach full term in pregnancy, came to Shanghai from Shandong to give birth at Xinhua Hospital, and the fetus in her abdomen was diagnosed with a serious congenital gastrointestinal malformation during pregnancy , a giant umbilical bulge , and the fetus had to undergo surgery as soon as after delivery to survive.
Unexpectedly, the sealing control began...
Fortunately, under the protection of the multidisciplinary team, on April 16, Ms. Liu gave birth smoothly at Xinhua Hospital, and the baby completed the operation at the first time, and has now been out of danger and has begun to eat.
Professor Sun Kun, president of Xinhua Hospital and director of the Intrauterine Pediatric Disease Diagnosis and Treatment Center, said: "Xinhua Hospital is one of the very few hospitals in China that can not only protect the mother in a hospital, but also treat the sick fetus in time. ”
Happy to be pregnant with the second child, the baby suffered from a giant umbilical bulge
Ms. Liu, 36, who lives in Jining City, Shandong Province, conceived her second child in July last year. Just when the whole family was expecting the birth of the second baby, the prenatal examination nearly 5 months of pregnancy found that there was an abnormality in the fetal abdomen. Ultrasound B found that there is an extra mass with a diameter of more than 5 cm in front of the fetal abdomen, considering the possibility of very rare and severe abdominal wall structural malformations umbilical bulging.
The whole family fell into anxiety, they inquired about almost all the well-known hospital information in the country, and finally found that in 2005, Xinhua Hospital's pioneering application of obstetric surgery technology successfully treated a child with a huge umbilical bulge, and in the following 10 years, dozens of cases of fetuses from many provinces and cities across the country were prenatally diagnosed as umbilical bulging fetuses. Ms. Liu also searched for a group of QQ patients with umbilical bulging out, and many parents of children who had been successfully treated in Xinhua Hospital were recommended to go to Xinhua Hospital for treatment.
Pregnant women and their families decided to go to Shanghai.
After more than ten years of development, Xinhua Hospital has accumulated rich experience in fetal diagnosis and treatment, integrated and built a pediatric disease diagnosis and treatment center in the united states, from prenatal diagnosis, childbirth, to early intervention of postnatal diseases, to give mothers and fetuses a more complete treatment plan.
Ms. Liu obtained the diagnosis of many experts in pediatric surgery, obstetrics, imaging and other experts in the multidisciplinary outpatient clinic of the Intrauterine Pediatric Diagnosis and Treatment Center, and clarified the diagnosis of fetal umbilical bulge, and the magnetic resonance image clearly showed that most of the baby's liver and part of the intestinal canal protruded from the body through the defect of the abdominal wall, which belonged to the giant umbilical bulge and was difficult to treat. Wang Jun, director of the Department of Pediatric Surgery of Xinhua Hospital, suggested that Ms. Liu come to Xinhua Hospital to give birth so that the operation could be performed as soon as possible after birth.
Fetal congenital diseases affect the mother and fetus
Umbilical bulge is a congenital malformation of the abdominal wall that involves some abdominal organs protruding outward through the umbilical ring defect at the base of the umbilical cord, covered with a transparent cyst membrane. Umbilical bulge can often be associated with malformations of other organs, with an incidence of about 1-2.5/5000 and an overall mortality rate of 25% to 35%. The umbilical bulge capsule membrane is very thin, very susceptible to external forces and rupture, resulting in serious consequences such as abdominal organ infection and injury, which requires great caution and caution during childbirth; at the time of birth, experienced specialists are also required to give appropriate treatment immediately.
In 2003, the Department of Pediatrics and General Surgery of Xinhua Hospital first proposed the concept of "obstetrics and gynecology", starting from clinical practice, it established a complete set of new diagnosis and treatment models for the diagnosis, treatment and prevention and correction of various congenital malformations, and achieved better treatment results.
Professor Sun Kun of Xinhua Hospital said: "The department of pediatrics involves two living organisms, the mother and the fetus, and the central team, due to long-term cooperation, starts from the details when making the plan, and strives to achieve it in one go." ”
Come to Shanghai to give birth, and the mother and baby are safe under the static management of the whole region
According to the plan, one day in March, Ms. Liu came to Shanghai as planned to give birth, and after several ultrasound examinations, she found that the bulging tissue in the abdomen was getting larger and larger, and the diameter had exceeded 6 centimeters. The COVID-19 pandemic raged and Shanghai entered a lockdown period in April, which added more tension and anxiety to Ms. Liu's originally worried mood.
Under the coordination of Professor Sun Kun, the doctors were anxious about the patient's urgency, overcame the difficulties, and arranged for the pregnant woman to be hospitalized smoothly as scheduled. On the morning of April 16, Obstetrician Xiong Ying, deputy chief physician and attending physician Ni Jiaying, underwent a caesarean section and successfully delivered the baby.
The nurses then transferred Xiao Bao to the operating room adjacent to the delivery room, where Wang Jun, chief physician of the Department of Pediatric Surgery, Attending Physician Wu Wenjie, Chief Physician of the Department of Anesthesiology Peng Yuanzhi, Shen Xiaofang, and nurses of the Pediatric Operating Room were already waiting.
Director Wang Jun again physically examined the baby, and found that the situation of umbilical bulge was consistent with the prenatal examination, the abdominal mass was about 6cm in diameter, the abdominal wall defect was 5cm in diameter, and most of the liver and part of the small intestine were outside the abdominal cavity through the defect. After careful evaluation, Wang Jun decided to use the method of first-stage surgical repair.
With the operation, doctors found that in addition to the umbilical bulge, the baby had another serious deformity - poor intestinal rotation, which is a congenital intestinal development deformity that can easily lead to intestinal torsion and necrosis, and also requires emergency surgery. Director Wang Jun has rich experience in the treatment of such multiple malformations, and after the complete correction of the intestinal malformations, the liver and intestinal tubes are completely returned to the abdominal cavity, and the abdominal wall is successfully closed layer by layer according to the normal abdominal wall structure, and the umbilical cord is completed, and the whole operation takes only two hours.
After the operation, the baby was transferred to the neonatal intensive care unit, and after close observation and active treatment by medical care, the baby recovered smoothly, was out of danger and began to eat through the mouth. If all goes well, this baby will grow up healthy.
During the closure period, the medical staff of the Pediatric Disease Diagnosis and Treatment Center of Xinhua Hospital and the Pediatric General Surgery Team also treated a number of children from Shanghai, Hebei, Yunnan, Guangdong and Jiangsu who were prenatally diagnosed with congenital fetal structural malformations, all of which were successful.
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In the Pediatric Disease Diagnosis and Treatment Center of Xinhua Hospital, fetuses involved in congenital gastrointestinal malformations are jointly diagnosed and treated by pediatric surgery and obstetrics, neonatal internal medicine, medical imaging departments and other departments (fetal abnormality MDT clinic), and various congenital gastrointestinal malformations (intestinal atresia, esophageal atresia, meconium peritonitis, abnormal development of intestinal neurons), abdominal wall deformities (abdominal fissures, umbilical bulge), diaphragm deformities (congenital diaphragm hernias, hiatal hernias), lung development deformities (isolated lungs, pulmonary cystic adenomas), Solid tumors and other diseases implement an integrated diagnosis and treatment model.
Author: Tang Wenjia
Editor: Tang Wenjia
Editor-in-Charge: Fan Liping
*Wenhui exclusive manuscript, please indicate the source when reprinting.
![Pregnant women came to Shanghai to seek medical treatment and were sealed, and the baby's giant umbilical bulge + poor intestinal rotation was smoothly operated[fig]](data:image/gif;base64,R0lGODlhAQABAIAAAP///wAAACwAAAAAAQABAAACAkQBADs=)