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Jimu News reporter Yan Wen
Correspondents: Luo Huarong, Huang Jieying
The 31-year-old mother of the second child suddenly suffered from amniotic fluid embolism during childbirth, with respiratory and circulatory failure, severe coagulation dysfunction, and postpartum hemorrhage, and the life of the mother and child hung by a thread. More than 20 doctors and nurses won the "battle of life and death" after 22 hours of life and death rescue, not only the safety of the mother and child, but also the successful preservation of the uterus for the young mother of the second child.
Wu Pan (second from right) led the medical team to make rounds for Ms. Wang
4,300 ml of blood products used to rescue Ms. Wang
After a cough, the "most dangerous" disease in obstetrics came
At 14:44 on January 6, Ms. Wang (pseudonym), who was 39 weeks pregnant, spontaneously broke water in the delivery room of the Optics Valley Branch of Hubei Provincial Maternal and Child Health Hospital. A minute later, she suddenly let out a cough, and when Pomegranate, the midwifery team leader who accompanied her, asked if she was uncomfortable, Ms. Wang did not respond, but waved her arms irritably, and then became unconscious.
"Oh no, it could be an amniotic fluid embolism!" Pomegranate exclaimed, and the doctor in the delivery room and the medical staff of the surgical anesthesiology department came to help. Once an amniotic fluid embolism occurs, the mother and fetus are in danger and must be delivered by cesarean section immediately. Clinically, it is known as the "Grim Reaper's Lottery", which can occur without warning, is almost impossible to prevent, and has a high mortality rate.
At the same time, Zhao Yun, deputy director of the obstetrics department, and Chen Xiangyi, deputy director of the obstetric ward, reported the situation to the medical management office of the Optics Valley Hospital, and quickly activated the emergency plan for multidisciplinary joint treatment of the whole hospital.
A thrilling rescue of the whole hospital kicked off.
Sterilization and spreading, establishment of peripheral venous access, catheterization, anesthesia...... Chen Xiangyi led a team of doctors to start the operation. At the same time, tracheal intubation, central venous and radial artery puncture and catheterization, and unblocked venous access, surgical anesthesiologist Wen Gang quickly completed the establishment of treatment channels.
Four minutes later, a 3,320-gram baby boy was successfully delivered, crying clearly, and the neonatologist took over the baby, all indicators met the standard, and he was in good condition. At this moment, the mother and baby have survived the first hurdle!
It is reported that the Hubei Provincial Maternal and Child Health Hospital has established a "safe delivery room" mechanism, which is equipped with an operating room with obstetricians, midwives, anesthesiologists and neonatologists, who can complete cesarean section within 5 minutes.
"Hold on a little longer", and the young mother saved her uterus
In the face of the "obstetric death", a "collective battle" must be carried out. Under the organization of the medical office of the Optics Valley Hospital, experts from the Department of Surgical Anesthesiology, Gynecology, Adult ICU, Laboratory Medicine, and Medical Imaging Department quickly assembled, and the experts from the headquarters also rushed to the rescue immediately.
Rescue the scene
As expected, the mother soon had cesarean section wound bleeding and non-coagulation, if the coagulation function cannot be corrected in time and the bleeding is stopped, not only the uterus needs to be removed, but the resulting multi-organ failure may even lead to maternal death.
On the stage, Chen Xiangyi and Duan Jie, deputy director of the Department of Gynecology, quickly performed iliac artery ligation, compression sutures and other methods to stop bleeding.
The team guards Ms. Wang in the ICU
In the audience, Gan Quan, director of the adult ICU, and Wu Pan, the head of the adult ICU of Optics Valley Campus, were responsible for the circulation management of the mother, adjusting the medication and blood transfusion, and Li Na, the deputy director of the Department of Surgical Anesthesiology, led the team to monitor the changes in the patient's vital signs, select appropriate anesthetic drugs, ensure oxygen supply, and maintain hemodynamic stability.
At 16:30, the wound was still oozing blood, and the blood was not clotting, "The state of the mother is like a roller coaster, wave after wave." Ganquan said that in the process of treatment, the mother also encountered respiratory failure, heart failure, oliguria, and her vital signs were extremely unstable.
"According to the usual rescue method of amniotic fluid embolism, the removal of the uterus should be considered at this time to stop the bleeding. But after urgent discussion by experts, this mother is so young, and if the situation allows, we will make more efforts to try our best to save the uterus for her. Lian Hongmei, head of the medical office of the Optics Valley Hospital, said.
At 17:35, there was finally a turnaround, after transfusing about 4,300 ml of blood products, the mother's respiratory circulation was stable, the blood and urine became clear, and then a small clot appeared, and the wound stopped oozing blood. Everyone couldn't help but cheer softly, which means that the coagulation dysfunction is gradually improving, and the uterus is saved!
At 19:18, the mother's vital signs basically returned to stable. "It's finally saved!" everyone at the scene breathed a sigh of relief. Zhao Yun carefully completed the abdominal sutures for the mother, and the operation was successfully completed.
From 14:45 to 20:20, more than 20 doctors and nurses participated in this "battle". Chen Xiangyi said that when she walked out of the operating room of the delivery room, she couldn't help but shed tears.
Doctors and nurses guarded all night, and life-and-death rescues continued
After the operation, the mother was immediately transferred to the adult ICU, "The mother is still at risk of pulmonary hypertension, multi-organ failure, severe infection, re-coagulation dysfunction, impaired neurological function, and even unable to wake up." Wu Pan said.
The life-and-death rescue continued, and many experts stayed in the ICU and stayed awake all night. The patient's condition was quickly controlled, circulation and breathing were stable, and the risk of massive cerebral hemorrhage and cerebral infarction was ruled out by CT examination.
At 10 a.m. the next day, after trying to reduce the amount of sedative medication, Ms. Wang gradually regained some consciousness.
At 11 o'clock, during the multidisciplinary joint ward round, Chen Xiangyi called Ms. Wang's name, and she replied clearly in her voice: "Hey!" "I don't know how happy I am when I hear that 'hey'!"
At 12 o'clock, after 22 hours of hard work, Ms. Wang removed the endotracheal intubation and fully recovered consciousness.
In the following days, the ICU team continued to observe, and Ms. Wang's organ function and infection were restored and controlled, and there were no complications such as impaired neurological function and severe organ function.
After experiencing this "life and death catastrophe", Ms. Wang, who came to her senses, had palpitations. With the encouragement of the doctors, her husband, Mr. Cao, wrote a "love letter" for her, and she smiled and shed tears when she read about her husband's love and encouragement.
"We listen to the doctor", and the mutual trust between doctors and patients ushered in a perfect ending
"Thank you for saving my wife and children. After the operation, Mr. Cao thanked the doctors and nurses repeatedly.
During the rescue process, Ms. Wang's condition was very critical, and the doctor spoke with the family four times. Knowing that his wife had suffered an amniotic fluid embolism, Mr. Cao felt extremely uncomfortable and anxious, but he said sincerely: "I believe in you, you just have to let it go!"
"We are also grateful to the families of the patients, who have fully trusted, understood and cooperated with us and have supported us the most. Lian Hongmei said that it is this heavy trust that makes the expert team more confident.
On the 11th, the baby was in good condition after a comprehensive examination and treatment in the neonatal department, and was successfully discharged. On the 17th, Ms. Wang's vital signs were stable, her mental state was good, all indicators had tended to be normal, there was no damage to any organ function, and she was successfully transferred to the obstetric ward.
Dabao is an older sister, almost 2 years old, and she is especially looking forward to seeing her mother and younger brother. Mr. Cao said that now he is to accompany his wife to continue treatment, and strive to be discharged from the hospital as soon as possible and go home, so that the family of four can be reunited.
"The incidence of amniotic fluid embolism is not high, but the mortality rate is extremely high, Ms. Wang was able to 'protect the uterus and give birth' after the amniotic fluid embolism, and successfully removed the tracheal intubation within 24 hours, and ensured that the function of various organs returned to normal, which can be said to be a textbook treatment. Lian Hongmei introduced that this is due to the hospital's standardized management and normalized daily drills, so that the doctors and nurses can accurately judge and carry out rescue at the first time; the continuous optimization of the multidisciplinary treatment process and plan for critical and critical illness can be assembled at any time to assemble the "top" team of the whole hospital for rescue; the safe delivery room mechanism established over the years, with complete personnel and equipment, provides a good foundation for treatment; and the multi-hospital coordination guarantees sufficient blood products and drug reserves, providing a steady stream of "ammunition" for rescue.
(Photo courtesy of Hubei Provincial Maternal and Child Health Hospital)
(Source: Jimu News)
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