"Wow..." With a loud baby cry, the hearts of the 18 doctors in the operating room of Ruijin Hospital were released. Recently, the operating room of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine underwent a thrilling operation, and 8 major departments and 18 doctors and nurses joined hands to realize Yingying's desire to be a mother who suffered from congenital heart disease and tracheal stenosis since childhood.
01 Never thought I could be a mother
In August last year, the 26-year-old Yingying was surprised to find out that she was pregnant, but then came endless fear, she never expected to be a mother.
It turned out that Yingying suffered from congenital heart disease and tracheal stenosis, and at the age of 3, she had open chest deficiency repair surgery, and since childhood tracheosy, tracheostomy opened the stent, because of repeated granulation hyperplasia in the trachea, repeated interventional treatments were done, and until four years ago, frequent airway surgery was stopped, but the diameter of the narrowest part of the airway was only 6.7mm.
CT of the trachea
"This is a gift from Heaven." Thinking that she could easily live like a "normal person", Yingying did not want to give up the opportunity to be a mother.
Yingying was about to start a maternity examination, thinking of her "special", she and her family unanimously decided to go to a hospital with the strongest comprehensive strength to give birth.
"Except for Ruijin Hospital, we are not at ease anywhere," said the couple who have been living in Shanghai for many years and went straight to the obstetrics department of Shanghai Ruijin Hospital.
02 Pull bellows-like breathing sounds
After the meticulous care of Ruijin Obstetrics, Yingying spent 34 weeks safely. In April this year, Yingying, who was 34 weeks pregnant, felt that her breathing was very difficult, and every breath was accompanied by a "hiss... Hissing...".
"You have developed significant dyspnea and must be hospitalized, and if hypoxia occurs, it will affect the development of your baby in the abdomen." At the insistence of Chief Physician Liu Yan of the Obstetrics Department, Yingying was hospitalized for observation. Fortunately, all the indicators were normal after checking, and because they did not want to produce prematurely, the strong Yingying decided to take another look.
Left: The trachea with the inverted ying ying
However, less than 2 weeks after being discharged from the hospital, Yingying felt that it was more and more difficult to breathe, and the breathing sound was getting louder and louder. When she came to Ruijin for maternity examination in early May, she was once again left in the hospital by Director Liu Yan, when every breath she took was very laborious, and the sound of breathing was like pulling a bellows, hula hula.
"Your heart and lung conditions are about to exceed the limit of what your body can bear, and if you drag it on, not only will your child face hypoxia and asphyxia, but you will also face great risks," Director Liu Yan said bitterly, "It is recommended that you have a caesarean section as soon as possible." ”
After thinking about it again, Yingying finally agreed.
03 Life and death are in an instant,
You have to be prepared
Yingying's caesarean section surgery needs to be prepared: if the epidural anesthesia is not successful, it is necessary to perform endotracheal intubation under general anesthesia to maintain breathing, while Yingying's airway diameter is only 6mm, which cannot complete conventional endotracheal intubation, and once the pregnant woman suffocates, the fetus in the abdomen is also in danger of suffocation...
In order to ensure that nothing goes wrong, Director Liu Yan's team immediately took action - to improve a series of examinations, organize multidisciplinary collaborative consultations, and take joint action in eight departments: obstetrics, anesthesiology, cardiac surgery, respiratory medicine, critical care medicine, neonatology, obstetrics and security office, and operating room.
Chief Physician Liu Yan of obstetrics, Deputy Chief Physician Of Zhong Huiping, Chief Physician of The Department of Critical Care Medicine Li Lei, Deputy Chief Physician of the Department of Respiratory Medicine Chen Wei and Dr. Bao Chengrong of the Department of Anesthesiology, etc., have formulated strict treatment procedures and a variety of crisis response plans for possible dangers, and even prepared for ECMO, and have repeatedly communicated with Yingying and her family in detail to soothe their nervousness.
Scenario one
Caesarean section under epidural anesthesia is preferred
Scenario two
If the epidural plane is too high, breathing is suppressed, and the patient has difficulty breathing, endotracheoscopic intubation is tried to assist breathing
Scenario three
If the endotracheal intubation is not smooth, a caesarean section under the extracorporeal membrane oxygenation (ECMO) regimen is initiated immediately
"The life and death of the mother and the fetus is in an instant, and we must be prepared for everything!" The doctors who participated in the consultation immediately went their separate ways and made perfect preoperative preparations. Hu Qiumin of the Obstetric Safety Management Office and Wang Wei and Shen Jiefang, the head nurses of the operating room, as the strong backing of each department, did a good job in all coordination work.
04 Mother and child are safe, my choice is not wrong
On May 10, 18 medical staff gathered in the operating room, and the relevant staff of obstetrics, anesthesiology, respiratory medicine, intensive care medicine and operating room waited in a strict line, performed their duties, and devoted themselves to the caesarean section.
Director Dong Rong of the Department of Anesthesiology has a needle in place for epidural anesthesia, which perfectly controls the anesthesia plane and carries out the whole process of monitoring the operation.
No respiratory depression occurred in the mother!
The team of director liu yan of the obstetrics department did not relax and immediately performed a cesarean section.
Deputy Chief Physician Chen Wei of the Department of Respiratory Medicine, Deputy Chief Physician of Tang Haiting of the Department of Obstetrics and Gynecology, the operating room team and the intensive care medical team assisted in the operation.
At 13:58 a loud cry sounded, and this hard-won baby was born! Mother and child are safe, and the indicators of premature babies are normal! The 18 doctors and nurses present breathed a long sigh of relief, and Director Liu Yan's taut heartstrings finally let go...
During surgery (infographic)
"When I was most afraid, it was Ruijin Hospital that gave me courage, and there were 18 medical staff guarding me during the operation, they gave me a great sense of security, thanked them for helping me realize my wish to be a mother, my choice is not wrong!" 」 Today, Yingying's breathing difficulties have been greatly alleviated, and she can soon be discharged from the hospital with her baby.
In the past three years, the Department of Obstetrics of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine has received more than 2,000 cases of high-risk pregnant women, established a multidisciplinary information management system for the comprehensive treatment of critically ill pregnant women, carried out the integrated construction of the obstetric ward of the multidisciplinary diagnosis and treatment center for critically ill pregnant women, established a multidisciplinary treatment team for critically ill pregnant women led by obstetric professionals, and formed a multidisciplinary comprehensive treatment model of Ruijin obstetrics with "prevention-rescue-psychological intervention" model. It has improved the hospital's ability to mobilize comprehensive resources for maternal emergency, reduced the incidence of critically ill pregnant women, improved the survival rate of perinatal children and the long-term quality of life of critically ill pregnant women, and made the success rate of critical maternal treatment in Ruijin Hospital greater than the average level of 95% in Shanghai.
Clinic hours
_
Specialist clinics
(Main Hospital Outpatient Building)
Special needs clinics
(Building 10, Main Hospital)
Liu Yan
Chief physician
All day on Friday
Wednesday morning
Zhong Huiping
Deputy Chief Physician
All day on Thursday
Monday morning
Yang Chenmin
Monday afternoon
All day on Wednesdays
Written by | Jiao Haining Fang Juan
Edit the | Fang Juan