(Correspondents Luo Huarong and Huang Jieying) The fetus has a huge omphalocele of 8 centimeters, the pregnant mother has panda blood and her fourth cesarean section, central placenta previa and placenta accreta, each of which is a major risk during childbirth. A few days ago, 34-year-old Ms. Wu encountered the above three problems at the same time. With the cooperation of the multidisciplinary team of Hubei Maternal and Child Health Hospital, she gave birth smoothly.
"Panda Blood" mother encountered dangerous placenta previa
At the end of October last year, 34-year-old Ms. Wu unexpectedly became pregnant with her fourth child. Because the first three babies were delivered smoothly, she did not pay much attention to prenatal check-ups. A week ago, she found that her baby had a huge omphalocele during her 35-week prenatal check-up at the local hospital in Huangshi, . She followed the doctor's advice and came to the Hubei Maternal and Child Health Hospital for treatment. Sun Guoqiang, director of the obstetrics department of
, saw Ms. Wu. After asking about the past pregnancy and childbirth surgery history and completing relevant examinations, he initially judged that the fetus had a huge omphalocele, and the pregnant woman herself had a rare Rh-negative blood type, which is commonly known as "Panda Blood" had previously experienced 3 cesarean sections and 1 ectopic pregnancy for a total of 4 laparotomy surgeries. This time, she had dangerous placenta previa and placenta accreta.
"Pregnant women with dangerous placenta previa and placenta accreta will face the risk of heavy bleeding in the third trimester or during delivery, which may even endanger the lives of the mother and baby. They should undergo surgery as soon as possible to terminate the pregnancy . But the patient is 'Panda Blood' The rare blood type makes this operation even more difficult." Sun Guoqiang admitted Ms. Wu to the hospital and reported it to the Medical Department to organize a multidisciplinary consultation across the hospital.
On May 28, a large-scale consultation was held that brought together obstetrics, surgery, neonatology, gynecology II, adult critical care department, ultrasound diagnosis department, medical imaging department, anesthesia department, and blood transfusion department. After discussion by experts from multiple disciplines, , unanimously agreed that Ms. Wu’s pregnancy should be terminated in a timely manner, and she applied for blood preparation from the Wuhan Blood Bank. An abdominal aortic balloon was implanted before the operation, and the autologous blood reinfusion technology was used during the operation, and a specific surgical plan was drawn up.
During this multi-disciplinary discussion, Ms. Wu realized that she and her child were in a "dangerous situation", and the couple, who "belatedly realized", were worried. Gao Ying, deputy director of the obstetric ward, patiently comforted the couple, explained the surgical plan, and said he would do his best to protect the safety of mother and baby.
Multidisciplinary teaming up to protect the lives of mothers and infants
htmlOn the morning of the 30th, according to the predetermined plan, five units of panda blood products from the Wuhan Blood Bank were in place. Interventional doctors from the Medical Imaging Department inserted a balloon into the abdominal aorta of pregnant women and installed a temporary "switch." . Later, Gao Ying and chief physician Hu performed a cesarean section in parallel. Because the fetus had an omphalocele of 8 centimeters, the liver, intestines and other organs were all exposed outside the body. They were only wrapped in a thin film and could burst with the slightest force. The two experts designed a vertical incision surgery for the mother. When they opened the mother's abdominal cavity, the blood vessels of the placenta had attached to the uterine scar like tree roots, and the "root system" penetrated the uterine muscle wall. , penetrated into the cervical canal and bladder, and there were dilated blood vessels everywhere. This is the most critical type of dangerous placenta accreta.
The obstetrician first opened the uterus, took out the fetus steadily and briskly, and protected the bulging part. The interventional doctor first turned off the "switch" to temporarily block the pelvic blood supply and circulation, and the obstetrician expert continued to complete the placenta removal and suturing to stop the bleeding. The area of maternal placenta implantation was too large and almost penetrated the entire serosal layer. The situation was very serious. The two experts patiently and meticulously peeled the placenta away from the uterus and bladder little by little and repaired it. Not only did the operation go smoothly and the mother and baby were safe, but she also successfully saved her uterus.
After the operation, Ms. Wu recovered well. At present, the baby is sent to the neonatal department for monitoring, and surgical treatment will be performed after the baby's physical condition stabilizes.
