On July 11, the medical team led by Liu Junli, director of the obstetrics department of Heping Hospital, performed her fourth cesarean section for a high-risk pregnant woman. The newborn was delivered smoothly and the mother and daughter were safe. This was another successful completion of the obstetrics department of Heping Hospital. High-risk multiple cesarean sections.
Ms. Ren, who was about to have her fourth cesarean section, had three full-term cesarean sections in other hospitals in 2012, 2016, and 2020. Since the children who had been delivered by cesarean section in the first two times died in infancy, she had only one cesarean section. For Ms. Ren, who has a healthy child, she will face the fourth pregnancy and childbirth in her life. The risks waiting for her were also unprecedented. After she learned about the strength of the obstetrics department of Heping Hospital, Ms. Ren chose Heping Hospital from pregnancy, prenatal check-up to delivery because of her trust.
For pregnant women with a history of multiple cesarean sections, the uterus will be extremely enlarged in the later stages of pregnancy, and the uterine scars can easily rupture, causing massive bleeding and even life-threatening injuries. Moreover, after multiple cesarean sections, the layers of the abdominal wall and the peritoneum of the uterus, bladder, etc. are likely to cause severe adhesions, which increases the chance of bleeding during another laparotomy and can easily damage adjacent organs. Every possible accident requires obstetricians to make sufficient predictions and preparations before surgery.
So from the time Ms. Ren came to Heping Hospital for prenatal check-up, Liu Junli designated her as a key obstetric monitoring subject, monitored Ms. Ren's various indicators, and helped her go through the pregnancy smoothly.
When Ms. Ren was 36 weeks pregnant, she was admitted to the hospital to give birth on the advice of her doctor. Since she had had three cesarean sections, the doctor in charge explained the condition to Ms. Ren and her family in detail. Finally, under close supervision, the pregnancy was terminated at 37 weeks , the fourth extremely stressful cesarean section was performed.
In view of Ms. Ren’s situation, Director Liu Junli led the team to conduct a full pre-operative assessment, including the choice of anesthesia method, uterine incision, possible damage to surrounding organs when adhesions were difficult to separate during the operation, and heavy bleeding during the operation. An emergency plan was carefully discussed and formulated, and a detailed surgical plan was determined. In addition, notify the medical staff in the operating room to prepare rescue items to prevent unexpected situations during the operation.
On July 11, a battle for life under the shadowless light began! Medical staff from
obstetrics, anaesthesiology, neonatal room and other departments gathered in the operating room. Director Liu Junli performed the fourth cesarean section for Ms. Ren. Other doctors were also on standby, ready to rescue at any time. Let's work together to ensure the smooth delivery of Ms. Ren. There is no safer production environment than this!
The operation is full of thrills. As soon as the abdominal cavity was opened, I saw extensive and dense adhesions between the bladder, omentum, , peritoneum, and , the front wall of the uterus, as if entering a dense forest of thorns. In order to prevent damage to the intestines, bladder and other organs, Director Liu Junli carefully separated the adhesions layer by layer. , finally saw the lower segment of the uterus, only to see that the uterus was as thin as a butterfly wing, the lower segment muscle layer was missing, only the serosa layer was left, and there was a small amount of bleeding under part of the serosa layer. The entire uterus is fragile! Fortunately, there was no danger. With skillful skills and tacit cooperation, a live female baby weighing 2670g was successfully dissected in the left anterior occiput position.
Postpartum suturing of scarred uterus is also an important test, which is related to whether the uterus will crack and bleed and the mother's postoperative healing. In the end, the operation was successfully completed in more than an hour thanks to Director Liu Junli's superb skills and the close cooperation of the multidisciplinary team. The entire operation was completed in one go, and intraoperative bleeding was controlled within 300 ml.
The operation was successful. This is just a good start. Post-operative care must keep up. When Ms. Ren returned to the ward after the operation, the medical team seamlessly monitored her condition and provided careful treatment and attentive care based on her physical condition. On the third day after the operation, Ms. Ren recovered well without any complications, the baby was also very healthy, and the family was filled with happy smiles.
With the liberalization of the three-child policy, the number of older pregnant women and pregnant women with scarred uterus has increased accordingly. Liu Junli, director of the obstetrics department, also reminded expectant mothers that cesarean section will leave scars on the uterus. The more cesarean sections, the greater the risk that pregnant women will bear. html After 33 or more cesarean sections, the scar on the uterus is like a time bomb for the mother. Spontaneous uterine rupture may occur in the late pregnancy, and the risk of another childbirth will be very high.
Therefore, mothers who have experienced cesarean section and want to get pregnant again should pay attention to the following issues:
1. It is recommended to conduct a risk assessment before pregnancy, conduct standardized prenatal examinations during pregnancy, and pay attention to the relationship between the early placenta attachment position and the scarred uterus, strictly Control your weight and take good care of yourself during pregnancy.
2. For those who choose cesarean section to terminate pregnancy due to pregnancy complications and complications, it is recommended to move early after cesarean section to prevent the occurrence of pelvic adhesions and thrombosis. Pay attention to contraception and give the uterus 2-3 years of protection. Recuperation time.
3. Older (35 years old and above) high-risk pregnant women should go to hospitals with stronger emergency response capabilities and multi-disciplinary collaborative rescue capabilities to reduce the risk of childbirth. The mother can give birth to the next generation while she is in good health to avoid complications and sequelae.
(Source: Heping Hospital Affiliated to Changzhi Medical College )
(Editor: Zhang Wenwei)
