In this world, it is probably even more sad to lose a mother without a newborn child.
A few days ago, Sister Sa saw a news report that a 33-year-old second child mother in Jiangsu was about to be discharged from the hospital after a cesarean section, but she unfortunately died of sudden illness and rescue. The reason is unknown.
Read the news report that the mother's prenatal examination is normal after pregnancy, and the prenatal examination is normal when she is admitted to the hospital for delivery, and there are no other diseases in normal times. The mother went to the hospital on July 29 and gave birth to a boy weighing 10 pounds the next day.
This mother did not experience any abnormalities after giving birth. After the operation, the mother also walked down and walked on time. They were originally planning to go through the discharge procedures on August 4. But in the early morning of the day before discharge, the mother suddenly fell ill and unfortunately died after failed rescue.
After having a child, she couldn't see such news, and she really felt sad. The baby who had just arrived in the world lost her mother. For the mother, she left behind two children, as well as her heartbreaking parents and family. After the incident, the relevant departments quickly intervened in the investigation, but the final reason was not disclosed. Because the body of the mother was not subjected to an autopsy, the hospital and the family decided to settle privately, and the hospital finally compensated the family 360,000 yuan.
Many netizens said they didn’t understand, so why can’t they ask for the truth? Some people also said that it’s too cruel to dissect the family again.
. Sister Sa did not comment on this practice, but for the sudden death of the mother after suddenly developing the disease, Sister Sa guessed that it is very likely that it is pulmonary embolism !
People may not understand: I know that when giving birth, there may be amniotic fluid embolization . Why do I still have pulmonary embolization after giving birth?
First of all, we want to talk about:
Pregnancy and puerperal period, that is, postpartum, itself is a clear risk factor for the occurrence of venous thromboembolic disease (VTE)!
The incidence of VTE in pregnant women is 4-50 times that of non-pregnant women, while the risk of VTE in puerperal period is the most increased, 2-5 times that of prenatal patients. The risk is the highest within 6 weeks after childbirth, dropping to close to the general population at 13-18 weeks after childbirth.
Among them, the prevalence of blood clots in the left lower limb and pelvic cavity is higher than the usual level, and women with a tendency to have hereditary thrombosis will further increase their risk of VTE.
During these two periods, the incidence of venous thromboembolic is about 1/1600. In the United States, pulmonary embolism is the sixth leading cause of death of pregnant mothers.
Venous thromboembolism can manifest as isolated deep venous thrombosis in the lower limb blood vessels during pregnancy, or blood clots in the blood vessels in the lower limbs fall off and enter the lungs and appear as pulmonary embolism. Among the causes of maternal death, pulmonary embolism accounts for 9%, which is the seventh largest cause of death.
Factors often mentioned that increase the risk of VTE after childbirth include:
● Obesity of maternal obesity, BMI≥25kg/m2
● Pregnant women are older (≥35 years old)
● Cesarean section, especially emergency cesarean section
● There are coexisting diseases themselves, such as hypertension , varicose veins, heart disease, inflammatory bowel disease
1 ● 36 weeks ago premature birth , stillbirth, or accompanied by obstetric hemorrhage
has increased risk because the characteristics of pregnancy and puerperal period are that all three elements of Virchow appear: venous stasis, endothelial cell damage and hypercoagulant state . All characteristics may promote an increased risk of VTE during pregnancy.
If these symptoms occur, be sure to be vigilant and seek medical attention in time, because they may indicate proximal venous thrombosis:
Diffuse pain and swelling of the lower limbs, accompanied or not with redness, increased skin temperature and tenderness. If it is iliac vein thrombosis, symptoms may include swelling of the entire leg, with or without pain in the waist, lower abdomen, buttocks, or back.
Speaking of this, perhaps the most concerned issue for everyone is:
Is there any way to prevent it?
Both pregnancy and puerperal periods are risk factors for VTE, but in fact, most pregnant women do not need thrombosis prevention. Thrombosis prevention is often used to target patients who are considered to have the highest risk of VTE in both prenatal and postnatal, and the indications for thrombosis prevention in prenatal and postnatal women are different.
All prenatal women should undergo vigilant clinical monitoring during the entire pregnancy. In our daily prenatal examination, we often include related items. Therefore, performs prenatal examination on time , which can help detect whether the signs and symptoms of VTE are shown as early as possible.
If you are a specific group of prenatal women with high risk of VTE, can be given drug-induced thrombosis prevention . For example, the use of low molecular weight heparin, etc. Of course, this requires the doctor to weigh the risks of preventing thrombosis and bleeding, and strictly control the dosage according to the doctor's instructions.
For most postpartum women, we generally recommend to observe instead of using drugs to prevent VTE. However, patients with these conditions are recommended to follow the doctor's advice to prevent drugs after childbirth:
● have a previous history of VTE (single or multiple times);
● has hereditary thromboproliferative disease but no personal VTE history.
If you are a woman who has undergone cesarean section and does not have additional risk factors for VTE, we recommend getting out of bed as soon as possible or using mechanical equipment (such as gradient pressure stockings) instead of drug-induced thrombosis prevention.
This is why Sister Sa emphasized many times before that you will let you listen to the doctor's words after cesarean section and get out of bed as soon as possible. You should not lie in bed all the time during confinement. This seems to be a blessing, but it is actually not good.
Because of the hypercoagulant blood, the lack of exercise will make the blood flow slower, which will further increase the risk of thrombosis invisibly. This is how the tragedy in some news comes from:
For women who have undergone cesarean section and have other risk factors for VTE, doctors generally recommend drug-induced thrombosis prevention combined with mechanical thrombosis prevention , and this type of population should pay more attention.
Although the thrombus is small, the harm is great. Fortunately, we can prevent it through scientific means. The simplest thing is to control weight and gain weight reasonably.
In addition to taking enough water, you should insist on moderate activities during pregnancy and after giving birth. When you should walk, you should walk. As long as your physical condition allows, some mildly soothing exercises such as walking, yoga, etc. are also beneficial.
At the same time, must do a good job in prenatal examination . Once abnormalities are found, intervention and treatment should be carried out as soon as possible. During the puerperal period, follow-up should be followed by doctor's advice and confinement should be carried out scientifically.
Don’t “knowing that there is a tiger in the mountain, I tend to walk towards the tiger mountain”. Although pregnant women should really enjoy more, eat more good food, and rest more, everything needs to be analyzed in detail. The doctor calls you to endure the pain and get out of bed and walk around. It is really not a stepmother’s psychology, because the doctor understands the most:
The greatest blessing should always be that both adults and children can be safe.
References:
[1]Bates SM, Greer IA, Middledorp S, et al. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e691S.
[2]American College of Obstetricians and Gynecologists Women's Health Care Physicians. ACOG Practice Bulletin No. 138: Inherited thrombophilias in pregnancy. Obstet Gynecol 2013; 122:706. Reaffirmed 2017.
[3]Marik PE, Plante LA. Venous thromboembolic disease and pregnancy. N Engl J Med 2008; 359:2025.
[4]Morris JM, Algert CS, Roberts CL. Incidence and risk factors for pulmonary embolism in the postpartum period. J Thromb Haemost 2010; 8:998.
[5]James AH, Jamison MG, Brancazio LR, Myers ER. Venous thromboembolism during pregnancy and the postpartum period: incident, risk factors, and mortality. Am J Obstet Gynecol 2006; 194:1311.
If it is iliac vein thrombosis, symptoms may include swelling of the entire leg, with or without pain in the waist, lower abdomen, buttocks, or back.Speaking of this, perhaps the most concerned issue for everyone is:
Is there any way to prevent it?
Both pregnancy and puerperal periods are risk factors for VTE, but in fact, most pregnant women do not need thrombosis prevention. Thrombosis prevention is often used to target patients who are considered to have the highest risk of VTE in both prenatal and postnatal, and the indications for thrombosis prevention in prenatal and postnatal women are different.
All prenatal women should undergo vigilant clinical monitoring during the entire pregnancy. In our daily prenatal examination, we often include related items. Therefore, performs prenatal examination on time , which can help detect whether the signs and symptoms of VTE are shown as early as possible.
If you are a specific group of prenatal women with high risk of VTE, can be given drug-induced thrombosis prevention . For example, the use of low molecular weight heparin, etc. Of course, this requires the doctor to weigh the risks of preventing thrombosis and bleeding, and strictly control the dosage according to the doctor's instructions.
For most postpartum women, we generally recommend to observe instead of using drugs to prevent VTE. However, patients with these conditions are recommended to follow the doctor's advice to prevent drugs after childbirth:
● have a previous history of VTE (single or multiple times);
● has hereditary thromboproliferative disease but no personal VTE history.
If you are a woman who has undergone cesarean section and does not have additional risk factors for VTE, we recommend getting out of bed as soon as possible or using mechanical equipment (such as gradient pressure stockings) instead of drug-induced thrombosis prevention.
This is why Sister Sa emphasized many times before that you will let you listen to the doctor's words after cesarean section and get out of bed as soon as possible. You should not lie in bed all the time during confinement. This seems to be a blessing, but it is actually not good.
Because of the hypercoagulant blood, the lack of exercise will make the blood flow slower, which will further increase the risk of thrombosis invisibly. This is how the tragedy in some news comes from:
For women who have undergone cesarean section and have other risk factors for VTE, doctors generally recommend drug-induced thrombosis prevention combined with mechanical thrombosis prevention , and this type of population should pay more attention.
Although the thrombus is small, the harm is great. Fortunately, we can prevent it through scientific means. The simplest thing is to control weight and gain weight reasonably.
In addition to taking enough water, you should insist on moderate activities during pregnancy and after giving birth. When you should walk, you should walk. As long as your physical condition allows, some mildly soothing exercises such as walking, yoga, etc. are also beneficial.
At the same time, must do a good job in prenatal examination . Once abnormalities are found, intervention and treatment should be carried out as soon as possible. During the puerperal period, follow-up should be followed by doctor's advice and confinement should be carried out scientifically.
Don’t “knowing that there is a tiger in the mountain, I tend to walk towards the tiger mountain”. Although pregnant women should really enjoy more, eat more good food, and rest more, everything needs to be analyzed in detail. The doctor calls you to endure the pain and get out of bed and walk around. It is really not a stepmother’s psychology, because the doctor understands the most:
The greatest blessing should always be that both adults and children can be safe.
References:
[1]Bates SM, Greer IA, Middledorp S, et al. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141:e691S.
[2]American College of Obstetricians and Gynecologists Women's Health Care Physicians. ACOG Practice Bulletin No. 138: Inherited thrombophilias in pregnancy. Obstet Gynecol 2013; 122:706. Reaffirmed 2017.
[3]Marik PE, Plante LA. Venous thromboembolic disease and pregnancy. N Engl J Med 2008; 359:2025.
[4]Morris JM, Algert CS, Roberts CL. Incidence and risk factors for pulmonary embolism in the postpartum period. J Thromb Haemost 2010; 8:998.
[5]James AH, Jamison MG, Brancazio LR, Myers ER. Venous thromboembolism during pregnancy and the postpartum period: incident, risk factors, and mortality. Am J Obstet Gynecol 2006; 194:1311.
