Original title: Danger! The 40-year-old mother of the second child is in danger of encountering the "dangerous placenta previa"! What issues should mothers with second or third children pay attention to when they are pregnant again?
"second child" and "third child" are open, and many families are looking forward to the arrival of a new life with joy, but factors such as age, uterine scars, and dangerous placenta previa are also threatening the safety of pregnant women. On October 29, a "life rescue" was staged in the obstetrics and operating room of Maria Obstetrics and Gynecology Hospital in Heilongjiang. Obstetrics, gynecology, anesthesia, , neonatal and other disciplines jointly "escort" and successfully terminated the pregnancy by performing cesarean section on a dangerous placenta previa in 2 hours and 18 minutes. After the baby was successfully delivered, the doctor carefully peeled off the closely adhered placenta , squirted it with skillful hands to stop bleeding, and retained the uterine and fertility functions for the patient. At present, the mother and son are safe and discharged from the hospital successfully.
A Surgery on the tip of the knife
Multi-disciplinary experts work together to treat pregnant women with dangerous placenta previa successfully
"Fast, pregnant women bleeding continuously, second cesarean section, dangerous placenta previa, placenta implanted ..." The shouts resounded in the green channel of the hospital, and every medical pronoun conveyed the message of the dangerous condition. Ms. Wang (pseudonym), 40, had undergone cesarean section. During her second child, she occasionally suffered bleeding from the lower abdomen, but she didn't care. On October 29, when the pregnancy was 35 weeks +5, vaginal bleeding increased, and the family immediately sent Ms. Wang to the Maria Obstetrics and Gynecology Hospital in Heilongjiang.
After the doctor on duty received the treatment, he was diagnosed as a dangerous placenta previa, and major bleeding may occur at any time and endanger the life of the mother and baby. This surgery on the tip of the knife once again accepted the comprehensive treatment ability and level of the multidisciplinary treatment team of Maria Obstetrics and Gynecology Hospital! According to Dean Yang Jinying, the patient has a history of cesarean section. This pregnancy is a dangerous placenta previa. The placenta is attached to the original surgical site. The risk of placenta implantation and fatal heavy bleeding is high. It is the most difficult and difficult high-risk operation in obstetrics. After sufficient preoperative preparation and multidisciplinary cooperation, Ms. Wang's cesarean section was performed as scheduled. Director Yang Jinying and Director of the Obstetrics Ward Cui Wei led the obstetrics team to hole the placenta and quickly deliver the fetus, and immediately hand it over to the newborn doctor waiting in the audience. At this time, this "hard battle" officially began. With the delivery of the fetus, a large amount of blood immediately gushed out of the uterine placenta incision, hemostatic forceps , separation, suture... The doctors quickly performed this well-known movement while their attention was highly focused. "I finally got abdomen smoothly, with a total bleeding of 450 ml." The mother and son are safe!
"In recent years, with the adjustment of fertility policies, the number of elderly and high-risk pregnant women has increased. The risky placenta previa is a difficult problem in obstetrics, and its incidence rate is also on the rise." Yang Jinying introduced that once the prenatal examination is a dangerous placenta previa, a professional doctor needs to make a comprehensive judgment based on the amount of vaginal bleeding, gestational week, birth rate, fetal position , whether there is shock , etc. to take corresponding treatment. "Regular maternal examinations are the key to preventing and treating mothers, especially for second and third-child mothers. Prenatal examinations cannot be ignored by relying on their 'experience'. If the diagnosis is dangerous placenta previa, it is necessary to observe closely, regularly encrypt the prenatal examination, and regularly review the ultrasound to clarify the placenta location. Once painless vaginal bleeding occurs, you need to seek medical treatment in time. If necessary, hospitalization should be treated to inhibit uterine contractions , correct anemia , prevent infection, and terminate pregnancy in a timely manner to ensure the safety of mother and child." Yang Jinying told reporters that Heilongjiang Maria Obstetrics and Gynecology Hospital has established a multi-disciplinary treatment team for critical pregnant women and a rapid obstetrics response team, standardize treatment procedures for different critical and severe cases, ensure "seamless connection" between disciplines and smooth green channels, and make every effort to ensure the safety of mother and child. B
Newborn Observation
"Insurance" that cannot be ignored is deepened in humanized nursing services
" Neonatal departments and obstetrics establish close cooperation between prenatal, time and postpartum periods. All high-risk pregnant women have neonatal doctors present during delivery, and are available 24 hours a day."Professor Li Mei, former director of the Department of Critical Care Medicine at Harbin Children's Hospital and currently the director of pediatrics at Maria Obstetrics and Gynecology Hospital, introduced that Ms. Wang, a patient with dangerous placenta previa, gave birth to a baby boy as quickly as possible on the operating table. She was born with a purple body and a slow heart rate. The midwife in the neonatal department and delivery room under the stage quickly dryed his skin and performed positive pressure ventilation on the face mask. The newborn's skin color quickly turned red, weighed 2,920 grams, scored 9 points, and the newborn was in good condition. Then, the baby was sent to the neonatal observation room.
"In medicine, those whose pregnancy is less than 37 weeks are considered premature . All babies born in the Maria Obstetrics and Gynecology Hospital in Heilongjiang must go to the neonatal observation room for observation. If the baby is found to have hypoglycemia and transient dyspnea (wet lung), treatment should be carried out immediately. Babies in a steady state can usually be sent back to the ward and be with their mother after one or two hours of observation. "Li Mei said, "Among the newborns we have saved, the lowest gestational age is only 31 weeks + 6, and the weight is 1,750 grams. "Li Mei has been engaged in pediatric clinical work for more than 40 years and has rich clinical experience in the treatment of neonatal and pediatric critical illnesses. She can diagnose and treat high-risk and difficult problems in neonatal babies in a timely manner. "The neonatal department can diagnose and treat jaundice , umbilical inflammation , ABO hemolysis, HR hemolysis, erythrocytosis , hypoglycemia, digestive system and other diseases, including screening of congenital hip dislocation , screening of congenital heart disease , and ultrasonic bone density testing. At the same time, it can help new mothers to provide baby feeding and nursing guidance. "Li Mei said. Regarding the treatment of premature babies, Li Mei suggested that parents should find a hospital with an independent neonatal department for delivery and maternal and infant care for . Premature babies have low immunity and should pay attention to avoid infection and careful feeding. After the premature babies are discharged from the hospital, parents should still pay attention to the baby's development and monitoring of jaundice and weight, and should follow up regularly. If abnormalities are found, they should communicate with the hospital in a timely manner. C The nutrition and health of pregnant women should not be ignored. "Growing fetus but not growing meat." Mother and infant health are more healthy according to the nutritional intake of pregnant women in the "Reference Dietary Nutrient Intake for Chinese Residents 2013 Edition", a random survey on the nutritional status of pregnant women showed that the nutritional imbalance rate of pregnant women reached 49.21%. "In clinical practice, pregnant women have insufficient dietary nutrient intake, especially calcium, iron, zinc, vitamin B2 and folate , which are very important for pregnant women. Pregnant women with second and third children still have this problem, and the nutritional status of pregnant women should be paid attention to. "Professor Li Yuhou, former director of the Nutrition Department of Heilongjiang Provincial Hospital and currently director of the nutrition clinic of Maria Obstetrics and Gynecology Hospital, said, "After the National Day holiday, I received a mother in the middle of pregnancy. Her weight increased by 10 kilograms in seven days, and her eyes and legs had edema and . The examination showed that her blood sugar was 8 mmol/liter on her fasting and her postprandial blood sugar was 12 mmol/liter. She was diagnosed with gestational diabetes , hypoproteinemia, and anemia. "Li Yuhou said, "Pregnant women take various 'soughing' during pregnancy. They seem to have gained weight, but in fact they still lack nutrition. They lack protein and iron deficiency, causing iron deficiency anemia and hypoproteinemia. Therefore, pregnant women should not "supplement" whatever they want during pregnancy. "Li Yuhou said that gestational diabetes caused by "overnutrition" can easily cause the fetus to be overweight, thus becoming " giant ". The child's chance of diabetes and hypertension will increase in the future. In addition, malnutrition, the probability of pregnancy complications is several times higher than that of mothers with normal nutritional supplementation. Among them, the complications include prenatal hyperemia, anemia, hypoproteinemia, and Edema , fetal development delay, fetal discontinuation, malformation, bone softening, low immunity, low birth weight, premature birth, miscarriage, premature rupture of fetal membranes, infection, etc. Malnutrition can also cause pregnant women to contract uterine contraction and fatigue during childbirth, dyspartum, and postpartum bleeding . After childbirth, they are also prone to puerperal infection , as well as milk deficiency.
"With the opening of the third child, mothers with multiple births should pay more attention to their nutrition and dietary health when preparing for pregnancy. For example, mothers who have had gestational diabetes, anemia, and hypoproteinemia should go to the nutrition clinic for consultation before the second or third time to prepare for pregnancy and issue a personalized nutrition plan that suits them to lay a solid foundation for healthy pregnancy and healthy babies." Li Yuhou suggested that you start taking small doses of folic acid in the first three to six months of pregnancy, often eat foods rich in iron and rich in vitamin C, quit smoking and ban alcohol in the first six months of pregnancy, and stay away from the smoking environment, reduce the harm of second-hand smoke, pay attention to the beginning of life, and give birth to a healthy baby. D. Women with mothers should pay more attention to the 42-day re-examination of pregnancy and health. Early intervention and early treatment. Epidemiological investigation of showed that pregnancy and childbirth are independent risk factors for pelvic floor dysfunctional disease in women with . More and more mothers are pregnant with their second and third children, and their postpartum recovery is also attracting more and more attention. When women give birth, pelvic floor muscles will be damaged. Not only does their figure become distorted, many mothers have problems such as urinary incontinence, uterine prolapse , chronic pelvic pain, etc., which are collectively referred to as pelvic floor dysfunction diseases in medicine. Sun Ying, former chief physician of the Department of Obstetrics and Gynecology at Harbin Red Cross Central Hospital and currently director of the pelvic floor rehabilitation clinic of Maria Obstetrics and Gynecology Hospital in Heilongjiang said that women preparing for pregnancy, women 42 days after delivery, women after abortion, women after pelvic surgery, women with low back pain, , obese women (BMI is greater than or equal to 28), middle-aged and elderly women over 45 years old, and women who have been sitting for a long time and are often in high pressure states should pay attention to their pelvic floor health, and pelvic floor screening and pelvic floor rehabilitation treatment should be carried out if necessary. "We would like to remind women 42 days after delivery to do pelvic floor screening. In many cases, no symptoms do not mean that pelvic floor function is good, and some often only appear after many years. 42 days to 12 weeks after delivery is the golden period of postpartum repair. The longer the time is delayed, the more difficult it is to recover." Sun Ying emphasized, "There are also women who have postmenopausal periods, and pelvic floor screening is also recommended. Women of this age group, as estrogen decreases, pelvic floor muscle will naturally relax, and there will be symptoms of one kind or another. The earlier you undergo rehabilitation treatment, the better the prognosis."
(Bingcheng + Client)
