"Not good, the patient may have amniotic fluid embolization . Immediately start the treatment process for critically ill pregnant women and prepare for cesarean section immediately!" A 30-year-old mother suddenly had amniotic fluid embolization, respiratory cardiac arrest, postpartum bleeding , cardiogenic shock... Life is at stake, and 100,000 is urgent. As the Southeast University Zhongda Hospital Affiliated to Treatment Guidance and Quality Control Center for Critical Severe Pregnancy and Female Pregnancy, , Southeast University Zhongda Hospital, , and local hospitals, as the center of Jiangsu Province's critically ill critically ill pregnant women. Seamless connection, a tense and intense life rescue with multidisciplinary team collaboration kicked off...
日本天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天天� However, when it was really time to produce, it also ushered in the arrival of "doom". On the day when she was 40 weeks + 4 days pregnant, the baby in her belly couldn't hold back and was finally about to be born. However, Ms. Li's cervix was open, and when she was about to give birth to vagina, Ms. Li suddenly coughed, and the nightmare began...
"The pulse oxygen progressively dropped to 84%, blood pressure was 108/35 mmHg , heart rate was 90 beats/min, fetal heart rate was 280 beats/min, and the mother became confused..." After Ms. Li suddenly coughed, she then had difficulty breathing and had a cyanotic complexion. Local obstetricians immediately considered the symptoms of amniotic fluid embolism during delivery, and the rapid response was made by the anesthesiologist quickly intubated the tracheal tube and general anesthesia under for emergency cesarean section, and a baby boy was given 5 minutes later. However, at this time, the alert was not lifted, but a more critical moment appeared. The patient suddenly experienced a sudden heartbeat and respiratory arrest! Immediately performed cardiac compression and adrenaline static push. After some emergency rescue, the patient finally recovered his autonomous rhythm. However, the wave just started again. After 6 minutes, the patient experienced cardiac arrest and again. He was rescued and ventricular fibrillation occurred again after 3 minutes. After defibrillation, he resumed his autonomic rhythm.
However, these thrilling scenes of treatment have just been relieved, and new problems have arisen in the patient. During the operation, the patient's uterus was found to have a purple uterine contraction and fatigue. What's even more terrifying is the obvious bleeding of the uterine incision and abdominal wall incision. With the support of active respiratory circulation, local doctors performed hemostatic methods such as medication and uterine water capsule filling. However, the bleeding was still not controlled and the blood pressure continued to drop. They could only perform hysterectomy immediately. At this time, the cumulative bleeding had reached 2,000 ml. After
, Ms. Li was transferred to critical care medicine department and continued to observe and treat closely. At this time, she still had active bleeding, , hemorrhagic shock, and severe anemia, and she was in danger of life at any time. At the same time, the local hospital's obstetrics and gynecology department contacted Yu Hong , director of the Jiangsu Provincial Critical Severe Pregnant and Severe Care Pregnant and Postpartum Treatment Guidance and Quality Control Center and deputy director of the Obstetrics and Gynecology Department of Zhongda Hospital, hoping to provide guidance on treatment.
was transferred urgently. The two places coordinated to relay the rescue
, Yu Hong , chief physician, received the call for help, responded quickly. Under the organization and coordination of Chen Hui, director of the Medical Department, he quickly formed a treatment team of experts including experts including Yu Hong , chief physician, Liu Songqiao, chief physician, intensive care unit, anesthesia , and deputy chief physician, Zhang Qi, deputy chief physician of interventional and vascular surgery, to connect with local medical staff and discuss treatment plans. At the same time, Chief Physician Liu Songqiao of the Department of Critical Care Medicine was sent to the Department of Critical Care Medicine of the local hospital to provide on-site guidance on treatment.
Chief physician Liu Songqiao arrived at the local area and checked the patient's condition and found that the patient still had bleeding, heavy bleeding, coagulation dysfunction, and multi-organ dysfunction. The condition was critical. It is recommended to undergo intervention or surgery immediately to stop the bleeding again, continue blood transfusion, correct coagulation dysfunction, and save lives. It can create conditions to be transferred to Zhongda Hospital for further treatment.
Therefore, on the premise of ensuring the safety of transfer, the patient was transferred to Zhongda Hospital. During the transfer, experts from Zhongda Hospital always guide the treatment.
cooperated with multiple departments to regain a life
patients. Once they went to the emergency department of Zhongda Hospital, they consulted experts in obstetrics and gynecology, critical care medicine, interventional and vascular surgery.At this time, Ms. Li was still in a light coma, state, hemorrhagic shock, DIC, cardiogenic shock, and was still bleeding. hemoglobin dropped to 3.8 grams per liter, causing severe anemia. After continuing to monitor vital signs and further improving relevant examinations, experts from multiple disciplines decided that the most urgent task was to stop bleeding. Therefore, Deputy Chief Physician Zhang Qi of the Department of Interventional and Vascular Surgery urgently performed bilateral internal iliac angiography + right uterine artery embolization on Ms. Li. After an hour, the operation was successfully completed, and it was already past 10 o'clock in the evening. After the
operation, Ms. Li was closely monitored and treated in the intensive care unit. Continue to carry out invasive mechanical ventilation, pressure boosting treatment, blood transfusion, anti-infection treatment and fluid replenishment... The chief physician team of Pan Chun of the Department of Critical Care Medicine formulates accurate treatment plans for patients and strives to rescue this second child mother with a weak life.
However, the patient is in critical condition and further stop bleeding and control infection. The day after admission, Yu Hong, Director of Obstetrics and Gynecology Department, led the team to attending physician Qian Huiqin and Dr. Zhang Xiaoyu, who were in charge of the patient's emergency surgery, investigated the bleeding in the abdomen, took out the 4+1 gauze strips of hemostasis and vagina, and performed pelvic wound hemostasis and pelvic drainage. After the successful operation, he was transferred to the intensive care medicine department for further treatment.
Three banners, thanks to the multidisciplinary experts for saving their lives
After careful treatment from multiple disciplines, Ms. Li's condition gradually improved and she gradually escaped from danger of life. After 7 days of treatment in the intensive care medicine department, he was transferred to the obstetrics ward to continue to fight infection, improve brain metabolism, prevent thrombosis, and nutritional support. Although Ms. Li was pulled back on the verge of life and death, there were still many health problems. Ms. Li was choking, hoarse, and underresponsive when drinking water. After consultation, she decided to undergo treatment such as nutritional nerves, atomization, hyperbaric oxygen, etc. After three days of treatment, the situation improved significantly.
When Ms. Li is about to be discharged from the hospital, she and her husband will dedicate three banners with the words "Excellent medical skills, noble medical ethics, affection for patients, and careful treatment" to experts in obstetrics and gynecology, critical care medicine, interventional and vascular surgery who treated her. Thank them for not only saving a life, but also saving a complete family.
, Director of the Jiangsu Provincial Critical Severe Pregnancy and Pregnancy Treatment Guidance and Quality Control Center and Deputy Director of Obstetrics and Gynecology Department of Zhongda Hospital, Chief Physician, admitted that Ms. Li's successful rescue was first of all due to the early identification and rapid response of obstetricians and midwives in the local hospital, and the efficient linkage between the two hospitals and the multidisciplinary expert team working day and night to do their best for treatment.
junction moves forward, pay attention to the total pregnancy cycle of pregnant women
Chief physician Yu Hong introduced that the high-risk factors of amniotic fluid embolism include elderly primary delivery, male maternal mother, cervical laceration, excessive amniotic fluid , multiple fetus, placenta previa , excessive uterine contraction, acute delivery, cesarean section, etc. Amniotic fluid embolism is a rare complication unique to obstetrics. Its clinical characteristics are rapid onset, dangerous conditions, and unpredictable conditions, which can lead to serious adverse outcomes such as disability and even death of the mother and child. When pregnant women experience prodromal symptoms such as holding breath, choking, shortness of breath, palpitations, chest pain, 2, chills, dizziness, nausea, vomiting, fatigue, numbness, acupuncture-like sensation, anxiety, irritability, changes in mental state, and dying and abnormal fetal heart disease during delivery and within half an hour after delivery. It should be taken seriously by medical and pregnant women and pregnant women to identify and respond quickly in advance urgent multidisciplinary treatment.
Director Yu Hong suggested that high-risk pregnant women with abnormal pregnancy and birth history and underlying diseases must move the checkpoint forward, especially for women of appropriate age with high-risk factors. It is recommended to consult multidisciplinary experts at the authoritative comprehensive Grade A hospital before pregnancy. We also pay attention to the health status of maternal and infants during pregnancy and the entire pregnancy cycle after childbirth. If there is any problem, we will go to a hospital with strong comprehensive treatment capabilities in time.
information provided: Zhongda Hospital Affiliated to Southeast University Liu Min Cheng Shouqin
Director: Qin Jingjing
Review: Long Bin
Produced by: Jiangsu Radio and Television Corporation Health Column "New Health 7 Points"
