On the night of September 27, the multi-disciplinary team of Jinan Fourth People's Hospital staged a life-and-death rescue, successfully treating a 32+4-week pregnant woman, severe placental abruption, DIC, and scar uterus.
Pregnant woman Xu suffered a sudden abdominal pain and a lot of vaginal bleeding in her private car back to Jinan, Dezhou , and rushed to the emergency department of Jinan Fourth People's Hospital. Obstetrics and listening physicians Fu Xiaohe and Jia Erxia immediately rushed to the emergency department after receiving the call. At this time, the pregnant woman had anemia, severe abdominal pain, and a lot of fresh vaginal bleeding. uterine is hard as plate-shaped. After quick inquiry about the medical history and physical examination, consider placental abruption , and immediately report to Director Zhang Guilian, and urgently activate the emergency rescue plan for critical and severe pregnant women in the hospital, open a green channel, and go directly to the operating room for emergency rescue. Notify the operating room, anesthesia department, , pediatrics, laboratory departments, blood transfusion departments and other related departments to prepare for emergency treatment. The rescue team urgently formulates a treatment plan: immediately perform an emergency cesarean section to rescue the life of the mother and the fetus!
Time is life, and the medical staff in the emergency department race against time, running wildly to transport pregnant women to the operating room. Dr. Zhang Yingli, who worked overtime, received a call and rushed from the obstetrician's office to the operating room. Immediately open the double venous channel to quickly infusion, indwelling the urethra catheter, keep warm, oxygen inhalation, electrocardiogram monitoring, arterial blood pressure monitoring, and urgently check blood gas analysis , blood routine , blood coagulation four items, blood biochemistry, and notification blood transfusion department to combine blood. Notify the neonatologist to go to the operating room to rescue premature baby . Caesarean section was performed quickly under general tracheal intubation.
incision of the uterus, a large amount of fresh blood gushed out instantly, and the membrane was immediately broken. At 19:16, the premature baby was successfully delivered (the premature baby had only heartbeat and weak irregular breathing), and the newborn resuscitation team quickly rescued. Blood gas analysis shows that hemoglobin 74g/L (hemoglobin 124g/L on September 26, 2022), the estimated total bleeding volume is about 2,000ml. The emergency laboratory called to inform me that fibrinogen cannot be measured, and the DIC diagnosis is clear. During the operation, 4U of red blood cells, 600 ml of plasma, and 4.0 g of fibrinogen were injected.
The operation was finally over, the mother's uterus was preserved, and the child was sent to the neonatal department for active treatment, and the mother's condition gradually stabilized. From the time the mother arrives at the emergency department, the premature baby will be successfully delivered in less than 30 minutes. It is precisely because of the seamless connection and close cooperation of the hospital's multi-disciplinary team that the mother and the fetus can help the mother and the fetus pass through the smooth progress.
Obstetrics is a key department of the Fourth Hospital of Jinan City. The successful treatment of every critically ill pregnant woman is a demonstration of the strength of a comprehensive tertiary hospital, and it is inseparable from the continuous drilling and close cooperation of multidisciplinary teams.
correspondent Chen Liyan Wang Yan
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