When the aggressive amniotic fluid embolism, encounter a calm and calm expert team …

Tongren Medical Line Series ⑤

What is the reason for constantly bleeding?

The 26 -year -old Xiaoqin was pregnant for the first time. After survival of the test of pregnancy, she finally ushered in a new life.Xiaoqin was also immersed in the joy of the first mother.

At 20:10 in the evening, Xiaoqin, who had just given birth to the placenta, suddenly had a vaginal bleeding of 400ml, which immediately caused the alertness of the Director of the Medical Department. She keenly discovered that Xiaoqin’s uterine contraction was not good and immediately handled it accordingly.

Strangely, after the shrinkage of the uterus becomes better, although Director Bian Zheng has passed the inspection to exclude the possibility of herb production damage, the blood in the vagina continues like a trickle.

After precisely weighing estimates, the bleeding has reached 700ml at this time, and the face of the help of the producers and young doctors be anxious.I saw that the experienced Director Bian Zheng successfully placed the uterine balloon in just a few minutes to compress the hemostasis. The B -ultrasound showed that the position of the balloon was accurate.Just when everyone just wanted to relax, they found that bleeding continued.

"This must not be a postpartum bleeding caused by the simplicity of uterine contraction!".

Later test reports confirmed the judgment of Director Bian Zheng, and the origin of blood fiber protein was only 0.32g/L!(Normal range of 2-4g/L), it is reminded that Xiaoqin has severe coagulation dysfunction, which indicates that the test results that are obviously inconsistent with the amount of bleeding indicate the more terrible cause of postpartum bleeding behind-not typical amniotic fluid embolism!

This disease refers to a series of pathophysiological changes caused by the blood circulation of amniotic fluid and its contents during the childbirth, which will lead to severe consequences such as bleeding (DIC), shock, and hypoxemia. The mortality rate is as high as 60-70%, the god of death raised the sickle to Xiaoqin.

The battle to snatch life with the god of death began!Director Bian Zheng immediately launched the rescue process, and the trained delivery room team and the anesthesia surgery team were busy and unwilling to start rescue.The directors and heads of the nurse who had come home from get off work and took off the phone, and quickly rushed back to the hospital to participate in the rescue.

5 hours of fighting, the multi -disciplinary team shows the power again

The first obstetrics Lu Qin and Director Bian Zheng, who were present, once again excluded other causes of postpartum bleeding.Qiu Jin, Chief of the Medical Department, and Chief of the Obstetrics and Gynecology Department, gathered a rescue team consisting of the obstetrics and gynecology department, anesthesiology surgery department, intervention department, blood transfusion department, and blood internal medicine director.

Director Zhang Guangming led the anesthesia surgery team to maintain the stability of life indicators such as Xiaoqin’s blood pressure and heart rate.Director Weng Wei of the Hematology Department guides the supplement of the coagulation factor from the side.Director Gong Mingzhu of the Department of Blood Diversion is responsible for deploying all kinds of blood products.

Although Xiaoqin’s life signs are stable, the condition is still very dangerous. The bleeding of the uterus is still continuing. The total amount has reached 1600ml, and the uterus continues to develop.

But for Xiaoqin, who is only 26 years old, this means that she will always lose her fertility.For the rescue, Xiaoqin’s husband who learned of the condition was helpless, "Fate must be guaranteed, and the uterus must be guaranteed!" Director Bian Zheng said to the new dad.

Although this means higher risks and greater difficulty, Director Bian Zheng decided to involve involved in the team of Chairman Ke Shangming for perception of uterine arterial embolism, and tried to keep the uterus for Xiaoqin.

Director Shang Mingyou, who has been in the battlefield for a long time, has rescued many cases of severe postpartum bleeding. Outside the DSA computer room, everyone waited anxiously across the glass.A large uterine vein directly flows back to the lower cavity vein, which may be the culprit of a typical amniotic fluid embolism!The skilled Director Shang Mingyou and his assistant accurately blocked the uterine blood vessels.Director Pei Dongliang, the Department of Anesthesiology, accompanied the heavy lead clothes to ensure the smooth infusion of blood and coagulation factors.

The bleeding slowly decreased, but the coagulation function still did not fully recover. Xiaoqin, who successfully ended the intervention surgery, was sent to the operating room to continue observing.Director Zhang Guangming’s surgical anesthesia team accurately managed the amount of liquid, while the obstetrics directors stared at the bleeding of the outflow bag and puzzle pads.

Xiaoqin, who was slowly sober in the operation room, didn’t seem to know that he was just one step away from death just now. He looked at the doctors and nurses full of rooms, a little nervous.Captain Li Yan comforted her with the sweat on her forehead while comforting her.

The heart rate and blood pressure on the life monitor have always been stable, and the test results of each hour indicate that the coagulation indicator is gradually getting better.It wasn’t until this time that everyone slowly relaxed.

At this time, the hour hand has been pointed at 1 am, and the tug -of -war war on the 5 hours of thrilling and death has finally won!

Under the careful care of the obstetrician medical team, Xiaoqin was discharged from the hospital a week later.

(After Xiaoqin was discharged from the public comments, I would like to thank the rescue for this rescue)

The primary cause of postpartum bleeding is caused by the dysfunction of pregnant women’s death, mainly caused by uterine contraction, placenta factors, soft lane damage, and coagulation dysfunction.The obstetrician needs to make the cause of the cause in a short period of time, and give appropriate timely treatment. Otherwise, the patient will soon have a blood loss shock, which will eventually endanger life.

Xiaoqin’s severe postpartum bleeding is characterized by a sharp declined coagulation function indicator, so it greatly increases the difficulty of rescue. Fortunately, the experienced Director Bian Zheng made accurate judgments in the shortest time, and passed timely through timely through timely.The correct disposal not only saved Xiaoqin’s life, but also retained her uterus and fertility.

The successful rescue of this municipal -level dangerous pregnant maternity is remarkable. The obstetric team’s performance is remarkable. Their professional adherence, not afraid of hardships, and enthusiasm for their performance reflects the mission and love of medical staff.

This time, the intervention department led by Director Zhang Guangming and Director Shang Mingyi, once again played an extremely important role in the rescue process with superb technology.It is these powerful multidisciplinary team support and help that they can ensure that the rescue of dangerous pregnant women can always be dangerous.

On the second day after the rescue, Director Qiu Jin and Director Bian Zheng of Obstetrics and Gynecology specially prepared the cake. Thanks to the strong support given by the Anesthesiology Surgery Section and Intervention Section in this rescue.On the cake, "The knowledge is not confused, the benevolent is worrying, the brave is not afraid" twelve words drawn a successful end for the rescue.

(Obstetrics and gynecology team and surgery anesthesi

(Members of obstetrics and gynecology team and intervention team, from the left: Shang Mingyi Director)

Expert introduction

Bian Zheng, deputy chief physician of obstetrics and gynecology, master’s degree, graduated from Fudan University Medical College.He has been engaged in clinical obstetrics and gynecology for 20 years, and has worked at the Shanghai First Maternal and Infant Health Hospital. He has long been committed to the management of obstetrics for delivery.Good at special technical management, production management and VBAC management, as well as diagnosis and treatment of obstetrics.Obstetrics such as obstetrics, complications, and difficulty in obstetrics have rich clinical experience.At the same time, he has also been engaged in clinical teaching and scientific research. He has published several academic papers in many core journals at home and abroad, and has participated in the compilation of many medical works.

H outpatient characteristics: good at handling and treating various obstetrics, complications, appropriate techniques of childbirth, management of delivery, and treatment of obstetrics and critical illnesses.

【Outpatient Time】

Our obstetric expert clinic: Wednesday morning

Occupible clinic: Friday morning

Special needs outpatient clinic: Monday afternoon

Supply: Chen Xinyi Qiu Jin

Edit: Promoting Corou Simin, Zhang Yaoxin

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