A pregnant woman with "panda blood" who had undergone three IVF cycles had a sudden hemorrhage: a maternity and infant program started a "life-saving battle" for mother and daughter during the Mid-Autumn Festival
After years of trying to conceive and three IVF cycles, she suffered from severe abdominal pain and difficulty in maintaining pregnancy. She had a rare blood type and placenta accreta. The mother started off in "difficult mode" and had many "risk factors" added to her. She suffered from sudden severe bleeding in the third trimester. How to turn danger into safety?
The day after Typhoon Bebejia left Shanghai was the Mid-Autumn Festival. In the early morning, when most people were still asleep, a race against time to save lives had quietly begun at Shanghai First Maternity and Infant Health Care Hospital - the rescue process for critically ill pregnant women was immediately initiated. A few hours later, good news came: the rescue was successful, and the mother and daughter were safe. In this traditional festival of family reunion, it was undoubtedly the best gift for all the medical staff of Shanghai First Maternity and Infant Health Care Hospital and the pregnant woman's family.
Severe adenomyosis and rare blood type made her pregnancy extremely difficult
Yingying and her husband started preparing for pregnancy a few years ago, but good things come to those who wait, and there was no sign of natural pregnancy. It was not until the third IVF that she finally succeeded in becoming a "squadron leader". However, Yingying always had a "heartache". Five years ago, she was diagnosed with adenomyosis and suffered from abdominal pain and severe dysmenorrhea for a long time. After pregnancy, the abdominal pain did not ease, but became more and more severe as the baby in her belly grew. In the first three months of pregnancy, she was hospitalized in a local hospital and took a lot of pregnancy-preserving drugs. In the end, she needed to take painkillers every day to maintain her pregnancy.
In order to keep the "precious baby" in her belly, Yingying went to the obstetrics department of the First Women and Children's Hospital to register when she was three months pregnant. The attending doctor was Zhou Jian, deputy chief physician of the obstetrics department. During the consultation, it was found that Yingying not only had severe adenomyosis, but also had "panda blood". Her blood type was AB type RH negative, which is very rare worldwide.
Yingying's "ten-month pregnancy" was extremely difficult. From the 14th week of pregnancy, she had repeated abdominal pain and occasional small amounts of bleeding. Her husband did not want her to bear more danger and pain, so he reluctantly proposed to give up the child and asked for the uterus to be removed. In view of her special situation, the hospital organized a multidisciplinary discussion and invited experts from the city's maternal and child rescue center to consult. Should the pregnancy be terminated? The doctor informed Yingying and her husband in detail about the pregnancy risks of adenomyosis and the maternal risks of terminating the pregnancy, and recommended observation after a course of anti-inflammatory treatment.
Perhaps God was blessing this couple. After taking the medicine, Yingying's abdominal pain became bearable. After discussion, the couple decided to continue the pregnancy.
The whole hospital was busy and orderly in rescuing the mother with "panda blood" and she was out of danger.
At the end of August, Yingying was hospitalized for the fourth time due to abdominal pain and bleeding. Considering the anterior central placenta previa with placenta accreta indicated by ultrasound, Zhou Jian did not let Yingying leave the hospital again. "Severe adenomyosis, rare blood type, placenta previa, placenta accreta, this is equivalent to the special clinical factors of 'four encounters', which greatly increases the risk factor. For example, placenta previa alone can cause heavy bleeding in the late pregnancy at any time, and the baby may be born prematurely at any time, so she needs to be closely observed in the hospital. It's just the 'last step', and we must not take it lightly at this time."
At 5 a.m. on September 17, Yingying suddenly bled nearly 400 ml of bright red blood when she turned over. The attending doctor immediately led the nurses to open an intravenous line, perform ECG monitoring, and perform fetal monitoring at the bedside. The obstetrics team quickly developed an emergency cesarean section to terminate the pregnancy and urgently initiated the rescue process for critically ill pregnant women in the hospital.
The night shift and day shift were quickly in place to ensure sufficient rescue forces. Yingying was transferred to the operating room. Xu Zhendong, director of the Department of Surgery and Anesthesia and ICU, led the team to make full preoperative preparations for her, including autologous blood transfusion, deep vein opening, arterial puncture, comprehensive monitoring, and various vasoactive drugs. After preparations were completed, the cesarean section officially began at 7:45. Three minutes later, the 32-week premature baby was successfully delivered.
When the morning light brought a bright day, the "Cradle of Life" had already become a battlefield for saving lives. Li Xiaocui, the vice president in charge of medical care, Hua Xiaolin, Shu Qun, Du Qiaoling, the director of obstetrics, Zhu Haiyan, the chief physician of gynecology, Zhao Minhui, the director of the nursing department, and dozens of medical staff from the medical department, nursing department, neonatology department, laboratory department, ultrasound department, radiology department and other teams rushed to the hospital from all corners of the city upon hearing the news. Considering that the blood used for surgery of "panda blood" mothers is the top priority, the hospital contacted Pudong New Area Maternal and Child Health Hospital as quickly as possible and coordinated with the Shanghai Blood Center for blood preparation for surgery.
On the operating table, Yingying, who had just become a mother, was still under great test of her life safety. During this period, Yingying's uterus was weak and bleeding was turbulent, with more than 2000 ml of bleeding. Her AB type RH negative blood reserve was very limited. Her hemoglobin once dropped to 48 g/L, and her blood pressure also dropped to 60/30 mmHg. Each team divided the work and cooperated to rescue: the anesthesiologist promptly started autologous blood transfusion, adjusted vasoactive drugs, and actively corrected coagulation function and internal environment; experts from the Pudong New Area Maternal and Child Health Center also rushed to the scene to assist in directing the rescue.
Go all out, busy and orderly. At 10 a.m., the on-site commander announced that the rescue was successful. Yingying was sent to the ICU for observation, and the newborn had been sent to the neonatal ward for monitoring. Yingying's husband cried with joy, "Our family can finally put down the big stone in our hearts and welcome this unforgettable Mid-Autumn Festival." At present, Yingying's vital signs and internal environment are stable, and she is recovering steadily; the baby is receiving non-invasive respiratory support in the neonatal ward and is in stable condition.
Yang Xinchao, secretary of the Party Committee, said that Shanghai has long attached great importance to improving the comprehensive treatment capabilities of critical and severe diseases in various clinical disciplines such as obstetrics. As the "cradle of life", one out of every four to five newborns in Shanghai is born in the First Maternity and Infant Hospital. "The First Maternity and Infant Hospital team will continue to strengthen practical training and drills, combining peacetime and wartime, building a solid line of defense for maternal and child safety, and strive to ensure that every family welcomes a new life smoothly and safely." said Wang Wei, vice president.
