The blood loss of pregnant women reaches the blood of the whole body 4/5!Multi -disciplinary "hemostasis" turns danger into safety

It is often said that having a child is like walking outside the Ghost Gate. However, it is not just a child, and it may be accompanied by unimaginable risks during the whole pregnancy. Recently, a pregnant woman who was 29 weeks pregnant+4300ml due to thoracic bleeding was 4300ml, and the amount of bleeding reached 4/5 of the total blood of the normal adult women. The life was in danger. In the end, the danger is safe.

Unknown causes of chest bleeding, pregnant women's life is in danger

The time was pulled back to July 23. A pregnant woman who was pregnant for more than 29 weeks had chest pain, chest tightness, and shortness of breath to our hospital for treatment.

"There is no trivial matter for pregnant women." The emergency department for the first time was custody, and the symptoms were dealt with, and the relevant sections of related sections such as obstetrics, cardiology, and respiratory department were requested in time, and quickly reported to Vice President of the Medical Department and Hu Yunzhao. After investigation, it was found that a large number of thoracic effusion on the left side of the patient decreased hemoglobin.

"Immediately contact thoracic surgery!" Vice Dean Hu Yunzhao issued instructions. Dr. Tan of the Department of Deep Surgery rushed to the rescue room of the emergency department. At this time, the pregnant woman's lips were pale and their breath was short. It was maintained with blood pressure under the maintenance of vascular active drugs. CT prompted a large amount of effusion in the left chest cavity. Is it active blood chest? Or acute dysplasia? No matter which one, it is an emergency for pregnant women!

Multi -discipline closely cooperates with "drain" bleeding liquid

The emergency maternal rescue process of thoracic surgery was launched, and it was agreed that the left thoracic closed drainage was needed to be urgently implemented. Considering that the pregnant woman's current signs of life is unstable, the operational risk is great, and there is a risk of emergency chest opening surgery. After discussions and obstetrics discussed, the green channels were not allowed to be opened, and the pregnant woman was urgently sent to the operating room to prepare pre -surgery related to the chest closed drainage.

Soon, the thoracic surgery team was closely cooperated with the anesthesiologist, and under the precise fetal supervision of the obstetrics, the left thoracic closed drainage was performed for pregnant women. However, the chest drainage turned out to be a large amount of dark red bloody liquid! This shows that there may be mobilized bleeding in the left chest of the pregnant woman, but the reason is still unclear.

At the time of the moment, multi -department experts such as thoracic surgery, obstetrics, and imaging are quickly assembled. When the machine is interrupted and comprehensive analysis, it is believed that the rescue of pregnant women is the first place. Wait for an emergency, and prepare for the thoracic detection surgery at the same time.

Precisely determine the "culprit" of bleeding and restore the life of pregnant women

At 18 pm on the same day, the CT examination issued a critical value of the report -the left pulmonary intravenous fistula on the left pulmonary dynamic fistula of pregnant women. In the case of eliminating the possible combination of the anesthesia surgery, obstetrics, blood transfusion departments and other related departments, the thoracoscope team performed thoracoscopy and stopped thoracoscopic hematopoietic surgery for pregnant women.

During the operation, it was found that the left thoracic cavity of the pregnant woman had accumulated blood. After absorbing the stuma of the thoracic cavity and carefully exploring the chest cavity, it can be seen that the blood vessels with a piece of blood vessels on the left lower lung surface are continuously bleeding. Kissing, indicating that the "culprit" of the bleeding position has been accurately "out"!

The thoracic surgery team was in an orderly manner of the blood vessels with bleeding, and the surgery was successfully completed. According to statistics, pregnant women have 3500ml of blood in the thoracic cavity, 800ml of intensive drainage blood, and a total of 4300ml of blood loss, reaching 4/5 of the total blood of normal adult women.

After surgery, pregnant women have been tightly monitored and treated in multiple disciplines in the severity medical discipline, and their condition tends to stabilize, and she is transferred back to the normal ward of thoracic surgery on July 25. At the same time, the hospital's nursing department carried out the hospital's nursing plenary consultation, and under the cooperation of the thoracic surgery team, it comprehensively followed the postoperative treatment of pregnant women to escort the rehabilitation of pregnant women and fetuses. On August 2nd, pregnant women and fetuses were resumed from the hospital.

In recent years, our hospital has continuously improved the emergency plan and rescue process of the treatment of dangerous pregnant women. Through multidisciplinary cooperation, many mothers who need emergency rescue have been successfully saved to escort the safety of maternal and infants.

Medical science

Understand "blood breasts"

Blood chest refers to the accumulation of pleural cavity. The stuma of the thoracic cavity is mainly derived from the heart, the large blood vessels in the chest and its branches, chest walls, lung tissue, diaphragm and pericardial blood vessel bleeding. After the occurrence of blood and chest, not only the blood capacity loss affects the cycle function, but also can compress the lungs and reduce the breathing area. Blood and thoracic transfusion, which causes the lungs of the healthy side to be pressured and affects the return of the cavity vein. Continuing a large amount of bleeding, the pleural cavity blood accumulation is called performing blood breasts.

If the pregnant woman is a non -performing blood chest, the amount of blood accumulation of the thoracic cavity can be discharged in time with chest puncture. If the blood chest is more than medium amount, the continuous existence of blood breasts may increase the possibility of solidarity or infectious blood chest. It should actively resettle the closed chest drainage, promote lung swell, improve respiratory function, and use antibiotic prevention prevention. Perform sexual blood breasts should be performed in time.

What is pulmonary fistula?

Pulmonary intravenous fistula, also known as pulmonary venous deformity, is a rare pulmonary vascular abnormal disease. It is characterized by the capillaries between the pulmonary artery and vein by the abnormal thin -walled blood vessels, forming abnormal tubular traffic, causing pulmonary arteries blood Without gas exchange, it directly enters the pulmonary vein and then into the body circulation, so that the oxygen content in the blood flowing into the body circulation is low, and the impact of these traffic branches on the body can be different due to the degree of blood vessels. Patients with mild symptoms may be asymptomatic. In severe cases, symptoms such as dyspnea, hemoptysis, etc. can even lead to death.

Clinically, it is often manifested in breathing difficulties, hemoptysis, nasal pheasant, migraine, tinnitus, dizziness, resulted, sensory abnormalities, hemiplegia, etc. If the lesions of the pulmonary fistula are limited, surgical treatment is needed regardless of whether there are symptoms or no symptoms. For extensive pulmonary intravenous fistula, it is not suitable for surgery, and it can only alleviate the clinical symptoms of patients as much as possible. Doctor reminds: It is necessary for medical examination before pregnancy!

There is a greater risk of surgery during pregnancy, which not only affects the health and safety of the pregnant woman itself, but also causes danger to the life of the fetus. During pregnancy, surgery should be considered only when it is extremely necessary. This case shows the risk of "shocking step by step", but this risk may be avoided. We try to think deeply. If the pregnant woman performs a systemic health examination before or regularly, we may be able to detect the pulmonary intravenous fistula as early as possible, and we can treat pulmonary vascular lesions before pregnancy. Maybe today's crisis will not occur.

Here I call on everyone that the pre -pregnancy medical examination is very necessary, and many hidden dangers can be eliminated for your safety of you and your baby. Welcome expectant parents to come to our hospital for professional, comprehensive and personalized medical examinations.

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