The road to the rise of great doctors

Chapter 73: Progressing multiple processes simultaneously

Placental abruption is one of the main causes of maternal hemorrhage in late pregnancy and an important cause of increased mortality and morbidity before and after childbirth.

When is it likely to happen?It is easy to occur after 20 weeks of pregnancy or during childbirth. According to domestic and foreign statistics, the incidence rate is about 1%. It is a disease with a high incidence rate, but is extremely dangerous when it occurs.

So, what exactly is placental abruption?Normally, the placenta grows on the uterine wall before giving birth and falls off after giving birth.Placental abruption, as the name suggests, means that the placenta in its normal position is partially or completely detached from the normal uterine wall before giving birth.Then, the main symptoms include persistent maternal bleeding, intermittent abdominal pain that does not relieve, abnormal fetal heart rate and other detection indicators, etc.

Liu Dong knew what he was doing, and he was well-targeted when he asked the man's family members. It seemed like he was just making a routine, but the things he asked were all necessary.Occasionally a few words of comfort or kind words are also to ease the emotions of the male family members, and stop repeating the same words. If that is not nutritious, it will not help the current situation at all.
"Oh, if I had known better, I should have come to the Medical College earlier."

"Why didn't I think earlier that giving birth would be less dangerous? How could it be?"

"Doctor, if you want to 'protect the elder and the younger', no matter what other people think, I will definitely still want my wife."

Liu Dong interrupted him, first answered his question, and then pulled back to the part of asking about the medical history, "Don't worry, we will do our best when we come here. There is no problem of protecting the big and the small, It all depends on your lover's situation, save lives first, and then look at other things."

"Because you will have an operation later, you will definitely need to use drugs. Let me ask you, what drugs or things is your lover usually allergic to?"

Under Liu Dongxiao's skillful questioning, it took five or six minutes to complete the medical history collection.

This pregnant woman is 33 years old this year. She and her husband went through the "long-distance love race" in high school and college. They were still in a long-distance relationship during college, and then experienced work together and separation, and finally got rid of it two and a half years ago. The state of "living in two places".

Then, after more than half a year of pregnancy preparation and no movement, the two sides began to have examinations in the obstetrics and gynecology department and the andrology department respectively. In terms of "same examination for men and women", the concept is also very advanced with the times, and it is very correct.

Then, they first found some abnormalities in the man's examination. The test results showed that he had oligospermia and asthenozoospermia. The doctor considered that it was related to long-term fatigue, mental stress and environment. Her husband began to have a regular schedule, adjust his mood, and began to take some Chinese medicine orally. Treat with patent medicines.Because of long-term staying up late and irregular work and rest, her husband was a little obese and did not exercise much. In order to encourage him to exercise, the girl also patiently encouraged him and set aside at least 3 days a week to run and exercise with him.

Finally, after about half a year, the man lost 20 pounds in weight and his physical endurance improved. When he went for a review, he found that his sperm vitality and quantity had improved.

The woman's pre-pregnancy check-up is basically OK, but there is one problem - her age.The best age is still in her 20s. Now she is over 30. Although she has not yet reached the limit of 35-year-old mothers, the impact is not that big, but according to epidemiological statistics, the pregnancy rate at this age has still become lower. .Although I am a little helpless, I can't change it. I can only adjust my mentality and let nature take its course.

The two have also made plans to conceive through assisted reproduction if they try for another year with no results.Unfortunately, I finally got pregnant successfully.When the girl discovered that her period had not come, she was careful not to tell her husband the news immediately. Instead, she waited another week, bought urine test strips and tested positive before sharing the good news.

The two quickly went to the hospital and took a blood pregnancy test, which was also positive.This is the girl's first pregnancy and the first child they will have.After receiving the confirmed news, they couldn't wait to share it with their parents.The two of them also prayed to God to express their gratitude for the new life.

Men accompany girls for regular pregnancy check-ups, and they work harder.

During the entire pregnancy check-up period, the girl's blood pressure was basically normal. It only increased more than 10 days before coming to the hospital this time.The fetal heart rate and fetal position are normal.It has been 6 hours since the pregnant woman had stomachaches and bleeding, and it took 4 hours to go from the hospital for prenatal check-up to here.

The blood pressure was measured at the hospital before transfer, and it was 140/95mmHg. The pregnant woman was also told to rest and given antihypertensive drugs.

Although Liu Dong wanted to go back and continue to look at the ultrasound examination results, but thinking of the mother's crisis situation and the instructions of the superior doctors, he went directly to the doctor's office next to him, pulled up the medical record template, and combined it with the medical history he had just asked. After modification, in just a few minutes, a series of necessary documents such as hospitalization medical records, first course records, informed consent for surgery, informed consent for blood transfusion and power of attorney were prepared and printed out.

This pregnant woman was 37 + 4 weeks pregnant. Her blood pressure was normal during pregnancy. However, her blood pressure was recently found to be elevated, and she developed hypertensive disease during pregnancy. She has persistent abdominal pain, progressive aggravation, and bleeding and discharge from below. She should consider the third trimester of pregnancy. Bleeding is a common disorder.

Maternal vasculopathy is the most common factor associated with placental abruption, including preeclampsia, eclampsia, chronic hypertension, or chronic kidney disease.This pregnant woman has a history of gestational hypertension, combined with abdominal pain and bleeding, and is considering a high possibility of placental abruption.

When she first arrived at the hospital, her face was pale, her hands and feet were cold, her heart rate was fast, and her blood pressure was 100/55mmHg. Considering that her blood pressure was relatively high at 140/95mmHg some time ago, she first considered the possibility of shock caused by blood loss.

In the case of abdominal pain, the abdominal examination revealed that the tension was relatively large, and the fetal heart sounds were far away, and the fetal position was unclear, indicating that there was persistent uterine contraction, and there was an obvious swelling on the left anterior wall of the uterus. Tenderness, these all support the possibility of placental abruption, but other causes are not ruled out.

After arriving at the Affiliated Hospital of the Medical College, the green light was sent all the way to the obstetrics ward. I immediately contacted the ultrasound doctor to do an ultrasound. At the same time, I also had blood drawn for routine blood tests and coagulation tests, and urine was collected for routine urinalysis and other tests.For treatment, an intravenous access was established, fluids were administered to correct the shock, and the blood type was tested.
Multiple processes are carried out simultaneously, all in order to preserve life now and to better meet life in the future.
Based on the results of ultrasound and other examinations, placenta previa was initially ruled out, and multiple examinations were highly suspicious of placental abruption.Moreover, simultaneous intermittent fetal monitoring also revealed signs of fetal distress during fetal heart rate monitoring.

　When people reach middle age, they have no control over time.It was already early in the morning after yesterday's work. I was too exhausted and had no choice but to give up on coding.It was also evening when I started coding today.I am a handicapped person, have no manuscripts, and few recommendations, so I can only do it and cherish it.Thanks for the support!
　　


(End of this chapter)