-- zhen-hua gao Jiang Yongjie figure the first affiliated hospital of xinxiang medical college/article
reading tips : two years she had uremia, do hemodialysis 200 times, found himself pregnant, she insisted that the child was born.She still panda blood type, in order to give the cesarean delivery, the whole xinxiang for the type of blood here.To cesarean section, the doctor gave her up, she very common ground to say: as long as I keep children happy!She knew that danger, she know may not under the table!The common life and death doctors have fought back a tear!
this is our treated patients, on March 20's fourth day, I am rotary obstetrics patients from xun county, directly to the doctor's office door, said to the hospital.She looks about 40 years old, dressed in a bright red thick cotton pajamas, abdomen of peng, dim complexion, panting, forehead rolling with bean big sweat.
the second sentence of her, I am scared, she said: "I am a uremic patients, in our county hospital during hemodialysis, check B to exceed an accident found himself already 7, 8 months pregnant, county hospital said the child is taken down, suggest transfer."Despite her expression of calm, but I from her anxious eyes, can see the child for her.
I started to ask for details of the history, learned that she was two years ago a local hospital diagnosed with uremia need long-term hemodialysis therapy, my heart thumped, "my god, this woman is insane," she added, but also to have children."
ask from hpi, past medical history, personal history, history of marriage, menstrual history to family history, I have a better understanding of how to her.Her a 8 years of hypertension, renal insufficiency, dilated cardiomyopathy "six years, 2 years, regular dialysis of more than 200 times, these experiences let this just 28 years old woman seemed to have more than 40 years old.I told her, both expressed sympathy and understanding, and for her patience and strong behind said helplessly.After a few days, my heart is always infinite regrets, the in the mind say a bein.
don't want to, another crisis is waiting for us, the patient must still "panda" blood type, namely rh-negative blood.I immediately put her condition report to the superior doctors Jiang Yongjie teacher, ginger teachers has been out of the inspection report and ultrasound results: since dialysis patients, irregular menstruation, the specific time is not clear, the last period but in combination with ultrasound fetal development situation, gestational age should be at least 37 weeks, also is one of the term, the best treatment plan is cesarean delivery to terminate pregnancy.But if the operation uremia mother risk faced by many times higher than normal pregnant women, the most concern is the blood coagulation function in patients with poor, lead to bleeding difficult, poor healing of incision, but it happened that she again rare blood type, for the blood is more difficult, these factors lead to increase operation difficulty.
when cardiac monitoring score is 9 points, Jiang Yongjie teacher remind me: "the current rating can also, but still can't relax vigilance, patients in the delivery process, at any time there will be a fetal distress and fetal intrauterine, maternal renal function worse and the possibility of maternal death, observation patient's condition should be tight and communication with the patient and family members, sign it at any time."
ginger teacher repeatedly stressed to me, I can feel his worry!That is life!Maybe two!
then, ginger teachers instruct yan-fang ren, director, we started preparing for preoperative work, immediately call xinxiang center blood bank, renal medicine consultation, please at the same time.Is a Fried of blood, such as process, look at the patient vomiting is getting heavier and heavier, more and more high blood pressure, heart guardianship has 7 points, began appearing in my heart also follow up, every day, before coming off work, I want to look at her in the past, look at the blood pressure, urine output, and so on and so forth, I'm really worried about the strong woman suddenly carry not to live.
patients blood pressure fluctuations, vomiting response, I consider is associated with renal function worse, require dialysis, so check with ginger teacher, blood purification room, I quickly reservation phone calls to her before dialysis, adjust the physical condition.One day, two days, three days...Finally wait until the fifth day, xinxiang center blood bank back words, "4 u type B, of rh-negative blood that has been ready (the whole xinxiang only 4 u blood)".
it sounds really is a exciting news.All nervous and orderly, ready to surgery on Monday.I want both doing well in silent prayer, the bottom of my heart.I'm heavy not so nervous!
on Monday morning, the window is TaoGongLiuLu, but the weather is still warm.I early in the department, the first thing is to go to see her, my thumb up say: "you're good, don't be nervous, come on."She still calmly said: "I'm not nervous, as long as can keep children, I am satisfied."To tell the truth, I have never seen such as she was young after experienced so many frustrations, still can so calm of rural women, a respect arises spontaneously.I think perhaps this is a mother's love, have personal life and death.
at around 10 am on March 27, fan, yan-fang ren, director of the work in person, miss jiang and I when the assistant, in order to guarantee the security of the whole operation, anesthesia the director himself, maternity wards delivered physician, new pediatrician, have been in place, ready to deal with emergency.Special patients, surgery time could be extended, need general anesthesia, but for patients with kidney failure, heart failure, this is undoubtedly to a serious test anesthesiologists.Anesthesia at first, the blood pressure in patients with up to 180/110 MMHG, when she cut each level of organization, the blood vessels are the injection status, and when the puncture the amniotic sac, because all sorts of reasons cause abdominal muscle stress, amniotic fluid spray out like a fountain, good in any separate organizations and knot, director of the speed, reduce the bleeding greatly, shorten the operation time, make the whole operation process through all the difficulties, is expected to take about 40 minutes.Baby to head childbirth, scoring eight points, crying, considered at high risk of perinatal, anoxic condition, turn into the NICU for treatment.
postoperative day 1, call the NICU, asking that the newborn all aspects in good condition.Admittedly, this is indeed a miracle, because from medical Angle, uremia patients were pregnant are banned, and would be able to childbirth is extremely rare.The operating table, when the moment I heard the child crying all breathed a sigh of relief.
after surgery, some people say that this woman is strong enough, others said the woman was a fool to bitter days lie ahead.Here, I don't comment, but first I want to say is that medicine is a study, patients with all hopes on the child, the child for her, she is the best gift before the end of life.
postoperative recovery is still very critical!
in order to let it pass convalescence, although nurses are very attentively, head nurse Guo Fang still repeatedly to emphasize uremia patients puerperal infection, compared with ordinary women, greater risk, must prevent the venipuncture site infection and reproductive system infection.Each time dressing, I strictly according to the aseptic operation, supervise and urge patients early ambulation, to enhance the nutrition, under our care nurse, "" uremia mother body recover quickly, body temperature has been normal, ready recently released?
she sent us a banner, I think it is not only an honor, but also happiness, is a watchman happiness for life!
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