On Dec 21th, Obstetric Safety Office of Renji Hospital and maternal and child health institute of Pudong New District combined some departments including obstetrics and gynecology, anesthesiology, critical care medicine, blood transfusion and other departments, to rescue a pregnant of placenta previa with peripartum hemorrhage. At present, the women were at stable and received treatment in intensive care unit.
On December 17th, Miss Zhou came to maternity clinic in Renji Hospital, asking the doctors to save her life and her child. Miss Zhou, who aged 36, got pregnant for 36 weeks with a history of cesarean section before. Now she was pregnant again, which made the whole family very pleased. However, pregnant women with scar uterus always accompanied great risk. This time, Miss Zhou was diagnosed as "placenta previa", and might bleed at any time. The local doctors were baffled, which makes Ms. Zhou and his family into a great deal of pain and despair. Finally, they had got to Renji hospital for help. Admissions physicians improved the inspection, and made a diagnosis of central placenta previa with placenta implantation, and might bleed at any possible time. Because of her complex and critical condition, she was immediately admitted to the hospital, for close observation and treatment. In order to save her life and her child, the staff of obstetric conducted a number of discussions, and relevant departments were invited to consultation and developed a detailed treatment and contingency plans. Finally, the medical team decided to conduct cesarean section on December 21st, to save her life and her child.
At 13:30 of Dec 21st, Ms. Zhou was sent to the operating room for this extremely difficult cesarean section. Prof. Su Yu conducted this cesarean section. And a healthy baby girl of 2500 grams weight was delivered. However, at the time of peeling adhesion of the placenta, the worst happens. Miss Zhou suddenly appeared bleeding, and associated with hemorrhagic shock, DIC, and ventricular fibrillation, her lives was at stake. Health care team immediately launched emergency plans, by Prof Di Wen, Prof Lin Jianhua, Prof Chen Jie, and Prof Zhou Jie. Together with emergency blood transfusion, hysterectomy was conducted by Prof Lou Weihua at the same time.
Although blood shortage in Shanghai, a green channel was opened and 8800ml red blood cells, 6100ml plasma were provided under the help of Medical Service Office and maternal and child health institutes of Pudong New District. At 8 pm, the patient's condition has finally been effectively controlled, was admitted to the intensive care unit for subsequent treatment. Next morning, the patient's vital signs were stable, and regained consciousness. After a whole busy night, all medical staff finally relieved.
According to reports, placenta previa is one of the main reason of peripartum hemorrhage in late pregnancy, which is a serious complication of pregnancy. It is much more common in multipara, especially in those who had a history of cesarean section. Because of the sudden occurrence of bleeding and other serious complications associated with DIC, this disease has become a serious life-threatening maternal "killer" which was difficult in rescuing. The successful rescue of the placenta previa reflected the ability to handle this critical situation, and provides a solid and effective protection on the China's Maternal and Child Health.
At present, caesarean section rate was up to nearly 50% in China. With the release of a comprehensive two-child policy, experts advised that if the first child was delivered in caesarean section, pregnant should be carried out prenatal care to identify problems for early intervention.
( Correspondent Haoning Wang , Translator Yujun Sun )