I don’t know how many friends
On the TV series “Huanzhugege (3)”
This famous scene
Zhihua in order to win Yongqi’s love
Unable to keep him
Break the table legs with a big belly
Causes premature delivery
Not to mention in the ancient times when medical and sanitation conditions were not developed
Even in a modern society with advanced technology
Pregnant woman suffered trauma or trauma to her abdomen
Also very prone to stillbirth
Even the mortal danger of “two lives”
This pain is only for women
In Anhui Huangshan people Saisai (pseudonym) is even more
The most painful realization——
Two consecutive intrauterine stillbirths, placental abruption
within 6 years
This July is the most thrilling scene
Make everyone sweat and cry
Seven years of marriage and two placental abruptions, Anhui nurse almost died
Xai Sai, 31, is a nurse from Huangshan, Anhui. She works conscientiously, has a strong sense of responsibility, and has a deep relationship with her husband. The couple have been married for 7 years and have always wanted to have a baby of their own.
I thought that having a child was a natural thing after marriage, but unexpectedly it became a difficult time for the couple. The word “pregnancy” also became the weight of life that Sai Sai could not bear.
At the end of December 2016, at the 37th week of pregnancy, Sai Sai was rushed to a local hospital with sudden abdominal pain and vaginal bleeding. “My colleagues at the hospital told me, baby I can’t hear the fetal heart, it’s like being struck by lightning.” Recalling the past, she still couldn’t express her sadness, the child was about to be full term and could see the new world right away, but there was no life in her belly. breath. Because of placental abruption, the local hospital performed an emergency cesarean section on her, but the fetus could not be saved, and she herself bleeded continuously after the operation, and was referred to the ICU of Zhejiang University First Hospital for treatment. Fucked a life back.
Three years later, in June 2019, Sai Sai, who was pregnant again, developed severe dizziness and vomiting at 33 weeks of pregnancy. Purchased a fetal heart rate monitor. But late one night, along with persistent severe abdominal pain and vaginal bleeding, the feeling of despair struck again – Sai Sai’s baby was silent again. Her husband sent her to the First Hospital of Zhejiang University overnight, and it was “placental abruption” again.Stillbirth in the womb”, which hit the couple deeply. Since then, the couple insisted on regularly commuting to Hangzhou from Huangshan to visit the specialist outpatient clinic of Chief Physician Li Yang, the director of obstetrics, for consultation on pregnancy preparations.
Another 3 years, hard work pays off. In early 2022, Sai Sai found out unexpectedly that she was more than a month pregnant. In her third pregnancy, she no longer dared to take it lightly, so she suspended her work and specially rented a place near the first phase of the headquarters of Zhejiang University First Hospital to raise and protect her baby. Because she had a history of placental abruption twice before, Director Li Yang also carefully instructed her to adhere to weekly obstetric examinations. As a result, at the end of June this year, the baby showed a dangerous sign in Sai Sai’s belly.
During the 26-week gestational check-up, the results of B-ultrasound indicated that a hematoma with a size of about 4.6cmX3.6cm was found behind Sai Sai’s placenta. It was normal, and there was no obvious abdominal pain. The expert was “placental abruption”. Director Li Yang immediately admitted Sai Sai to the hospital.
“Doctor, can you help me and save this little baby, I’m so eager to be a mother!” Facing Sai Sai’s unstoppable pleas, all the medical staff in the obstetrics department of Zhejiang University First Hospital said Be moved by it.
Every minute, every second,Care for the safety of mother and baby
Under normal circumstances, the placenta is stripped only after the baby is born. If the placenta is partially or completely stripped from the uterine wall before the baby is delivered, it is “placental abruption”. Once the placenta is stripped from the uterine wall , like a tree being uprooted by its roots, without the skin, where will the hair be attached?
The baby cannot get enough oxygen and essential nutrients in the mother’s belly, which will cause major problems. Severe asphyxia and fetal death may occur in minutes, and the perinatal mortality rate is earlier than that of non-placental infants. Peel 25 times higher. In addition, expectant mothers are also at risk of massive bleeding, coagulation disorders, and shock.
Placemental abruption can be divided into grades 0, I, II, and III according to the severity of the condition:
26 weeks of pregnancy is equivalent to the fetus growing in the mother to about six and a half months. In order to prevent the further deterioration of placental abruption, if the baby is “cut off” early, the chance of survival is relatively low, because some organs of the fetus are not yet mature at this time; but placental abruption occurs again. It is very hidden, and the progress is fast. If it is not handled in time, it may seriously endanger the life of the mother and child.
Every minute and every second after admission, Director Li Yang’s team must take care of the safety of mothers and babies. A little carelessness can lead to unimaginable consequences! After careful discussion in the obstetrics department, as well as multiple daily fetal heart rate monitoring and urine protein testing, at the 28th week of Saisai’s pregnancy, Director Li Yang performed a cesarean section for her.
At the beginning of July, the operation was intensively carried out – anesthesia, disinfection, drape, abdominal entry, membrane rupture, fetal retrieval… The terrible bloody amniotic fluid spewed out, and the fetus was delivered smoothly. When the newborn was just delivered, the bruises around the mouth were rescued by the emergency team of the neonatology department. After immediate oxygen inhalation and warm-keeping treatments, the complexion quickly returned to ruddy, and everyone was relieved. Immediately after the delivery of the placenta, blood pressure on the dissection surface of the placenta was obvious, occupying 1/4 of the entire placenta, shocking! The results also confirmed Director Li Yang’s initial diagnosis – this blood accumulation trace is a typical feature of placental abruption.
“The edge of the placenta is not peeled off, and there is a continuous gushing of blood between the placenta and the uterine wall. As the postplacental bleeding increases and the pressure increases, the blood will rush The edge of the placenta, or the amniotic membrane penetrates into the amniotic fluid.” Director Li Yang explained that Sai Sai’s “placental abruption” is a hidden abruption, if it is not for the B-ultrasound doctor who found the hematoma in time during the earlier obstetric examination and she did not have persistent abdominal pain, etc. Symptoms, it is very likely to cause stillbirth again, and more seriously, with the further progress of recessive placental abruption, it will also cause uteroplacental stroke (also known as “Couveraire’s uterus”), The entire uterus will turn blue and purple, and in severe cases, the uterus may be insecure, severe bleeding, and life-threatening.
Fortunately, after quick and effective treatment, Sai Sai and the baby have both turned their backs and have been discharged from the hospital safely.
How terrible is placental abruption? Experts say so
“Thank you so much for the First Hospital of Zhejiang University! If it wasn’t for your timely rescue, my baby might have…” When they were discharged from the hospital, Sai Sai and her husband thanked Director Li Yang repeatedly. Director Li Yang said that placental abruption has many chronic predisposing factors, resulting in a high recurrence rate. The risk of third placental abruption was increased by 50 times if there were 2 previous history of placental abruption.
“Because of various incentives such as gestational hypertension, Sai Sai belongs to recurrent placental abruption. It was chronic at first and then acute abruption. She and the baby were able to be discharged from the hospital safely and smoothly. It is not accidental, this is inseparable from Sai Sai’s timely medical treatment, clear ultrasound examination, timely cesarean section, neonatal rescue and resuscitation, and the high level of cooperation from family members.”
According to domestic reports, the incidence of placental abruption is 0.46%~2.1%, and the perinatal mortality rate of placental abruption is 20%~35%. With the liberalization of the “universal three-child” policy in recent years, the number of elderly mothers has increased, and cases of placental abruption are more common in clinical practice, “I have dealt with 3 cases in the past month. Director Li Yang introduced that placental abruption may be possible. It is closely related to the following factors:
①Vascular disease: Pregnant women with gestational hypertension, chronic hypertension, chronic kidney disease or systemic vascular disease are prone to bleeding at the placental attachment, forming a placenta A posterior hematoma, causing the placenta to separate from the uterine wall. This is the main cause of placental abruption, accounting for about half of them.
②Mechanical factors: Trauma such as a strong blow to the abdomen, or an accidental fall while walking can cause the uterus to suddenly stretch or contract and induce placental abruption , generally occurs within 24 hours after trauma.
③Sudden decrease in intrauterine pressure: Preterm premature rupture of membranes; in twin pregnancy, the first fetus is delivered too quickly; in polyhydramnios, After the artificial rupture of the membrane, the amniotic fluid flows out too fast, the pressure in the uterine cavity decreases suddenly, the uterus contracts suddenly, and the placenta and the uterine wall are dislocated and peeled off.
④Other factors: Pregnant women with a history of placental abruption and advanced age have a significantly higher risk of recurrent placental abruption. In addition, smoking, drug use, chorioamnionitis, assisted reproductive technology, and thrombosis.
However, there are still about 28.7% of placental abruption related high-risk factors, so every mother should be vigilant and not relax!
Experts stress that vaginal bleeding, persistent abdominal pain, tonic uterine contractions (hard as iron plates), abnormal fetal movement and bloody amniotic fluid are the most common symptoms of placental abruption. If you have this symptom, do not hesitate to seek medical attention immediately.
How to prevent placental abruption?
It is necessary to strengthen the prenatal check-up and seek medical attention immediately if there is a suspected placental abruption.
In the event of discomfort such as abdominal pain, bloody amniotic fluid, or vaginal bleeding, seek medical attention immediately.
Be extra careful during pregnancy to prevent bumps and squeezing of the abdomen.
Pay attention to fetal movement. If there is abnormal fetal movement, sudden decrease, disappearance, or severe or frequent occurrence, it may indicate that there is a problem with the fetus.
Exercise moderately, avoid lying on your back for a long time, quit smoking, alcohol, and drugs, pay attention to personal hygiene, and prevent infection.