medical road high rise

Chapter 378 Pregnancy Ruptured
Chapter 3 Pregnancy rupture
During pregnancy, the secretion of progesterone and estrogen levels will increase significantly, which will lead to a gradual decrease in the tension of the sphincter muscle of the pregnant woman, and the continuous enlargement of the uterus will press the stomach upward, resulting in increased gastric pressure and gastric emptying. The rate slows down, causing gastric juices and food to stay in the stomach for too long, which can cause acid reflux, heartburn, and abdominal pain.

There are still many aspects to consider. All in all, abdominal pain in pregnant women is very complicated and has many causes, but many tests cannot be done.

Instead, Qin Feng had some guesses in his mind, that is, the intrauterine stillbirth was caused by the patient's abdominal pain.

"Let's discuss with the patient's family first to see what to do." Qin Feng said, "The cause of the abdominal pain cannot be determined for the time being, but the patient still needs to undergo surgery. My opinion is to check for abnormalities while cleaning up the stillbirth to confirm the abdominal pain. The cause of the disease is determined by laparotomy.”

The obstetrician nodded repeatedly and ran directly to negotiate with the patient's family.

Qin Feng stayed in the auxiliary department and continued to understand the patient's situation.

When Qin Feng returned again, he found that the atmosphere in the ward became strangely quiet, and no one dared to speak first.

The patient's family members gathered together in silence, and the patient was lying on the hospital bed with his eyes blank.

For a person who is about to become a mother, it is a very cruel thing to have to die before the fetus in the womb develops.

"The patient's family and the patient have agreed to the operation." The obstetrician quietly pulled Qin Feng over.

"Then arrange the surgery in the operating room directly. The unknown abdominal pain can't be delayed any longer." Qin Feng said, "Also, let me clean up the stillbirth and put it under your name. I'll try the newly learned abortion technique. .”

"??? You know how to induce labor? Isn't this the exclusive skill of our obstetrics department? You are an emergency doctor!" The obstetrician couldn't believe it.

Qin Feng fell silent, he seemed to have said something wrong, mainly because he was too hasty.

That's right, how can emergency doctors know how to induce labor, and the emergency department can't accept pregnant women. Qin Feng knows the procedures of other departments, and it can be said that he has tried in the emergency department, but induced labor...

"That, you should do it, I'll do the investigation." Qin Feng could only give up this opportunity.

The obstetrician also thought that Qin Feng had said something wrong and did not continue to ask about the situation.

To be on the safe side, the obstetrician still called in his own deputy director.

The experience of the deputy director of the obstetrics and gynecology department is better than that of Qin Feng and the obstetrician, but Qin Feng is better at diagnosis and treatment.

Entering the operating room, Qin Feng began to issue instructions.

"Establish venous access."

"anaesthetization."

"Prepare blood to prevent heavy bleeding during the operation."

……

Instructions came down one after another in an orderly manner.

After the instructions were completed, Qin Feng picked up the scalpel and opened a 10cm incision in the patient's abdomen.

Layer by layer peeling off, the peritoneum was opened, revealing the situation inside.

When the peritoneum was opened, Qin Feng found that the omentum and the anterior abdomen of the patient were seriously adhered, which greatly affected the operation.

Qin Feng picked up the suction device and began to deal with accumulated blood and blood clots, widened the surgical field, and then cleaned up the adhesions, allowing the sticky tissues to be themselves again.

Then, Qin Feng carefully opened the uterus and looked through the opening. He could clearly see a fetus wrapped in amniotic fluid. Unfortunately, the fetus was already dead.

This was Qin Feng's first experience with stillbirth, and Qin Feng was a little uncomfortable with it.

On the contrary, obstetricians and deputy directors of obstetrics seem normal and have become commonplace.

Qin Feng got out of the way, and the deputy director of the obstetrics department personally started to separate the fetus from the womb with the obstetrician.

During the stripping, the deputy director of the obstetrics department was a little surprised, the fetus was still wrapped in amniotic fluid, and the amniotic sac was still very complete.

This kind of cutting through the uterus without damaging the amniotic sac is very difficult for Qin Feng, who has little contact with obstetric surgery. It can only be said that Qin Feng has a precise understanding of the human body. Grasp the distance.

The fetus is removed and the uterus becomes empty.

Qin Feng began to observe the condition of the patient's abdomen. First, he looked at the uterus. The normal uterus is usually on the right side of the pelvis, but the patient's uterus is tilted forward, and some scars can be seen on the lower part of the anterior wall. The cause of the formation is temporarily unknown.

"I suddenly have two guesses, it may be a ruptured uterine pregnancy, or congenital eclampsia." Qin Feng said.

Uterine pregnancy rupture means that the patient has a double uterus, which is a uterine malformation. During the formation of the fetus, uterine rupture may occur.

Congenital eclampsia is a complex disease that occurs during pregnancy, which can cause changes in the blood vessels of pregnant women, which can affect multiple organs, including liver, kidney, brain, and placenta.

Relatively speaking, eclampsia should be more serious. It not only endangers the life of the fetus, but also threatens the life of the mother.

The onset period of eclampsia happens to be around [-] weeks of pregnancy, which is exactly in line with the patient's pregnancy period, and the symptoms are also similar to the patient's.

The way to judge these two diseases is quite simple, that is to check the uterus and blood vessels. If the uterus ruptures, it is uterine pregnancy rupture. If there is something wrong with the blood vessels, it is eclampsia.

When Qin Feng continued to inspect the scar on the lower part of the anterior wall, he found that there was an unidentified tissue attached to it. When he opened this mass of tissue, he could clearly see a breach at the bottom, about eight centimeters in length and half a centimeter in width. The uterine myometrium has been everted, and the placental tissue has flowed out along with the uterine myometrium.

At this point, it is basically confirmed that the uterine pregnancy has ruptured. Qin Feng checked the blood vessels again and confirmed that it has nothing to do with congenital eclampsia. Qin Feng was relieved.

"Notify the family members that they are going to have a hysterectomy." Qin Feng said.

The obstetrician nodded and went out, and the deputy director of the obstetrics department looked at Qin Feng curiously, wanting to see how much this young man with a reputation in Ruijin still has.

Ten minutes later, the obstetrician said: "The family members have agreed, and the operation can be performed."

The deputy director of the obstetrics department did not compete with Qin Feng for this operation, she wanted to see how Qin Feng would do it.

As for the obstetrician, she was still far behind. She was not at ease about doing this kind of operation.

Qin Feng's resection operation was also extremely clean and neat. The deputy director of the obstetrics department found that he had worked in the obstetrics department for decades, and it seemed that he could not compare with Qin Feng.

He is indeed a genius doctor who is mentioned in every meeting. The gap between geniuses and ordinary people is really huge.

After Qin Feng's operation was finished, the deputy director of the Department of Obstetrics and Gynecology took the initiative to ask, "How did you guess that the patient's uterus was ruptured?"

(End of this chapter)