Start From Emergency Doctor

Chapter 174

Zhou Yuan took the placenta and directly flattened the operation table next to him, spreading the placenta on the table.

“what are you doing?”

“Check the cause of the bleeding! He Jing, now you find a way to slow down the bleeding rate of the patient!”

He Jianyi ran in when he heard the situation, his face paled when he saw the blood on the floor in the observation room.

“I control the patient’s blood pressure and heart rate!” He Jianyi immediately walked up.

The child’s father was standing at the door, looking at his unconscious wife lying on the operating bed with horror.

While Sun Meng retrieved the emergency blood, the old director of the obstetrics and gynecology department also followed Liu Kai, who was to report the letter.

“what’s the situation!”

The old director walked into the observation room and was shocked by the blood on the ground.

“The girl holding the blood bag should have a blood transfusion immediately! If the blood is lost like this, the person will be gone!-”

After speaking, he put on sterile gloves, squatted down, and looked carefully.

“The vision is not good… the medical flashlight!”

After observing for ten seconds, the old master’s face became serious.

“Bleeding is very serious. If you want to stop the bleeding, there is only one best way…”

“What!” the child’s father asked immediately.

“Removal of the uterus…”

The old director’s words quieted the observation room.

The child’s father looked at the old director blankly, thought for a long time, and said, “Is there only one way?”

“At present, the safest thing is to remove the uterus!”

At this moment, He Jianyi successfully stabilized the pregnant woman’s vital signs, Sun Meng also completed an emergency blood transfusion, and the pregnant woman gradually became sober under He Jianyi’s rescue.

“No, I don’t cut the uterus, I still have a baby!” The pregnant woman suddenly shouted out of nowhere.

Although the voice was very small, everyone heard it.

The old director looked embarrassed: “If the uterus is not removed, it will be difficult to stop the bleeding!”

At this time, Zhou Yuan, who was frowning next to him, suddenly widened his eyes.

“There is a break in the placenta…a gap!”

Zhou Yuan turned his head and looked at He Jing: “He Jing, did you feel any abnormalities in the placenta when you touched the glass placenta?”(Read more @ wuxiax.com)

He Jing stayed for a while, recalled for a moment, and said, “It seems that there are some places where the placenta is rough.”

Hearing Zhou Yuan’s self-talking, He Jing walked over and looked at the place where Zhou Yuan’s finger was. She couldn’t help but stunned: “It’s really hurt…”

Zhou Yuan quickly walked to the pregnant woman, took the medical flashlight, and checked it carefully.

“I don’t think it is necessary to remove the uterus! You can use thrombin perfusion to stop bleeding, but it is impossible to perform hysterectomy.”

Thrombin perfusion therapy is mainly aimed at coagulation dysfunction caused by postpartum hemorrhage. If coagulation dysfunction occurs, thrombin perfusion therapy can achieve good results, but it is ineffective for other causes of postpartum hemorrhage.

Zhou Yuan noticed the wound on the placenta and suspected that the postpartum hemorrhage of the pregnant woman was due to the coagulation disorder.

To put it simply, it is because the placenta was not completely peeled off before, and the uterine contraction was weak, causing the blood vessels on the endometrium to be unable to contract and close tightly, so that diffuse bleeding occurred and the blood coagulation function could not keep up.

“Are you sure?!” The old director was stunned for a moment, then said in a questioning tone.

Thrombin perfusion can indeed treat postpartum hemorrhage, because this method has hemostatic effect.

For general postpartum hemorrhage, by acting on the surface of the wound after topical administration, the blood can quickly form a stable clot, and then control capillary venous bleeding, which can play a better hemostatic effect.

But… when postpartum hemorrhage occurs clinically, the situation is more critical, and blood needs to be supplemented in time. A reasonable treatment plan should be selected according to the specific situation. When the life of the parturient is endangered, the removal of the uterus is the best way to control postpartum hemorrhage.

In the current situation, the old director could not judge the location of bleeding and the cause of the bleeding at all.

To be honest, the use of thrombin perfusion therapy is actually not safe…

Zhou Yuan prepared the thrombin medicine and said, “I don’t think we have the right to deprive a woman of the right to be a mother…I have a certain degree of thrombin perfusion therapy to stop the bleeding.”

Zhou Yuan is confident in his master-level thrombin hemostasis method, and the current situation shows that there is a high probability that there is a problem with the coagulation function.

“Prothrombin complex, fibrinogen, which one do you want?”

The old director hesitated for a moment, and finally chose to believe in Zhou Yuan.

He is older, so he is more inclined to conservative treatment, and removal of the uterus is the most conservative and safest way.

·········Ask for flowers···········

But… the other party is Zhou Yuan, a doctor who has performed miracles in various departments, and now he chooses to take a gamble!

“Both drugs are ready, and Sun Meng, you will get some cryoprecipitated, fresh plasma and prepare some platelets!”

Zhou Yuan squatted down and cleaned the uterine cavity and birth canal, expelling some remaining placenta and endometrial fragments.

“He Jing, install an extracorporeal drainage tube!”

This is to draw out the blood in the uterine cavity of pregnant women.

“Zhou Yuan, the two thousand milliliters of blood has been transfused!” Sun Meng said nervously after changing a new blood bag.

Zhou Yuan nodded, looking serious, and said: “Old Director, please prepare two thousand units of prothrombin complex immediately, plus 100ml of normal saline to inject into the uterine cavity!”

………. 0

According to Zhou Yuan’s estimation, after the prothrombin complex and normal saline are infused into the pregnant woman’s uterus, the amount of bleeding will be significantly reduced within 20 minutes. One hour later, another infusion will be performed, plus the infusion of platelets that promote blood clotting, Plasma, etc., can achieve complete hemostasis.

Of course, everything is just Zhou Yuan’s guess. As for the result, it can only be done step by step.

“Two thousand units of prothrombin complex!” The old director handed it over.

Zhou Yuan quickly took it and looked at the pregnant woman’s lower body.

He Jing has completed the placement of the external drainage tube, and a large amount of dark red blood is drawn from the pregnant woman’s body and discharged into the external drainage bag.

“The patient’s blood pressure can’t be measured!” Director He’s expression changed.

Zhou Yuan was taken aback.

“Director He, please come back to the rescue, hemorrhagic shock cannot occur at this time!”

Zhou Yuan hesitated.

Now… Is it to remove the uterus or perform thrombin perfusion…

If the uterus is removed, it means that the woman has lost the most basic characteristics of being a woman, including reproductive function, menstrual period, etc.

However, thrombin perfusion will be very dangerous if the patient has already experienced hemorrhagic shock and more than two thousand milliliters of whole blood has been infused…

Soon, a slightly joyful voice came from He Jianyi again: “Zhou Yuan, the rescue is back, the patient has regained consciousness!”