Start From Emergency Doctor

Chapter 500

Abdominal pain in pregnant women is difficult to judge.

On the one hand, it is normal for pregnant women to have abdominal pain.

In the first trimester, pregnant women often feel mild cramps, soreness, and continuous dull or severe pain in the lower abdomen.

The slight soreness comes from the implantation of the fertilized egg. After landing on the endometrium, the fertilized egg needs to integrate itself into the endometrium for further development, which will cause the movement and contraction of the uterine wall, resulting in slight cramps and soreness.

Generally this abdominal pain lasts for one to three days.

As for the persistent dull or severe pain in the lower abdomen, it may be due to the wrong implantation position of the embryo, that is, ectopic pregnancy. However, ectopic pregnancy is usually accompanied by phonological bleeding, and this patient does not have this symptom after physical examination, so it can be excluded.

In addition, during pregnancy, the secretion of progesterone and estrogen levels will increase significantly, which will gradually reduce the tension of the sphincter under the jurisdiction of the pregnant woman, and the uterus will continue to enlarge and press the stomach upwards, resulting in increased gastric pressure and gastric pressure. The emptying rate slows down, leading to a longer residence time of gastric juice and chyme in the stomach, which can cause acid reflux, a burning sensation in the stomach, and a sensation of abdominal pain.

In addition, threatened abortion needs to be investigated.

All in all, the abdominal pain of pregnant women is 26 extremely complicated.

There are many causes, but because of the special status of pregnant women, too many examinations cannot be done.

Zhou Yuan was lost in thought.

Threatened miscarriage and a series of physical changes caused by pregnancy can now be ruled out.

Intrauterine stillbirth should not be the cause of abdominal pain, and it is unlikely that someone will suffer from intrauterine stillbirth for a week.

Even Zhou Yuan guessed that this abdominal pain was still the cause of intrauterine stillbirth…

In other words, the patient’s fetus was originally normal and should be waiting for birth. However, because the patient had a sudden illness, the fetus was abnormal, which eventually led to intrauterine stillbirth.

“Go and discuss with the patient’s family. The intrauterine stillbirth needs to be cleaned up. As for the cause of the abdominal pain…” Zhou Yuan hesitated.

“The cause of abdominal pain cannot be determined for the time being, but the current indications for surgery are obvious. My suggestion is to open the abdomen for exploratory examination, and check for abnormalities while cleaning the dead fetus to confirm the cause of abdominal pain.” Zhou Yuan said.

He Jing nodded quickly, “Then I will discuss with my family members now!”

Zhou Yuan stayed in the imaging department and continued to understand the situation.

Ultrasound films are more complicated. Although Zhou Yuan can watch some simple films, he is not a doctor in the imaging department, and he certainly cannot replace the other party.

More often, the results of the examination need to be reported by the doctor of the imaging department after reading it.

“The patient’s condition is not optimistic.” The imaging doctor looked at the film and sighed.

…

When Zhou Yuan returned to the ward, the atmosphere reached a freezing point again.

The family members of the patient are aware of the situation and are silently guarding the patient’s side at this moment.

The patient was still sobbing and his eyes were red and swollen.

For a person who is about to become a mother, it is a cruel thing that the fetus in the womb has to pass away before it can fully develop.

Seeing that Zhou Yuan had arrived, He Jing dragged him out of the ward and said, “Zhou Yuan, are you planning for surgery?”(Read more @ wuxiax.com)

Zhou Yuan nodded: “If the patient’s family agrees, let’s start the operation.”

“Okay, then we are responsible for cleaning the stillbirth, you come to check the cause of the abdominal pain.”

“Also try the stillbirth cleanup. My induction of labor is okay.” Zhou Yuan said.

He Jing was slightly surprised, “You can also induce labor? Isn’t this the skill of our obstetrics department? How can you in an emergency department be able to induce labor?”

Zhou Yuan was silent.

Yeah… how could I induce labor.

Could it be said that I have performed induction of labor on chickens that make chicken feet?

“However, the induction of labor is different from this stillbirth cleanup. Is it really necessary?” He Jing did not continue to ask, but asked another question.

Induction of labor is to remove the stillbirth from the sound channel, but this time the stillbirth is removed by opening the abdomen and uterus. The two are not the same.

Zhou Yuan nodded: “The principle is the same, let me do it.”

He Jing didn’t ask any more, she had an unfounded trust in Zhou Yuan.

Since Zhou Yuan said yes, he definitely did better than himself!

He Jing felt a little dazed to think about it this way.

Who the hell is the obstetrician doctor!

“Do you have any opinion?” He Jing asked again.

Zhou Yuan shook his head.

What He Jing wants to ask is the cause of abdominal pain. Zhou Yuan has not made a clear judgment yet.

He was not good at obstetrics. This was the first case of abdominal pain in a pregnant woman he encountered.

However, although there is no accurate judgment, Zhou Yuan still has a few guesses, otherwise Zhou Yuan would not be on the operating table. He doesn’t make jokes about the lives of patients.

“Round ligament disease or enlarged uterus? Pseudo-uterine contraction? Ovarian cyst torsion?” He Jing said a series of possible causes.

Zhou Yuan shook his head and said, “I knew it during the operation.”

Preoperative examination, signatures of family members, emotional comfort of patients…

Soon, preparations for the operation were completed and the patient was pushed into the operating room. Zhou Yuan and He Jing also entered the preparation room and began cleaning and disinfection to prepare for entering the operating room.

For this operation, Zhou Yuan also called Wei Lili, the director of the obstetrics department, for insurance.

In addition, an old obstetrician in his forties was also present.

This doctor configuration can be said to be foolproof.

If this operation fails, then no one else can be found to treat it, and it can only be said that the life must be absolutely…

Huh.

Zhou Yuan stepped on the air door and entered the operating room.

He Jing and others were already waiting by the operating table. Everyone looked at Zhou Yuan. The female doctors and nurses, regardless of their age, had their eyes brightened.

After all, the appearance of a handsome man in a boring operating room is very seductive.

“Establish venous access.”

“Start anesthesia.”

“Prepare blood, be prepared for bleeding during the operation at any time.”

Zhou Yuan was unambiguous and gave orders in an orderly manner.

He picked up the scalpel and moved along the position marked by the marker pen, and soon his abdomen was opened.

“The omentum adheres to the front abdomen.” Zhou Yuan frowned.

As soon as the abdominal cavity was opened, the patient’s abdominal condition was not optimistic.

The surgical field of vision becomes bad due to the adhesion of tissues and the influence of a large amount of blood in the abdomen.

“Clean up blood and clots.” Zhou Yuan said.

He Jing immediately picked up the suction device and carefully attracted the blood in the abdomen, and at the same time removed the blood clot in the abdomen.

The operation field became clear again.

Immediately afterwards, Zhou Yuan carefully opened the uterus.

With the appearance of an opening in the uterus, the entire uterus is exposed to the air. Looking through the opening, you can clearly see a fetus wrapped in amniotic fluid.

Of course, it’s a stillbirth now. .