The Imperial Women's and Children's Hospital was one of the best gynecological and pediatric hospitals in the country.
It delivered about 15,000 newborns every year.
This place was bustling with activity all year round, and it was as crowded as a marketplace. Even during the New Year, when other large Class Three Grade A hospitals were deserted, it was still lively here.
What was different from other large comprehensive tertiary grade A hospitals was that most of the people here were in high spirits instead of being dejected.
After all, it was a good thing to have a baby.
There were more than a dozen obstetrics wards in the Women's and Children's Hospital. The doctors' offices in each ward were full of banners.
People were in high spirits when they were happy. It was natural to send money and banners when the mother and child were safe.
However, the atmosphere in the first obstetrics ward was a little strange today.
The door of the doctor's office was closed. Those who did not have surgery were sitting in the office. Experts and professors from other hospitals and hospital leaders were sitting in the office.
The air was stagnant, as if a major medical accident had happened. No one spoke.
It happened more than two months ago.
A 39-year-old woman found that the child in her belly had congenital aortic stenosis.
At that time, the fetus was only 24 weeks old, and congenital aortic stenosis could be seen. It could be said that the level of the Women's and Children's Hospital was quite high.
Seeing the results of the examination, the doctor explained the condition to the patient and the patient's family.
Due to congenital aortic stenosis, left ventricular outflow tract obstructive heart disease accounted for about 3% to 6% of congenital heart disease.
If the fetus had aortic stenosis in the early or middle stages of pregnancy, the blood volume of the left ventricle would be affected and continue to decline as the pregnancy progressed.
Eventually, it could lead to progressive dysplasia and heart failure, forming left ventricular dysplasia syndrome.
From birth to treatment, even in the mother's womb, the child would face new dangers every day.
Every step was a hurdle, and one wrong step could lead to death.
The possibility of the fetus dying in the womb was very high. Even if it was born alive, it would face countless troubles.
The doctor suggested induction of labor, which was the most suitable option for the current situation.
However, the pregnant woman was almost 40 years old. In order to give birth to a child and realize her dream of being a mother, she had sacrificed a lot. Even though she was already suffering from pregnancy induced hypertension, she still persisted.
For her, the option of giving up did not exist.
After listening to the doctor's tactful explanation, the pregnant woman firmly refused induction of labor. She cried and hoped for a miracle.
Perhaps as the pregnancy progressed, the child's condition would not worsen but would instead be alleviated. This situation wasn't impossible, but the possibility was extremely low, so low that it didn't even need to be considered.
After choosing to protect the fetus, the pregnant woman went to the entire Imperial Capital. As long as it was a high-quality hospital, the final conclusion was the same.
This time, it was because the prenatal examination yesterday found that the fetus's condition was deteriorating.
The aortic valve pressure gradually increased from 22 mmHg to 85 mmHg. The ratio of the left and right ventricles was gradually out of balance. During the observation process, fetal pericardial effusion and mitral regurgitation appeared one after another.
All the signs indicated that the child's congenital aortic stenosis was developing to an extremely severe degree, and there were signs of heart failure and other symptoms.
It was only 32 weeks …
The pregnant woman still did not agree to the induction of labor. She did not agree at 24 weeks, but after 8 weeks, her attitude became firmer.
Although she knew that after the cesarean section, the child might have to endure continuous major surgeries and might even die, she still did not give up.
After the discussion between the experts in and out of the hospital, they concluded three treatment methods.
First, close observation and conservative treatment.
In fact, there was no other way. The child's current condition could not support natural childbirth at 38 to 40 weeks.
Second, prepare for a cesarean section. After the child was delivered, they would directly go to another operating table and perform a thoracotomy to treat his congenital aortic stenosis.
This treatment method was extremely risky.
The child's growth in the pregnant woman's body was not very good. At only 32 weeks, there were already symptoms of pericardial effusion and heart failure.
The surgery was easy to perform … It was extremely difficult, but compared to the child's postoperative recovery, it became a very simple and easy surgery.
This step was also voted on by almost all the doctors.
The hospital also invited the nationally renowned Doctor Liu Cixi to be the chief surgeon for the surgery.
Doctor Liu Cixi was the person who had performed the most such surgeries in the country and had the highest success rate. But even so, the success rate of the surgery was less than 30%.
To be honest, if they chose to keep the child, the family was very likely to face the outcome of losing both people and money.
The ultra-difficult surgery, the ultra-low success rate, and the huge daily expenses were all problems.
In addition, there was a third surgical method — the development of neonatal cardiac surgery and catheter interventional technology, which could be used for intrauterine interventional treatment.
It sounded like an impossible method of treatment.
The principle was very simple. Interventional surgery to treat congenital aortic stenosis. Open the stenosis as soon as possible and improve the aortic blood flow as soon as possible.
The benefits were huge. It could promote the development of the fetus' left ventricle and create opportunities for biventricular circulation after birth.
Moreover, if the surgery was perfect, the fetus could continue to grow in the mother's body until 38 to 40 weeks of natural delivery.
The next one and a half to two months were crucial for the fetus!
However …
However …
It sounded very beautiful.
Intrauterine interventional treatment did not appear for long.
In 1991, the world's first related treatment case was reported by Maxwell and others.
The first related treatment case in the world was reported by Maxwell and others. The literature was published in a case report in the New England Journal, which attracted the attention of many interventional doctors at the time.
So far, more than 200 clinical cases had been reported internationally, concentrated in Western countries. Aortic balloon dilation was the majority, and the technical success rate was more than 50%.
Yes, more than 50%. In other words, the mortality rate was more than 40%, nearly 50%.
Compared to cardiothoracic surgery after laparotomy, this mortality rate was barely acceptable.
But!
Intrauterine interventional surgery was extremely dangerous.
In addition to the fetus, there were also risks to the pregnant woman.
The second plan, the pregnant woman was certain to be fine. However, to choose intrauterine interventional surgery, the pregnant woman shared half of the risk of the fetus's life.
At this time, there was a disagreement between the patient and the patient's family.
The pregnant woman herself insisted on the third type of intrauterine interventional treatment, while the family asked for the second type of surgery.
Save the adult or save the child, this was an ancient question.
When medical standards were not developed, dystocia was fatal. At that time, there was no cesarean section, so such a question appeared.
Now that the level of medical technology had advanced by leaps and bounds, saving the adult or saving the child had become a false question.
However, when this ancient choice was placed on the table, all doctors helplessly discovered that it actually existed.
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