Chapter 870: Torn blood vessels all over the body
It seems that I am indeed overly worried.
The next step is to wait for Fang Jiajia's daughter to be born.
Generally speaking, fetuses that have undergone such surgery will generally be born prematurely. Thirty-one weeks can be regarded as the expected date of delivery. The average delivery period is only thirty-four weeks, which is 37 to 42 weeks compared with the average pregnancy period. Weeks are too far in advance.
In the blink of an eye, another week has passed.
Fang Jiajia's fetus has reached its thirty-third week.
As her condition stabilized, the clinician transferred her from the emergency department to the obstetrics unit.
Jingle Bell!
That night, there was a call from the obstetrics department.
The young nurse at the nursing station looked at the bed number called and said, "This is Dr. Xu's patient!"
"33+5 weeks, she should be giving birth soon, right?"
"Doctor Xu said that her due date should be within these two weeks, and the probability of premature birth is very high!"
The young nurses talked for a while, and then one nurse hurried to the ward.
"Are you about to give birth?"
As soon as she arrived in the ward, the nurse was a little expectant.
She wanted to see how far the fetuses handled by Dr. Xu could recover.
Whether the IQ level and cardiovascular development of fetuses who are said to be sentenced to death can keep up with the passing standards of ordinary premature babies.
However, when she saw Fang Jiajia on the hospital bed, her face was extremely pale and she was sweating, the nurse's eyes immediately changed.
This expression of fear and pain is not what one should expect during childbirth.
"What's wrong!" The little nurse put away her smile and rushed in immediately.
"I, I, I, I... hurt!" Fang Jiajia twitched several times when she said a word, and finally expressed her feelings intermittently.
She was trembling all over, hunched over on the hospital bed, her wide-open eyeballs highlighted with streaks of blood, and she looked like she was enduring severe pain.
"This...aortic dissection?!"
Aortic dissection in pregnant women is not very common, but it is also a classic rescue textbook. The director of the obstetrics department and the head nurse often use it in lectures.
Therefore, seeing Fang Jiajia's behavior, the little nurse immediately made a guess.
"Quick, quick, contact the emergency department... no, contact the emergency department and open a chest pain channel!"
She quickly shook people off.
…
Soon after, the results of the chest CTA that Xu Qiu had ordered to arrange urgently came out.
The moment they saw the inspection report, everyone took a breath...
"1. Thoracoabdominal aortic dissection (Stanford type A) involves the ascending aorta-aortic arch-descending aorta, and the breach is located in the ascending aorta; the aorta is widened, with a maximum diameter of approximately 4.8cm, and irregular intima can be seen The maximum diameter of the false lumen is about 1.5cm. The left subclavian artery and left common carotid artery originate from the false lumen, and the brachiocephalic trunk and celiac trunk originate from the true lumen.
2. Pericardial effusion, a small amount of bilateral pleural effusion..."
This result made Xu Qiu frown.
He has encountered aortic dissection before, and he has saved not ten but eight Type A patients.
However, there has never been a house owner Jiajia who was so serious!
Her aortic dissection tore from her chest to her thigh, affecting almost all the blood vessels along the way.
It's like the scene everyone fears when tearing off a barb on a nail - the barb extends until the skin of the entire finger and arm is torn off.
However, Fang Jiajia tore a blood vessel.
And the scope and degree are much more serious than this.
Xu Qiu sighed.
My worries that day finally came true...
In patients with Marfan syndrome, the aorta is more fragile than that of ordinary people, so the chance of aortic dissection is high.
I just didn't expect that it would progress to this point.
Stanford type A acute aortic dissection has a very high mortality rate, with more than half of patients dying within 48 hours.
Judging from the extent of Fang Jiajia's tear, it was a miracle that she survived three hours.
"Convene an emergency consultation and prepare the operating room and ICU." Xu Qiu said decisively.
…
Ten minutes later, the cardiac surgery department, obstetrics department, neonatal intensive care department, anesthesiology department and Xu Qiu all arrived.
After quickly reading the medical records, everyone's expressions became extremely serious.
"The blood vessels in my body are almost torn out..."
Director Zheng pointed to the location of the pericardium in the CTA and said, "Also, the patient has developed pericardial effusion, which means her aortic dissection will rupture at any time!"
Tearing the lining of blood vessels theoretically only causes severe pain.
It's not a direct threat to life.
Doctors still have a chance to save her.
However, if an aortic dissection ruptures and a large amount of blood flows from the blood vessels from the chest to the legs, even if Jesus comes, he will have to say, "The Lord cannot do this."
After all, such a huge amount of blood loss is enough for the patient to replace all the blood in his body within five minutes.
No one can survive five minutes of rapid blood transfusion, which is also a physiologically impossible miracle for humans.
The obstetrics department sent experienced director Kong Huixia.
She glanced at the medical records and said seriously:
"The patient also has gestational diabetes and Marfan syndrome. In addition, according to the ultrasound images we did, she also has a low-lying anterior placenta..."
This situation, even if there is no acute aortic dissection, is a high-risk maternal condition that needs to be focused on by obstetrics departments.
Now endangered...
Director Zheng nodded and said, "The only way is to perform surgery immediately before the aortic dissection ruptures!"
The range of her tear is too large, and more and more blood is poured into the false lumen, so the risk of rupture is very high.
But Kong Huixia shook her head and said, "The treatment of acute aortic dissection in parturients is different from that of ordinary patients.
"The incidence of aortic dissection during pregnancy is very low. We have not encountered a case since the establishment of the hospital. Even in the international community, there is not a single case of aortic dissection rupture in 100,000 pregnancies.
"If I remember correctly, aortic dissection must be systemically heparinized first, and then deep hypothermic extracorporeal circulation?"
Director Zheng nodded and said, "These are the basis of surgery."
Kong Huixia said, "Then there is no problem. Even if the parturient can survive, the fetus in the abdomen will most likely die."
From Fang Jiajia's previous performance, she values the child in her belly more than her own life.
It would be too cruel for her to give up the child and choose life-saving surgery for herself.
And it is likely to leave a lifelong regret, which will become an indelible shadow.
…
In the main seat, Xu Qiu quietly listened to the directors' discussion.
After a while, there was a knock on the door.
Yang Yuen came with an abdominal CTA.
The previous aortic CTA could only clearly show the tear in the aortic area and was suitable for patients with aortic disease.
But Fang Jiajia's dissection spread to the thigh. If you want to understand it comprehensively, you must complete the abdominal CTA and check the situation more accurately.
"It's worse than we thought..." After reading the report, Xu Qiu's eyes sank slightly.
——
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