The Imperial Capital Women and Children's Hospital is one of the few gynecological and pediatric hospitals in the imperial capital and even the country.

There are about 15,000 newborns delivered every year.

This place is bustling all year round and crowded with people. Even during the Chinese New Year, other large-scale tertiary hospitals are deserted, and it is still lively here.

Unlike other large comprehensive tertiary hospitals, most of the people here are happy rather than depressed.

After all, it is a good thing to import children, but a great thing.

There are more than a dozen obstetric wards in the Women and Children's Hospital. In each ward, there are banners full of banners and they can't even hang them.

People feel refreshed when they are happy, and mother and son are safe. It is natural to send happy money and banners.

But today the atmosphere in the first ward of obstetrics department is a bit wrong.

The doctor's office door was closed, and everyone who had not undergone surgery sat in the office. Experts and professors from the outer hospital and leaders of our hospital sat in the office.

The air was stagnant, as if it was a major medical accident, and no one spoke.

It happened more than two months ago.

During the examination, a 39-year-old woman found that the child in the abdomen was suspected of having congenital aortic valve stenosis.

At that time, the fetus was only 24 weeks old, and it was obvious that congenital aortic valve stenosis was very high. It can be said that the level of women and children's hospitals was quite high.

After seeing the examination results, the doctor and the patient and the patient's family explained the condition clearly.

Due to congenital abnormality of the aortic valve, obstructive heart disease in the left ventricular outflow tract accounts for about 3%-6% of congenital heart disease.

If the fetus is in early pregnancy, aortic valve stenosis occurs in the middle stage. As the pregnancy period is prolonged, the blood volume in the left ventricle will be affected and continue to decline.

Eventually, progressive dysplasia and heart failure may lead to left heart dysplasia syndrome.

From birth to treatment, children face new dangers every day in their mother's uterus.

Every step is a hurdle, and one wrong step is the gate of hell.

There is a high possibility of stillbirth in the womb. Even if you are born alive, you will have to face countless troubles.

Doctors suggest inducing labor, which is the most suitable option for the current situation.

But the pregnant woman is almost forty years old. She has made a lot to give birth to a child and realize her dream of becoming a mother. She is still persisting while she is already suffering from prenatal hypertension.

For her, giving up this option does not exist.

After listening to the doctor's tactful narration, the pregnant woman firmly refused to induce labor, crying bitterly while expecting a miracle to happen.

Perhaps as the pregnancy process, the child's condition does not worsen, but is relieved. This situation is not impossible, but the possibility is extremely low, so low that it is not necessary to consider it at all.

After choosing to protect the fetus, pregnant women traveled all over the imperial capital. As long as the hospital with high level is in line, the final conclusions are consistent.

This time, it was because the fetal condition was worsening during yesterday's prenatal examination.

The pressure difference of the aortic valve gradually increased from 22mmhg to 85mmhg. The ratio of left and right ventricles gradually became unbalanced. During the observation process, fetal pericardial effusion and mitral valve regurgitation appeared one after another.

All signs indicate that the congenital aortic valve stenosis in the child is developing severely and heart failure occurs.

Just 32 weeks pregnant...

The pregnant woman still disagreed with inducing labor. She disagreed at 24 weeks, and after 8 weeks, her attitude became more firm.

Although she knew that after a caesarean section, the child might have to undergo continuous major surgeries and even die, she still refused to give up.

After discussions by the expert group inside and outside the hospital, three treatment methods were summarized.

First, close observation and conservative treatment.

In fact, there is no way to do this. The current state of the child is not enough to last for 38-40 weeks to give birth naturally.

Second, he was preparing for a caesarean section. After the child was born, he went directly to another operating table and performed thoracic surgery to perform surgical treatment for his congenital aortic valve stenosis.

This treatment method has huge risks.

The child's growth in the pregnant woman is not very good. He has symptoms of pericardial effusion and heart failure in just 32 weeks.

The operation is easy to do...it is extremely difficult, but compared with the child's postoperative recovery, it becomes a very simple and easy operation.

This step is also chosen by almost all doctors.

The doctor who was involved in the operation also invited Dr. Liu Cixi, a nationally renowned doctor, to take the lead in the surgery.

Dr. Liu Cixi has performed the most successful cases in China and has the highest number of successful cases. But even so, the success rate of the surgery is less than 30%.

To be honest, if you choose to keep the child, the family may face the ending of losing both people and money.

Super difficult surgery, ultra-low success rate, and massive daily expenses are all problems.

In addition, there is a third surgical method, which has the development of neonatal cardiac surgery and catheter intervention technology, which can be used for intrauterine intervention.

It sounds like this is an impossible treatment.

The principle is very simple. Interventional surgery to treat congenital aortic valve stenosis. Open up the stenosis site as soon as possible and improve the aortic blood flow as soon as possible.

The benefits are huge, which can promote the development of the fetal left ventricle and create opportunities for postnatal biventricular circulation.

Moreover, if the operation is perfect, the fetus can continue to grow in the mother and will give birth naturally for 38-40 weeks.

The next month and a half to two months are crucial to the fetus!

but,

only,

It sounds beautiful.

Intrauterine interventional treatment does not last long.

In 1991, the world's first related treatment case was first reported by Maxwell D and others. The literature was published in a case report in the magazine New England, which attracted the attention of many interventionists at that time.

To date, more than 200 clinical cases have been reported internationally, concentrated in Western countries. Aortic valve balloon dilation accounts for the majority, and the technical success rate exceeds 50%.

Well, over 50%, in other words, the mortality rate is over 40%, nearly 50%.

Compared with cardiothoracic surgery after laparotomy, this mortality rate is barely acceptable.

but!

Intrauterine interventional surgery is extremely dangerous.

In addition to the fetus, there are risks to pregnant women.

The second option is that pregnant women are sure that there is no problem. However, intrauterine intervention surgery is required, and pregnant women share half of the fetus’ life danger.

At this time, there was a disagreement between the patient and the patient's family.

The pregnant woman firmly demands the third type of intrauterine intervention treatment, while the family members require the second type of surgery.

It is an ancient proposition to protect adults or children.

When the medical level is not developed, it is fatal to have difficulty. There was no caesarean section at that time, so such a proposition would appear.

Nowadays, medical technology has made great progress, and protecting adults or children has become a false proposition.
Chapter completed!