When the newborn is born, the fetal membrane sac will naturally break away, commonly known as "breaking amniotic fluid".However, it is produced by expectant mothers with severe liver stasis, but due to the elevated serum bile acid, gallbladder salts are deposited in the placenta, bile acid has toxic effects, and it may be dead at any time.In order to protect the newborn to the greatest extent, on August 29, the obstetric experts from Hanyang Hospital of Hubei Provincial People’s Hospital for the reserved membrane cesarean section for her, and premature babies weighing 2.4 kg were wrapped in a transparent "membrane protective shell".After hospitalization and treatment, the mother and baby were discharged on September 2.
Ms. Mo, 28, finally conceived her baby at the end of last year. I did not expect that her whole body itching suddenly appeared in 28 weeks of pregnancy in early July this year. She couldn’t sleep at night and had to go to the hospital.Ms. Mo said that she began to feel itchy hands and feet, and then she was the belly, and then her whole body was all the seals of blood red.
Professor Wu Lirong, director of the obstetrics department of Hanyang Hospital of Hubei Provincial People’s Hospital, recalled that Ms. Mo’s total serum total bile acid is up to 252.6 μmol/L (the normal range is 0.1 ～ 10.0 μmol/L), which is a severe stasis in the liver during severe pregnancy.Too dangerous, the total bile acid is 25 times higher than the upper limit of the normal value, and there may be no signs of tires at any time.Immediately strengthen fetal care, treat bile depression, pay attention to protecting the liver, improve the placenta cycle, promote the maturity of the lungs, and try to extend the gestational week.After comprehensive treatment of hospitalization, Ms. Mo’s overall situation improved and asked to continue oral treatment for discharge.
Professor Wu Lirong repeatedly instructed that if you want to keep the child, you must review regularly and check on time. If you have any discomfort, you must come to the hospital as soon as possible.Until mid -August, Ms. Mo, who was 34 weeks of pregnancy, came to the hospital for a checkup, and the total bile acid rose to 40.2 μmol/L. The bile acid was very high. According to the principle, Ms. Mo had a strong desire to extend the week of pregnancy.After repeated communication, Professor Wu Lirong took a lot of risks and tried to help Ms. Mo extend the gestational week. After the comprehensive treatment of the drug, the situation improved again.Until August 29, the patient’s whole body itching symptoms increased again, and the review of total bile acid rose to 40.5 μmol/L again.
"I can’t wait any longer. After 35 weeks of pregnancy, I will immediately notify the anesthesiology department and neonatal department. Immediately prepare surgery, and perform a septic section in vitro." Professor Wu Lirong decisively disposal, thin fetal membranes thinSuch as the cicada wings, it is very easy to rupture, not to mention that Ms. Mo’s fetus is premature but too large. During the cesarean section, the fetal membrane should be completely retained.After evaluating the selected incision, Professor Wu Lirong and the surgery assistant Dr. Zhang Yuanyuan cooperated together to expose the fetal head from the narrow incision, followed by the shoulder and body, and finally gave birth to the in order to ensure that the amnia in the fetal membrane was not broken., A slowly moved out, and finally gave birth smoothly.Within 10 minutes of the operation, when the baby girl cried, the doctors finally relieved. After being guarded by the newborn department, 2.4 kg of heavy baby girls were very healthy.
Using this method to give delivery to the greatest extent to protect the fetus in Ms. Mu’s belly, Professor Wu Lirong said that because of the immature development of premature infants and organ development, the development of the nervous system is not complete, and the tolerance of hypoxia and mechanical stimuliPalace surgery damage to premature babies.The baby is born with a fetal membrane. They are still relatively safe as they are in the mother’s body when they are delivered. They can reduce the loss of moisture on the skin after birth.Pressure of uterine contraction is pressure on the fetus and its accessories.
Bile stasis during pregnancy is because the estrogen changes the cell membrane, which causes the bile excretion to be unobstructed. It can only be accumulated in the liver of a pregnant woman. Once a long time of pregnant women, bile acid is too high, causing symptoms of chole by stasis.Professor Wu Lirong, director of the obstetrics department of Hanyang Hospital of the Provincial People’s Hospital, introduced that although bile stasis has little impact on expectant mothers, the bile of stasis is the fatal poison of the fetus.It directly affects the nutritional supply and waste metabolism between the fetus and the mother. The use of useful things is insufficient, and the harmful things cannot be transported. The gall salt seizes the placenta, which will cause a series of complications of the fetus, such as amniotic fluid pollution, fetal distress, and distress, and the fetal distress.Premature birth and even death, and the death of this fetus may suddenly appear without signs.
The pregnancy in the liver of pregnancy cannot be predicted. Professor Wu Lirong suggested that the majority of pregnant mothers must be vigilant during pregnancy.Once diagnosis is confirmed, treatment should be treated as soon as possible. During pregnancy, bile acid treatment has no effect on the fetus, but it must be reviewed regularly.During this period, avoid scratching by hand. When you rest, choose the left side to increase the placenta blood flow. Pay attention to the light diet to reduce the burden on the liver and promote the discharge of bile acid.
Reporter: Correspondent Zhao Lin