2050 Saving the adult or saving the child is an ancient question.
The Imperial Women’s and Children’s Hospital was one of the top Gynecology and children’s hospitals in the Imperial City, and even in the entire country.
The number of newborns delivered every year was about 35000.
This place was bustling all year round, like a market. Even during the new year, when other large tertiary Grade A hospitals were quiet, this place was still lively.
Unlike other large-scale general tertiary Grade A hospitals, most of the people here were in a jubilant mood instead of looking dejected.
After all, it was a good thing to have a new child.
There were more than ten maternity wards in the Women’s and Children’s Hospital. The doctors ‘offices in each Ward were filled with pennant banners that could not even be hung up.
People were in high spirits when there was a happy event, and the mother and son were safe. It was only natural to send wedding money and banners.
However, the atmosphere in the first Ward of the obstetrics department was a little off today.
The door of the doctor’s office was closed. Those who were not in the operation were sitting in the office. The experts and professors from other hospitals and the hospital leaders were sitting in the office.
The air froze, as if a major medical malpractice had occurred. No one spoke.
It had happened more than two months ago.
A 39-year-old pregnant woman found that the child in her belly was suspected to have congenital aortic narrow during an examination.
At that time, the fetus was only twenty-four weeks old, and it was obvious that there was a congenital aortic narrow. It could be said that the standard of women’s and children’s hospitals was quite high.
After seeing the results, the doctor explained the situation to the patient and the patient’s family.
Due to the congenital abnormal development of the aortic valve, it led to left ventricular septal defect heart disease, which accounted for about 3% to 6% of congenital heart diseases.
If a fetus developed aortic valve anastomosis during the early or middle stages of pregnancy, the blood volume in the left chamber would be affected and continue to decline as the pregnancy dragged on.
In the end, it could lead to progressive dysplasia and heart failure, forming left chest dysplasia syndrome.
From birth to treatment, and even in the mother’s womb, the child would face new dangers every day.
Every step was a pit, and a wrong step would lead to death.
The possibility of the fetus dying in the womb was very high, and even if it was born alive, it would have to face countless troubles.
The doctor suggested abortion, which was the best choice for the current situation.
However, the pregnant woman was almost 40 years old. In order to have a child and fulfill her dream of being a mother, she had sacrificed a lot. Even though she already had pregnancy-induced hypertension, she still persisted.
To her, the option of giving up did not exist.
After listening to the doctor’s tactful explanation, the pregnant woman firmly refused to induce labor. She cried while hoping for a miracle to happen.
Perhaps, as the pregnancy went on, the child’s condition would not worsen, but would get better. This situation was not impossible, but the possibility was extremely low, so low that it did not need to be considered at all.
After choosing to keep the baby, the pregnant woman went to all the hospitals in the capital. As long as the hospital was of a high standard, the final conclusion would be the same.
This time, it was because the condition of the fetus had deteriorated during the prenatal examination yesterday.
The pressure difference between the aortic valve gradually increased from 22 mm hng to 85 mm hng. The ratio of the left and right ventricle gradually became out of proportion. During the observation, the fetus’s pericardium effusion and atrial septal defect were seen.
All the signs showed that the child’s congenital aortic valve breadth was developing into an extremely severe condition, and he was showing signs of heart failure.
She was only 32 weeks pregnant …
The pregnant woman still did not agree to abortion. She did not agree when she was 24 weeks old, but after 8 weeks, she was even more determined.
Although she knew that after a cesarean, the child might have to undergo continuous major operations and might even die, she still did not give up.
After a discussion by the hospital’s and outside hospital’s expert team, they concluded three treatment methods.
First, close observation and conservative treatment.
In fact, this was the last resort. The child’s current condition could not last for 38 to 40 weeks of natural delivery.
Second, prepare for a C-section. After the child was delivered, he would go to another operating table and perform a thoracotomy on him to treat his congenital aortic narrow.
This treatment method was extremely risky.
The child’s growth in the pregnant woman’s body was not very good. In just 32 weeks, she already had symptoms of pericelus effusion and heart failure.
The surgery was easy … It was extremely difficult, but compared to the child’s postoperative recovery, it was a very simple and easy surgery.
Almost all the doctors had voted for this step.
The hospital had also invited the well-known doctor in the country, Liu Cixi, to be the chief surgeon.
Doctor Liu Cixi had performed the most similar surgeries in the country, and the number of successful cases was the highest. 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 might end up losing both their money and life.
The extremely difficult surgery, the extremely low success rate, and the huge amount of money spent every day were all problems.
In addition, there was a third surgical method that surpassed the development of Cardiovascular Surgery and catheter intervention technology for newborns, and it could be used for ectopic transplantation.
It sounded like an impossible treatment.
The principle was simple. It was to perform interventional surgery to treat congenital aortic valve anastomosis. He had to clear the narrow part as soon as possible and improve the blood flow of the aorta.
The benefits were huge. It could promote the development of the fetus ‘left chamber and create an opportunity for the Twin ventricular cycle after birth.
And if the surgery was perfect, the fetus could continue to grow in the mother’s body until the 38th to 40th week of natural delivery.
The next one and a half months to two months were of utmost importance to the fetus!
But,
However,
It sounded very beautiful.
Ectopic transplantation had not been around for a long time.
In 1991, the world’s first relevant treatment case was first reported by Maxwell D and others. The article was published in a case report in The New England Magazine, which attracted the attention of many interventional physicians at that time.
So far, more than 200 clinical cases had been reported internationally, concentrated in Western countries. Most of the patients had a success rate of more than 50% when it came to aortic valve balloon dilapidation.
Well, more than 50%. In other words, the mortality rate was more than 40%, close to 50%.
Compared to cardiothoracic surgeries, this kind of mortality rate was still barely acceptable.
But!
Ectopic transplantation was extremely dangerous.
Other than the fetus, it was also dangerous for the pregnant woman.
For the second plan, the pregnant woman was sure to be fine. However, if the fetus was to undergo an ectopic transplantation, the pregnant woman would have to bear half of the risk.
At this time, the patient and the patient’s family had a disagreement.
The pregnant woman herself insisted on the third type of treatment, ectopic transplantation, while her family members demanded the second type of surgery.
To save the adults or to Save the Children, this was an ancient proposition.
When medical treatment was not advanced, difficult labor was fatal. At that time, there were no C-sections, so there was such a proposition.
Now that the level of medical technology had advanced by leaps and bounds, it had become a false proposition whether to save the adult or the child.
However, when this ancient choice was placed on the table, all the doctors helplessly realized that it actually existed.