She was pregnant twice, and acute pancreatitis was caused during the twice pregnancy. Once caused the dead child to induce labor, once made the baby’s palace distress and suffered from cerebral palsy.I walked a ghost gate. "
1
Pregnancy made her hover at "Ghost Gate Pass"
What will she choose when she is pregnant again
Having a healthy baby seems to be an ordinary wish, but it is difficult for some people. A Qing is one of them.
A clear body is very healthy, and the diet and schedule are also very regular. There is no dysmenorrhea. The indicators of the medical examination are normal. Hyperlipidemia and repeated acute pancreatitis feel that it is 100,000 miles away from yourself.As a people’s teacher, I never thought that I would have a bumpy on the "descendants".
A Qing had twice pregnant, and acute pancreatitis was caused during the twice pregnancy.At the end of the palace, she was in a coma in ICU for 8 days due to severe acute pancreatitis.After two painful experiences, she took acute pancreatitis in 2016 without being pregnant.The severe physical and mental damage to her almost made her lose her confidence.
She has recuperated, worked hard to find famous doctors, and flew from Shenzhen to Beijing for a good recipe. Her lover had secretly consult the doctor with a hint of hopes to try to conceive another child, and the advice given by the doctor was too high.It is not recommended to try danger.For the daughter of cerebral palsy, the A Qing family also thought about adopting a child.
In May 2018, A Qing accidentally found that he was pregnant.Her first reaction was not joy but fear, and even did not dare to tell her family.As a 36 -year -old mother, she had two unbearable memories, and she wanted to give up.
But with the unconditional support and meticulous care of the family, she finally chose to try again.On July 26, 2018, in Shenzhen Guangming, she also chose the Zhongshan Seventh Hospital as her "professional backing".
2
To ensure smooth pregnancy
The hospital establishes a "small team"
In the early stages of pregnancy, the indicators of Aqing during pregnancy were smooth and normal, and the diet was relatively balanced.
July
17th
Aqing detects blood lipids:
Triglyceride 2.64mmol/L
Total cholesterium 2.58mmol/L
Prompt that glycerin triglyceride is slightly elevated.
At first she was not too nervous, but the progress of the indicators beyond everyone’s expectations, as if a timing bomb opened the countdown, and it was possible to induce acute pancreatitis at any time.
October
4 days
Check blood lipids, data is not optimistic
Triglyceride reaches 13.91mmol/L
Total cholesterol also has 6.75mmol/
A Qingzan
Oral non -Nobeli lipid reduction treatment
November
22nd day
Still on the rise
Triglyceride is as high as 17.09 mmol/L
Total cholesterol rises to 7.53 mmol/L
Simultaneous platelet reduction
In the past three hospitalization, the triglycerides in A Qinghua have severely increased.
The obstetrician was aware of the seriousness of the problem. After explaining the condition to the patients and his family, he immediately received the hospital for further treatment, and the strict blood lipid management during pregnancy was performed.
After admission, the obstetrician conducted a detailed examination of it and found that A Qing had eliminated blood lipid abnormalities and had gestational diabetes.
Faced with A Qing’s special condition, Director Li Tian, the obstetrics of the obstetrics, gave a timely treatment of dual lipids and strictly monitoring changes in the condition.
November
24th
Triglyceride
It has risen to 19.37 mmol/l
The obstetrics immediately launched the discussion of difficult cases, and the patient’s condition was complicated to require multiple departments to work together.
The multidisciplinary discussion model is the characteristic of the Seventh Hospital of Zhongshan, and immediately launched a multidisciplinary diagnosis and treatment plan.
Nutrition of nutritional management, endocrine treatment, hemodialysis center blood purification, surgical escort of general surgery, hematology department of platelet reduction and anemia diagnosis and treatment, ultrasonic departmental protection, etc. The active cooperation of various departments has given obstetric management.Great confidence can strive for more opportunities for patients to extend pregnancy and safe production.
Multi -disciplinary discussion
In order to communicate with the doctor at any time, the medical staff also jointly established the WeChat group for the pregnancy of Aqing.
3
Strict diet management
Finally curbing the rising blood lipids
With the in -depth understanding and analysis of the patient’s condition, Zhongshan Seventh Hospital has released the rearranges of the management of pregnancy to "reduce blood lipids and prevent acute pancreatitis."
After taking the medicine, the triglyceride finally declined, but it was still about 10 mmol/L. This caused the nerves of the multidisciplinary team to be tight. Once the acute pancreatitis was triggered again, the consequences were unimaginable.
The triglyceride monitoring curve during the hospitalization period
In addition to drugs, intestinal nutrition, plasma replacement, there is also a most basic and safe treatment method, which is to reduce fat intake in food and carry out strict diet management.
To this end, the nutrition department formulated recipes and motion plans at different stages of pregnancy for Aqing, and dynamically adjusted according to the indicator.
Electronic scale, nutritional monitoring, diet supervision, software and hardware together.The food also consumes from oil -free cooking, livestock, poultry, and egg yolk to abandon soy products and fish in the end. Only high -protein foods with almost zero fat are retained, and low -fat and high -fiber ingredients such as coarse grains, fresh fruits and vegetables.
A Qing’s triglyceride decreased significantly, from the highest time of 19.37mmol/L (2018.11.24) to 5.94 mmol/L (2018.12.13), cholesterol also decreased from 6.95mmol/L (2018.11.24) to normal range4.9mmol/L (2018.12.5), and starting single medicine lipid -lowering treatment in 2018.12.5.
A record list of A Qing diet during pregnancy
At the same time, the blood glucose of Aqing during pregnancy is stable in the ideal range, without the sense of hunger, no severe hypoglycemia.The condition of pregnant women has improved, and we must also care about the growth of the fetus.
Deputy Director Zhu Yunxiao of the ultrasound department regularly conducts meticulous fetal monitoring for A Qing. What is pleased is that the fetus grows well and is in line with the gestational week.
With the multi-department collaboration and A Qing’s joint efforts, it only rely on non-Nobel Single medicine and nutritional management to stabilize the triglyceride at a relatively secure range of 5-6 mmol/L.
4
The mother and child are safe, and the four words carry are
The weight of multi -disciplinary cooperation
After more than two months of side -side battles, A Qing and the multidisciplinary team of the Seventh Hospital of Zhongshan gradually changed from doctor -patient relationships to close friends.Doctors have gradually expanded from the aspects of nutrition and treatment to psychological guidance from nutrition and treatment.
One day passed, and on January 23, 2019, I couldn’t wait any longer.
At this time, the pregnancy weeks have been 34+5 weeks. Previously, the onset of acute pancreatitis in pregnancy was 35 weeks ago. At this time, the fetus was basically mature. Although it was still premature, the neonatal department of Zhongshan Seventh Hospital had a strong diagnosis and treatment of premature infants.ability.
And even after diet and drug control, triglyceride cannot be controlled below 5 mmol/L. On the morning of January 23, 9.25 mmol/L was reached.
Director Li Tian, the obstetrics and gynecology department, made instructions.
Because the patient’s previous acute pancreatitis seizures caused hypertrophic spleen function, which led to low platelets. Director of the anesthesiology Chi Xinjin developed a small waist -patching solution based on the patient’s situation, which greatly reduced the risk of anesthesia for patients.Successful puncture, smooth implementation of cesarean section,
Surgery!Mother and son are safe!
The 26 weeks of pregnancy from A Qing was extended for 26 weeks.
A Qing named the baby "Wangzi", hoping that the baby’s advent would bring good luck to the family, healthy and safe.
Because Wang Zi was premature, he was sent to the neonatal department for further care.Breastfeeding, nutritional support, kangaroo care and other schemes are fully expanded immediately.
Wang Tsai was carefully taken care of in the neonatal department and was a "kangaroo baby"
Breast method treatment, physical therapy, etc., A Qing who had just given birth has had colostrum, and 1ml is not wasted. A drop of suction to a syringe for children.
Obstetric guards conduct breast care
Under the care of Director Fang Xiaowei and other doctors, Wang Tsai was discharged from the hospital on Valentine’s Day in 2019.
Mother and child peace
After giving birth, the doctor and A Qing himself still did not relax their vigilance. They designed a diet during postpartum breastfeeding during delivery, and strictly monitored the patient’s blood lipids and blood sugar. For the mother, the zero fat diet made her husband laugh and say "Are you addicted to it?", A Qing scolded: "You are here to try it."
A Qing took a happy rapeseed field across the hospital during pregnancy.
Although the process was hard and embarrassed, the gratifying A Qing gave birth to a healthy baby.
"I hope Wang Zai will learn medicine in the future!" As a teacher, A Qing said, his words are grateful.
A Qing sent Jinqi to the Seventh Court
Knowledge background
Acute pancreatitis
Acute pancreatitis can occur at any stage of pregnancy, but the most common in the third trimester is the most common, and the early pregnancy is relatively small. The onset of puerpeath is easy to misdiagnose and missed diagnosis.
The literature reports that the incidence of acute pancreatitis during pregnancy and puercles is about 0.01%~ 0.1%, and 19%, 26%, 53%, and 2.0%of the morning, middle, late and after delivery, respectively.
The clinical characteristics of acute pancreatitis in different pregnancy periods have different clinical characteristics, and the condition and pregnancy affect each other, which has brought difficulties to diagnosis and treatment, especially acute pancreatitis during pregnancy caused by hyperlipidemia.It is a type of disease that seriously threatens the life of mothers.
Text: Liu Anran, Tian Xiaohui
