Hospital of twin deaths: amniotic fluid embolism

 Hospital of twin deaths: amniotic fluid embolism

Amniotic fluid embolism is one of the top five causes of maternal mortality, according to a report released on the website of the National Health Commission. According to the 2017 statistical bulletin of Chinas health development, amniotic fluid embolism accounts for 11.2% of the main causes of death of urban pregnant women and 15.0% of the main causes of death of rural pregnant women.

According to the admission records of Jiahe County Peoples hospital provided by Cao Haiying, Cao Haibins younger sister, Xiao Yuyan, the deceased, was admitted to the hospital on December 25, 2019 with a 39 week + 5-day period of menopause. He was physically fit and had a boy before. The doctors examinations and daily course records were basically normal, and the changes occurred at 8:30 p.m. on January 1.

The medical record is just had a vaginal examination, the uterine opening was 4cm wide, and was sent to the delivery room for delivery.. On the way to the delivery room, the patient complains of chest tightness and shortness of breath, comforts the patient to calm down breathing and immediately delivers to the delivery room for oxygen inhalation.

At 10 oclock in the evening, the rescue records were as follows: the patient suddenly lost consciousness during the conversation and should not breathe; the patient immediately had hemoptysis after spitting at the mouth; the patient immediately received high flow of oxygen; the continuous ECG monitoring indicated that: the blood pressure could not be monitored and the heart rate was not monitored; the patient: the face was blue and the pupil was dilated: pulmonary embolism was considered? Amniotic fluid embolism? Immediately perform CPR and mouth to mouth artificial respiration Due to the failure of the patients midwifery without uterine aspirator, Li Jianbo, director of medical department, and Li Yanhua, deputy director of medical department, instructed the emergency diagnosis in the delivery room immediately to perform caesarean section to rescue the newborn; according to the caesarean section procedure, the fetus was quickly taken out, and if the fetus was paralyzed, it was immediately handed over to the newborn pediatrician for rescue. After cardiopulmonary resuscitation, the patient still had no vital signs and died at 22:00.

Cao Haiying told the surging news that doctors announced that both adults and children died of ineffective rescue. At that time, amniotic fluid embolism was mentioned, but the family still could not accept the fact.

On the evening of January 2, Li Jianbo, director of the medical department of Jiahe County Peoples Hospital, who participated in the rescue, told the surging news that Xiao had amniotic fluid embolism during production. This is a relatively dangerous disease, only a few minutes from onset to death. Pulmonary embolism is connected to the pulmonary artery, causing cardiac arrest. At the same time, Li Jianbo said, experts from our hospital have come. Anesthesiologists, cardiologists and neonatologists are all doctors above the deputy director, but amniotic fluid embolism is too fast. Its too late to predict. Nobody can do this.

Case records provided by Cao Haiying showed that the doctors ward round records on December 25 showed that the hospitals blood coagulation monitoring instrument was faulty.

But Li responded that the fault had nothing to do with Xiaos amniotic fluid embolism.

Li Jianbo also said that amniotic fluid embolism is very rare. In 2017, there was a case of amniotic fluid embolism in the hospital, in addition to pulmonary embolism in other departments. (embolism) this thing is unpredictable and unexpected

Surging news contacted Dr. Li Yanhua, an obstetrician and gynecologist involved in the rescue. She hung up after confirming the fact that the patient died. Deng sannu, the director of newborn Pediatrics who participated in the rescue, was still full of regret when she was interviewed. Amniotic fluid embolism was so fast that when the child was still in the stomach, the adults condition changed. I met this situation for the first time

Cao Haiying said that his sister-in-law had a 7-year-old boy who had been in good health. Unexpectedly, Cao Haibin, his elder brother, called out the medical records and relevant monitoring materials to apply for medical appraisal to confirm whether the doctor was at fault during the diagnosis and treatment process and caused the accident.

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