blenderwars Chapter 382
Chapter 382
Chapter 382
Twin Transfusion Syndrome (TTTS),
This is a relatively serious complication of “single villus, double amniotic sac, single egg twins”.
How serious is it?
In layman’s terms, it is the mother—the main valve of the blood supply system·artery—the blood supply system branches to the two fetus·artery (in the umbilical cord)—two fetuses—the blood supply branch·venous (in the umbilical cord)—the blood supply system Main valve-mother body…
And now, there is a problem with the main valve…
It should have been two branches, each taking about 50%.
And now, the younger sister supplies 35%, and the older sister supplies 65%…
In layman’s terms: it is the sister who “robbed” her sister’s blood.
In this case, it is of no benefit to either the sister or the sister.
The younger sister will develop anemia and hypovolemia, resulting in insufficient renal perfusion, oligohydramnios, and even death due to malnutrition.
The older sister has increased blood volume, congestive heart failure, fetal edema, and excessive amniotic fluid.
Without treatment, the mortality rate of the fetus is as high as 90%!
then what should we do?
It’s very simple,
That is, through the fetal mirror, under the guidance of ultrasound, it enters the uterus and uses laser to burn off the blood vessels that connect between the two babies.
Turn the main valve directly into a branch!
In this way, there will be no uneven distribution.
The explanation is simple, but the actual operation is difficult.
·Difficulty 1: Now the two babies are 22 weeks old, and the total weight is estimated to be less than 2 catties, or a little more than 2 kg, which is as big as a mouse. The smaller the target, the more difficult the operation.
·Difficulty 2: This is not to perform surgery on pregnant women, but to enter the uterus through the pregnant women and perform operations on the baby. The difficulty is increased by another level.
·Difficulty 3: The blood vessels at the main valve position are confluent and enriched, so the operation is difficult and it is easy to involve other blood vessels.
The above difficulties,
Decided that this operation is not something ordinary people can do!
The department of obstetrics and gynecology happened to be short of manpower, so the director of the department of obstetrics and gynecology approached Lin Feng and wanted to see if Lin Feng could do it.
“How is it? Dr. Lin, is this operation safe?”
“This operation is fine, I took it…”
Lin Feng readily agreed.
Director of Obstetrics and Gynecology Department: “Okay, Dr. Lin, this operation was arranged by another doctor. The time is to wait for 11 o’clock, but something went wrong at his house, so please come to the Obstetrics and Gynecology Department at 10 o’clock. Once, to understand the situation, the operation will start at 11 o’clock…”
Lin Feng: “Good.”
hang up the phone.
Lin Feng looked at the emergency doctors and nurses in front of him.
Shrugged,
“It looks like I’m going to take time off this morning…”
The doctors are embarrassing~~~
Crying~~
I thought that Lin Feng’s return could relieve their pressure, but he was called away all at once.
However, I was also shocked that Lin Feng could perform fetal surgery.
This difficulty is much harder than a gastroscope!
…
10:20…
Lin Feng came to the obstetrics and gynecology department, and then learned more about the conditions of pregnant women and fetuses (various examination results).
Then I communicated with the pregnant woman and family members several times, and obtained the consent and signature of the family members.
Then start 30 minutes early and take antibiotics to prevent postoperative uterine infections.
11 o’clock……
The pregnant woman is pushed into the operating room…
Sterilization is strictly carried out. Lin Feng and others strictly implement aseptic operation…
B-ultrasound, fetal scope, and laser are ready…
general anesthesia……
B-ultrasound start, observe the position…
Adjust the lying position of the pregnant woman and choose an appropriate angle.
Determine the fetal size and fetal position under B-ultrasound detection, understand the position of the placenta, amniotic fluid volume, and choose the puncture point of the fetal scope…
Lin Feng’s technique is still very powerful, and he succeeded in a one-time puncture.
Moving clouds and flowing water…
It seems to have done it 10,000 times!
After the puncture was successful, Lin Feng quickly inserted the puncture trocar into the amniotic cavity and then withdrew the needle core, inserted the fetal scope into the cannula, and extracted 40ml of amniotic fluid for chromosome karyotype analysis.
The 600um laser fiber is introduced into the amniotic cavity, and the output power of the semiconductor laser is conventionally set to 20W…
Choose a suitable position (1cm away from the vascular anastomotic branch (main valve))…
Start to burn…
Soon after the blood vessel was burned, it became “pale” under the display of B-ultrasound.
Successfully blocked!
When I got here, the operation was temporarily stopped,
Wait 10 minutes…
Lin Feng continued to observe the internal situation through B-ultrasound to see if there was any bleeding.
finally,
Make sure there is no bleeding.
Lin Feng began to withdraw from the fetal scope…
Then release the amniotic fluid of the blood fetus (sister)…
Why do you want to do this operation?
Because my sister has too much amniotic fluid, it is not conducive to growth.
0 ········Find flowers·····
When Lin Feng put about 1500ml, it stopped.
Here,
The operation is over!
Lin Feng continued to observe for 10 minutes.
The patient’s vital signs were stable during the operation, the twins were in good condition in the uterus, the placenta was not touched at the puncture point, and there was no amniotic fluid overflow or bleeding…
At this point, the operation was officially ended.
Lin Feng pulled out the puncture needle…
Suture the puncture hole…
Wait for the pregnant woman to wake up.
Operation time: 1 hour 04 minutes…
When Lin Feng pushed the pregnant woman out of the operating room, the family members surrounded him worriedly.
…
Got this operation done,
In the evening, the obstetrics and gynecology department invited Lin Feng to eat a meal, and many young nurses ran away.
…
at the same time,
0 …… …
at night,
Basketball court of Mizuki University.
A lively little game is underway.
“Pass…”
“Quick, quick…”
“Defend, cover him!”
“Be careful Zhang Chen…”
On the field, the ball game is very intense, and experienced players are in rapid offensive and defensive battles.
On the sidelines, many onlookers were waving the flag and shouting.
Sudden,
“Ah~~~~”
The player Zhang Chen suddenly felt dizzy, weak, and back pain. The shooting action he had prepared was stopped, and he fell directly to the ground, and then was accidentally stepped on by his teammate.
“Zhang Chen!”
“Are you OK?”
“Fuck me!”
The scene was a bit chaotic.
The game stopped.
“It’s okay, you continue, I’ll take a break…”
Zhang Chen limped to the side of the court and sat down to rest.
His waist started to ache again.
Since three months ago, he suffered from this old problem, suddenly dizzy, and sometimes low back pain. He used to play basketball very well, but now he has become more commonplace.
“What’s wrong? It hurts again?” The girlfriend walked over quickly and asked with concern.
“Yes… I don’t know what’s going on…” Zhang Chen frowned.
“It’s better to go to the hospital to check it, in case there is a problem, it will be troublesome.” The girlfriend said.
“Hmm…” As a student of Mizuki University, he has a bright future and naturally cherishes his body.
“There will be no class on Saturday the day after tomorrow. I will accompany you to the hospital for an examination…” said the girlfriend.
“good.”
……again.