Bilateral emergency surgery with rare blood transfusion syndrome

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A successful 14-week twin-engine surgery hospital with a delayed pregnancy, is one of the most of the Vietnamese fetal medicine industry.

Pregnant woman Linh Tram (25 years old) hospitalization Hospital of General Hospital of Hanoi, Ha Noi May 1 when the pregnancy is 14 weeks 5 days, diagnosed with a Phase 3 blood transfusion syndrome, very severe condition. Delayed pregnancy growth (IUGR) with an almost no longer pregnancy. This means that a pregnancy will stop the heart within 24 hours, the remaining pregnancy also opposite the risk of death.

Master, Doctor Dinh Thi Hien le-senior doctors of Obstetrics and Gynecology hospital (Ha Noi) said, usually, blood transfusion syndrome appears in the 16th Week of pregnancy. If the syndrome appears before this period, the fetal death is almost 100%, doctors also often specify termination of pregnancy. History of fetal Medicine recorded very few successful bilateral blood transfusion surgery in the gestational week of 14, 15 weeks due to the baby so the child should be cramped, difficult to observe, the risk of colostrum is very high, if not skilful will fail immediately because the maternity rupture and high miscarriage. At that time, the birth rate is very low.

Dr. Dinh Thi Hien le with Esyrians with foreign experts in this particular case.

However, the patient’s family wishes to perform surgery to save whether only one pregnancy or at least not regret it because it does not ignore the last chance of fragility.

The patient’s situation is very dangerous. Êkip quickly diagnosed with Dr. Julien Stirnemann-One of the leading surgical endoscopic surgeries in France, a surgical spine surgery for the fetus and thousands of endoscopic surgery for bilateral blood transfusion therapy in France.

“If there is no surgical treatment of blood transfusion syndrome for pregnant women, it will surely take both fetus. If a successful surgical operation can save a baby, “Dr. Le recalled the share from Mr. Julien Stirnemann.

While the water slapped, unable to let two baby spirits die slowly, we decided to emergency surgery to save the fetus even if hopefully only 20-30%, master, Doctor Dinh Thi Hien le-Direct surgical recounted.

“While the water is still slapped, it is impossible for two baby spirits to die slowly, we decided to emergency surgery to save the fetus even if hopefully only 20-30%”, Master, Doctor Dinh Thi Hien le-Direct surgical recounted.

To perform this surgery, specialists need a solid knowledge of obstetric, ultrasound engineering, especially surgical techniques in the uterine chamber. The hospital must have modern machine facilities, set of endoscopic equipment specialized in fetal medicine, absolutely sterile operating room. Converging all three important factors, the center of General Hospital of English has successfully surgically over 200 bilateral blood transfusion and continued success with the emergency operation for the maternity surgery. Over 3 hours of surgery, the initial result shows that a pregnancy is rescued. After only a few hours, ultrasound examination reveals fetal circulation develops, amniotic fluid returns to safety levels.

“This is a ‘ perfect ‘ surgery with a gestational period after surgery of a gestational blood transfusion syndrome up to 20 weeks while the world’s average gestational period after surgery is only 12 weeks,” Dr. Hien Le shared.

Baby was born after surgery at the center of General Hospital of England.

Baby was born after surgery at the center of General Hospital of England.

On 21/5, born in maternity boys 1.8 kg, mother-round squares in the gestational week 34, have marked a new volume of complex fetal medicine techniques with the success of the operation in the gestational week, very early in the world and few specialists performed.

“The Heart of England hospital once again established an achievement in the field of fetal medicine, which is the successful surgery for bilateral pregnancy and the smallest gestational age in Vietnam”, Dr. Le said.

According to Dr. Le, more than 2 years ago, all cases of bilateral pregnancies with right-to-water blood transfusion syndrome for treatment, costly money, time, again often ineffective due to excessive barrier to pregnant women can be in timely surgery, such as geographical distance, expensive costs, language barriers…. But nowadays, doctors in Vietnam have been able to master this technique.

Fetal medicine is a new specialisation in the world, it is possible to diagnose the detection and treatment of fetal pathology in the womb, which is the period of modern medicine, which helps to restore the fetus who is facing the death of a very sophisticated, complex technique.

“In the future, we continue to have more advanced techniques for special treatment of CA, such as bladder guidance to save two The kidney is at risk of loss of function after a child’s birth, pleural drainage to avoid the risk of pulmonary oliguria, aspiration of bladder drainage, pulmonary surgery, treatment of blood transfusion syndrome of large pregnancy by reducing the volume of amniotic fluid…, further reaching the surgical treatment of cracking the vertebrae ” , Master, Doctor Dinh Thi Hien Le said.

The syndrome of bilateral blood transfusion is a two or more fetus with only one joint, often encountered in the placenta, and eggs with a late division. The connection between the blood vessels of the two fetus in each one causes the blood of a pregnancy to be transmitted to the other pregnancy. Pregnancy for blood will be less developed, lacking, weakness, and atrophy gradually. Pregnancy receives blood due to excessive blood will grow rapidly leading to heart failure, edema, polymyopathy, bladder tension, polyuria…

The syndrome is divided into 5 phases, at the stage 3 bilateral pregnancies in danger, stage 4 falls into danger, while Stage 5, one or both children are killed. If one of the dead pregnancies the remaining pregnancy will die in the womb.

There is only one way to treat bilateral blood transfusion syndrome, which is fetal endoscopic surgery or laser surgery in the uterine chamber-the laser beam that cuts off the connected blood vessels helps each fetus develop individually, not dependent on the other pregnancy. This surgical method is highly difficult because all manipulations must be performed in the womb of the mother.

Ngoc An

The character’s name has been changed.

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