Health

Three specialties join forces to save the life of the fetus with a complicated congenital heart – VnExpress


17 weeks pregnant with rare cardiac abnormalities, many places are afraid, but the doctor of Obstetrics, Neonatal and Cardiology Department of Tam Anh General Hospital was determined to save the baby’s life.

Born at the gestational age of 38-39 weeks, with a weight of 2.86 kg on August 2, the baby girl of Ms. Le Trong Thien Huong (33 years old, Tan Phu district, Ho Chi Minh City) was treated by doctors at Tam General Hospital. He called it “miracle results”.

Doctor Nguyen Ba My Nhi, Director of the Center for Obstetrics and Gynecology, said that the close cooperation of leading specialties and experts helped the baby to be born safely, have successful surgery and win a chance to live. very little capital. Doctors closely followed, cared for from 24 weeks of pregnancy, treated aggressively right after birth and performed heart surgery for the baby at seven days old. The birth of the baby also had inter-hospital cooperation, with Children’s Hospital 1 in Ho Chi Minh City, Hanoi Viet Duc Hospital sharing rare drugs; Doctor Nguyen Minh Tri Vien from the Heart Institute of Ho Chi Minh City (advisor of the Cardiovascular Center of Tam Anh Hospital) performed the main surgery.

“Up to this point, we have recorded that the mother and baby are healthy, the heart surgery is also successful beyond expectations. The accuracy of the fetal echocardiogram by the cardiologist has helped the hospital to predict and prepare the best possible outcomes. the best conditions to keep the baby during pregnancy, to welcome the baby safely, to have surgery at the most appropriate time,” said Doctor Nguyen Ba My Nhi.

Congenital heart specialist Nguyen Pham Thuy Linh performed an echocardiogram for daughter Thien Huong. Photo: Minh Thuy

After two miscarriages, in the third pregnancy, Ms. Le Trong Thien Huong was shocked when the diagnosis results at week 17 found very serious abnormalities in the fetal heart: large ventricular septal defect, aortic hypoplasia. After many visits and ultrasounds combined with amniocentesis in many different hospitals and obstetric health facilities, by week 24, Ms. Huong still did not receive any hope because of the condition of the fetus with birth defects. The organism is heavy, complex, and beyond the reach of treatment.

Bewildered and desperate, Thien Huong went to Tam Anh Hospital and was diagnosed by doctors with severe hypoplasia of the aortic arch and a large ventricular septal defect in her heart but still had a chance to save her life.

Doctor Nguyen Ba My Nhi at the cesarean section for pregnant woman Thien Huong, August 2.  Photo: Provided by the hospital

Doctor Nguyen Ba My Nhi at the cesarean section for pregnant woman Thien Huong, August 2. Photo: Hospital provides

The Obstetrics and Gynecology team invited the Cardiology Center to perform fetal echocardiography, and held inter-departmental consultations with Obstetrics, Neonatal, Cardiology and Cardiac Surgery. Cardiologists say this is a complex heart disease that threatens to kill the baby right from the first hours after birth.

Hypoplasia of the aortic arch and dual outlet right ventricle is a ductal-dependent congenital heart disease. Normally, the ductus arteriosus will close physiologically a few hours to a few days after birth. As for this child, it needs to be open so that the baby can stay alive, waiting for surgery to completely repair the heart defects.

To open the ductus arteriosus requires a specific drug, Prostaglandin E1, which is a rare drug. At the time of preparing for the operation, hospitals in Vietnam were in short supply of this drug, said Associate Professor, Doctor, Doctor Pham Nguyen Vinh – Director of the Heart Center of Tam Anh Hospital in Ho Chi Minh City.

“We have nearly two months to prepare, but Covid-19 has stopped trade, and the process of approving the import of rare drugs is also very difficult. But the patient can’t wait because pregnant women can give birth earlier than planned. Therefore, we must by all means get medicine for the pediatric patient 10 to 14 days before the cesarean section and take the initiative to have a cesarean section,” said Master, pharmacist Tran Dang Trinh – Head of Pharmacy Department of Tam Anh Hospital in Ho Chi Minh City. speak.

Finally, with the support of doctors and pharmacists from hospitals across the country, 10 days before the caesarean section, the Pharmacy Department had enough medicine thanks to Children’s Hospital 1 in Ho Chi Minh City to share the only medicine tube. the rest, Viet Duc Hospital (Hanoi) sent 10 medicine tubes.

Dr.BS Cam Ngoc Phuong - Director of Neonatal Center of Tam Anh General Hospital resuscitated a child with congenital heart disease after coming out of the womb.  Photo: Tam Anh General Hospital.

Doctor, Doctor Cam Ngoc Phuong – Director of the Neonatal Center of Tam Anh Hospital resuscitated a child with congenital heart disease after coming out of the womb. Photo: Hospital provides

On August 2, the pregnant woman was admitted to the hospital after doing the necessary Covid-19 screening tests, preparing for a complicated surgery. The Obstetrics, Neonatal and Cardiology teams are present in the operating room ready to welcome the baby.

At the Neonatal Center, in addition to maintaining the baby’s life, doctors are also prepared for “pre-operative” conditions, ready for surgery when the baby is only 7 days old.

With severe and complex congenital heart defects, the baby can die right after birth. Therefore, postpartum resuscitation plays an important role. “We resuscitate in the operating room, ensure stable body temperature and respiration, immediately transfer the patient to the neonatal intensive care unit, echocardiogram right in the recovery bed, monitor oxygen saturation continuously, give PGE1 infusion. constantly keep the ductus arteriosus open, absolutely avoid neonatal infections and ensure the baby’s nutrition has enough energy,” said Doctor, Doctor Cam Ngoc Phuong.

The rosy baby was healthy while being cared for at the Neonatal Center, preparing for heart surgery at just seven days old.  Photo: Tuan Lanh

The rosy baby was healthy while being cared for at the Neonatal Center, preparing for heart surgery at just seven days old. Photo: Tuan Lanh

On August 10, the baby had heart surgery. After the surgery lasted nearly 5 hours, Doctor Nguyen Minh Tri Vien shared his happiness despite having operated on tens of thousands of children: “Amidst the peak of Covid-19 epidemic, with the state of Due to the complicated situation of a child from an infertile family, we cannot afford to make even the slightest mistake.”

The surgery was an unexpected success. In order to grow up healthy, the baby will still need to be monitored and cared for in the future. Mr. Duy Quang – the father of the pediatric patient shared his emotions and gratitude when his daughter was saved by doctors and the hospital supported hospital fees.

Doctor My Nhi recommends that, even in the midst of the Covid-19 epidemic, pregnant women should not delay or skip important antenatal check-up milestones in the trimesters of pregnancy because they may miss the opportunity to detect many diseases. hazardous. Modern equipment and experience of experts can detect many diseases and abnormalities in the fetus very early, so that they can be treated promptly while still in the womb or just born.

Minh Huy

In order to solve the worries and questions of mothers during pregnancy, childbirth, and newborn and child care, Tam Anh General Hospital system cooperates with VnExpress Organized Health Consultation Week on Obstetrics, Neonatology and Pediatrics from August 13 to 19 on the Electronic Newspaper VnExpress.

Counseling week with the participation of doctors from Tam Anh General Hospital in Ho Chi Minh City: BSCKII Nguyen Ba My Nhi – Director of the Center for Obstetrics and Gynecology; Dr. Cam Ngoc Phuong – Director of Neonatal Center; Master, Doctor Le Phan Kim Thoa – Head of Pediatrics Department. From Tam Anh General Hospital in Hanoi, there are Associate Professor, Doctor, Doctor Luu Thi Hong – Head of Obstetrics and Gynecology Department; Associate Professor, Doctor, Doctor Nguyen Thi Quynh Huong – Head of Pediatrics Department; Master, Doctor Dinh Thi Hien Le – Senior Doctor of Obstetrics and Gynecology and colleagues. Readers can ask questions here to get advice from experts in the program.

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