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    Medical Case 1: 
    Successful rescue of mother with amniotic fluid embolism

    Ms Liu, 32 years old, was hospitalized in Clifford Hospital after intrauterine pregnancy for 40 +5 week. Her admission diagnosis was G2P1LOA.  Her last menstrual period was February 2, 2006 and the expected date of childbirth was December 11, 2006. Her regular pregnancy checkups were smooth and normal. She had a previous pregnancy and delivered a full term baby boy, weighing 3.5 kg, in 2000.

    Physical Examination: T 36.5 ℃; P 76 times/min; BP 110/70 mm Hg; normal heart and lung. Cervix height 32cm, abdominal circumference 96cm, LOA fetal heart rate 146 beats/min, uterine contraction 25 seconds/6 points intensity. Internal Examinations: ostium uteri size 2cm, exposed caul of -2cm firstly. Normal results for 4 items of routine blood test and 4 items of coagulation tests.


    Four hours after being admitted into Hospital, ostium uteri open fully, resulting in a natural rupture of membranes and amniotic fluid pollution of I degree, then 30 min later, sudden convulsions appeared, with difficulties in breathing, body cyanosis and blood pressure 0, our initial diagnosis was amniotic fluid embolism. Immediately we gave her oxygen and injected dexamethasone (DXM) and treated her with dopamine. On re-checking, her blood pressure was 60/30mm Hg. Immediately we carried out a forceps delivery of a baby girl, her Apgar score: 7-8-10. Five minutes later, the placenta and fetal membranes came out one after another; fair uterine contraction; vagina and uterus bleeding, reason unknown. There was no laceration before delivery. The patient was still in shock and delirious with BP 50-60/30mm Hg. Laboratory tests: HB 6.0 g/L, abnormal coagulation 4 items, 3P test (+).

    Total hysterectomy was carried out after 2 hours: Total postpartum bleeding was 4,500 ml, blood transfusion of 800 ml. After operation, vital life signs were stable. After 6 hours she gradually recovered consciousness. We continued the therapy of blood transfusion, anti-infection and inspection of hysterectomy wall (amniotic fluid was found in myometrium plasma). Ten days later when they left hospital, mother and child were completely well.

     Comments: Amniotic fluid embolism is a rare and risky obstetric complication with a high mortality rate. The amniotic fluid can enter the maternal circulation and cause thrombosis, disseminated intravascular coagulation (DIC), renal failure among other complications. It spreads very rapidly and seriously. Normally, 50% of the patients with amniotic fluid embolism die one hour later. Therefore, hysterectomy played a very important role in rescuing the mother. At the sixth month follow-up consultation after discharge from hospital, mother and son were healthy.

    Medical Case 2: 
    Adopting minimally invasive techniques and integrated medicine therapies to cure sterility.

    Ms. Liao, 28 years old, lives in Shunde Country Garden Estate. She was married for 7 years without pregnancy and had 5 years of periodic abdominal pain which was exacerbated for the last 2 years.  Accompanied with symptoms of nausea, vomiting and diarrhea, she could not sleep well.Though she had visited many hospitals, it was diagnosed as digestive system diseases and could not be cured effectively.

    In February, 2006, she was admitted into the Gynecology Ward of Clifford Hospital to check on pelvic endometriosis. This was the initial diagnose after specialist panel consultation. Considering the strong desire for a baby by the patient and her family, we decided to carry out a minimally invasive operation, with laparoscope and hysteroscope, which are characterized by quick recovery and less interference to the womb. The examination ran smoothly and severe pelvic endometriosis was confirmed.

    In half a year, we prescribed therapy of integrated Traditional Chinese and Western medicines for the illness in order to prevent recurrence and enhance ability to conceive quickly. With great effort, Ms. Liao was confirmed pregnant in November 2006, 2 months after her medication was completed.  Her prenatal examinations were normal. In July 2007, she delivered a baby. It was not only a crystallization of love, but also expression of the mission of Clifford Hospital, and the sweet fruit of the combination of minimally invasive technique and integrative medicine.
     

     
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