I was very happy when I was pregnant for the first time. Listen to your family's advice and have a B-ultrasound at 2 months. When I was 8 weeks pregnant, I went to the community hospital to build a card for an examination. I found all the fetal heart germs, and almost everything was normal, except for the low platelet count, which was 60. The doctor asked me if I had any bleeding symptoms, but he ignored me.
I went to the city for a maternity check-up in pregnancy 16 weeks, and the Tang screening passed smoothly, but the blood routine showed that the platelet was still low, only 44. Scared by the doctor, I suddenly panicked and began to take all kinds of blood-enriching drugs.
Bad luck happened during the 20-week pregnancy test. At that time, the doctor repeatedly helped me listen to the fetal heart, but I couldn't hear it.
The doctor made a B-ultrasound report: second trimester, stillbirth.
At that time, the whole person was confused and could not accept this fact. It was dark in front of me, but fortunately my family was with me to comfort me.
The doctor asked me to go to the hospital to induce labor as soon as possible, which was very painful. Everyone who has experienced it knows the helpless pain. After induced labor, a 350g baby boy was born, which was in line with 20 weeks of pregnancy. Fetal umbilical cord placenta looks normal.
The doctor couldn't tell the reason why the fetus died in the palace. He said that such a large gestational age might be an accident. Generally, there are many accidents in the first three months, encouraging me to start while I am young and well.
However, Xiao Gu did not believe that something had happened. She said that she searched for articles about stillbirth in the palace almost every day and joined some sisters to keep warm before she came out slowly.
After 45 days of induced labor, Xiao Gu started my examination. The first examination she did was bone marrow puncture, in order to find out the cause of low platelets.
But the conclusion of the examination is idiopathic thrombocytopenia. To put it bluntly, even doctors don't know why.
After that, she and her husband checked a series of complete sets of abortion tests for urban women and children, such as chromosomes, nails, cervical human papillomavirus, autoantibodies and so on. I didn't find any problems after doing it. The doctor told her to rest for half a year before she could prepare for her next pregnancy.
Later, she said, intuition told her that she could no longer check locally, and it was a waste of time not to find the problem locally. Inadvertently, she joined the sister group and talked about Bao Shihua's team and Zhao Aimin of Yan Chai Hospital.
After that, she went directly to a woman and baby for a full set of fetal arrest. The problems found are: high platelet aggregation rate and high anti-β glycoprotein IGG.
A woman and baby, Dr. Gu Lei told her that she had anticardiolipin syndrome, which was a bad pregnancy caused by immune coagulation factors. This factor may lead to insufficient blood supply or fetal growth restriction, not only in the first three months, but also at any stage of pregnancy.
So under the guidance of the doctor, I began to use aspirin+prednisone to prepare for pregnancy. Because of low platelets, there is no heparin in pregnancy.
Soon, in the third month after taking the medicine, Xiaogu became pregnant again. She was surprised and happy, and then bought a ticket to give a woman and baby their first diagnosis after pregnancy. After examination, it is good to double the progesterone, the platelet aggregation rate and anti-β glycoprotein are normal, and the D2 polymer is 0.3, continuing the abortion protection scheme of 3 Aga 1.
In the seventh week of pregnancy, she had the fetal heart of the embryo bud, and the D2 aggregation rose to 0.4. Dr. Gu Lei added 1 heparin every other day, but considering the low platelet, he voluntarily refused to add heparin, and wanted to observe it again.
Xiao Gu/KLOC-graduated a pregnant baby in 0/2 weeks. She is not at ease. She heard that it was better for Renji in Shanghai to have a miscarriage in big month, and later she went to Renji to have a miscarriage.
Considering anticardiolipin syndrome and thrombocytopenia, we should not only do anticoagulant therapy, but also be alert to bleeding. She hung up on Jin Yi, director of Renji Obstetrics, and decided to stay with her until she was born.
At the 0/9th week of pregnancy, the D2 aggregation of her sister-in-law suddenly soared to 3.44, and her platelet dropped to 30. She asked Dr. Gu Lei and Dr. Jin Yi to prescribe heparin for her, but both doctors refused her because her platelets were too low.
Dr. Gu told her that her condition needs heparin, but her platelets must be raised to above 50 first, otherwise she and the fetus are at risk of bleeding.
Jin Yisheng thinks that she doesn't need heparin, because her platelets are low and her blood coagulation function is not good, so she shouldn't do anticoagulant therapy.
During this pregnancy near the last accident, she said that she felt that if heparin was stopped, the fetus might die again in the womb.
She searched online for the fastest way to improve platelets: intravenous injection of human immunoglobulin. After returning to the local hospital, she immediately went to a doctor for hospitalization. She injected gamma balls for 5 days and lost 8 bottles every day. As a result, when she was discharged from the hospital, her platelets not only did not rise, but also fell.
At that time, she was devastated, and the hematologist told her in-laws not to take such a big risk with her body in order to save the child. But she didn't want to give up. She said that if Shanghai can't help her keep the insurance, she will go to Beijing, and she will keep the child anyway!
Everyone thinks she's crazy and doesn't think about herself at all.
After leaving the hospital, she consulted Liu Xiangyuan of the Third Hospital of Beijing Medical University online. Liu Xiangyuan told her that she must take heparin, and it is 2 tablets a day!
Under the guidance of Liu Xiangyuan, she replaced prednisone with methylprednisolone, and added vancomycin, cyclosporine, calcitriol and heparin.
After heparin injection, her platelets remained between 30 and 40 and did not drop again. The D2 composite index fell to 2.4. After 365,438+0 weeks, she rented a fetal heart and did fetal heart monitoring at home every day, afraid to relax.
By the 34th week of pregnancy, she went to Renji for a check-up, and blood coagulation in the third trimester became more and more difficult to control. Her D2 polymer was injected with 2 heparin tablets every day, the value was 4.25, and the S/D ratio was 2.94.
Dr. Yan Ji Jin Yi assessed that the baby is developing well and is almost 5 kg. She suggested that you can receive platelet transfusion in advance at 36 weeks of pregnancy, and then cut the baby out to prevent accidents.
However, at 35 weeks+1, Xiao Gu had severe contractions, which could not be suppressed even if he hung up the security guard. The fetus is in breech position again. In case of emergency, caesarean section is performed under general anesthesia. At that time, she went directly to the operating table without losing platelets. After the operation, the doctor told her that her platelets were only 24, and where the knife was cut, the blood poured out. Intraoperative bleeding 1000 ml, everyone changed it for her.
Fortunately, in the end, the baby was fine, male treasure, 5 kg and 2 Liang, and everything was safe!
Today, Xiao Gu's baby is over one year old. Looking at the healthy and lovely baby, she felt that all her efforts were worth it.
Xiao Gu said that she was helped and encouraged by many people throughout her pregnancy. She was considered to be a doctor after a long illness. Here, she summed up some experiences to share with her struggling sisters:
1. Don't take any chances. Most abortions are not accidents. Be sure to check the reason!
2. Don't waste time in small places, the inspection items are limited and the results are inaccurate. Abortion must be seen in a big hospital. Some doctors in the local hospital don't know anything about this.
3. We must pay attention to anticardiolipin syndrome. Obstetrics often manifests as repeated abortion, intrauterine growth restriction, fetal death and so on. Sisters who have had accidents, even if they are positive and then turn negative, must use drugs to prevent miscarriage throughout pregnancy.
Liu Xiangyuan, a doctor from the Third Hospital of Beijing Medical University, thinks that the possibility of anticardiolipin syndrome should be highly considered for those who have clinical manifestations, even if they are not positive, because anticardiolipin antibodies include 13, but only a few items have been investigated in China.
4. Aspirin, prednisone, fenle, cyclosporine, heparin and other drugs are safe to use during pregnancy under the guidance of a doctor. Take prednisone for example. In the doctor's words, more than 90% are inactivated before entering the placenta, and the remaining ingredients are not enough to affect the fetus.
6. When you meet some big decisions, you should consider the opinions of several doctors comprehensively, and don't make a decision just by listening to the opinions of one doctor.
7. Don't give up your baby easily unless you have to, but don't treat it blindly. Only by protecting your body can you have combat effectiveness.