1.Severe disseminated intravascular coagulation complicated by acute renal failure during pregnancy
World Journal of Emergency Medicine 2023;14(5):411-413
Disseminated intravascular coagulation (DIC) is a clinical syndrome caused by various etiologies and characterized by systemic activation of blood coagulation, leading to vessel thrombosis, organ dysfunction, and severe bleeding.[1] DIC represents a life-threatening condition that is the endpoint of uncontrolled systemic activation of the disease. Once it enters the stage of malignant DIC, the patient’s death becomes unavoidable. DIC always occurs as a secondary disorder and is commonly associated with postpartum hemorrhage, followed by hypertensive disorders, acute fatty liver of pregnancy, sepsis, and amniotic fluid embolism (AFE).[2] In clinical obstetrics, DIC often occurs during delivery or postpartum, while cases of prenatal acute DIC as the first manifestation are uncommon. Patients with DIC have higher rates of multiple organ dysfunction syndrome, including acute renal failure (ARF), respiratory failure, and disturbance of consciousness.
2.Perinatal nursing care of a patient with twin pregnancy and delayed delivery of the second fetus with placenta previa
Xuerong ZHANG ; Yuqun PU ; Shuping LU
Chinese Journal of Nursing 2023;58(24):3023-3027
To summarize the experience of perinatal nursing for 27 days of delayed delivery of the second fetus of a twin pregnancy with placenta previa.Key nursing points include:the start of high risk warning during delayed delivery,and being alert to placenta previa hemorrhage;effective prevention of infection,reducing the incidence of maternal sepsis and chorioamnionitis;actively inhibiting the contractions to prolong gestational age and improving the perinatal survival rate of the second fetus;strengthening in utero fetal monitoring,identifying the early signs of fetal distress;targeted implementation of personalized psychological nursing,to ensure the mental health of patients.The rescue plan during delivery should be improved to ensure the safety of mother and child.Postpartum prevention and treatment of massive bleeding was actively conducted,as well as the prevention of puerperal infection.After 79 d of active treatment and intensive nursing care,the patient was treated and discharged from the hospital without any signs of infection or a massive bleeding.The second newborn,whose delivery was delayed,was discharged from the hospital 59 d after birth,and the follow up was continued for a month until the reach to the standard growth development parameters and the overall physical examination was good.