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Pregnant woman in critical condition with unknown cause

Ho Chi Minh CityA 37-year-old woman, 27 weeks pregnant, suddenly had pulmonary hypertension, severe heart failure, and the risk of death for both mother and child.

Before that, the pregnant woman’s health was normal, the pregnancy was monitored at the local hospital and no cardiovascular disease was detected. Two weeks before being admitted to the hospital, at 25 weeks gestation, she had difficulty breathing and swollen feet, thinking that the symptoms were normal in pregnancy, so she did not go to the doctor. When her illness got worse, she went to the Hospital of University of Medicine and Pharmacy in Ho Chi Minh City for examination.

Doctor Bui The Dung, Head of Cardiology Department, University of Medicine and Pharmacy Hospital, Ho Chi Minh City, at the end of April, said that the patient had severe pulmonary hypertension leading to grade 3 heart failure, right ventricle and upper veins. liver, inferior vena cava dilated, poor prognosis. In fact, such severe pathology contraindicates pregnancy. Doctors consider the option of terminating the pregnancy to preserve the mother’s life. However, not willing to give up the first child, 27 weeks pregnant, which the couple had been waiting for 6 years to have, the mother earnestly suggested that the doctors “still have water to slap”, try to save them both. .

In order to realize this legitimate but extremely difficult wish, an interdisciplinary consultation of Cardiology, Obstetrics and Gynecology, Neonatology and the Emergency Open Cardiovascular Surgery Resuscitation unit and the Anesthesia unit found the best solution. superior. Accordingly, the patient was transferred to the Department of Cardiology for medical treatment of heart failure and pulmonary hypertension. At the same time, the treatment team plans to prolong the pregnancy, try to raise the fetus in the womb until the body is fully developed, in order to minimize the effects of premature birth on the baby’s health. after.

Pregnant women are supported to breathe oxygen, use diuretics, help increase myocardial contractility, dilate pulmonary arteries. When her condition was more stable, she was transferred to the Anesthesia and Resuscitation unit for cardiovascular surgery, specially monitoring the mother and fetus’s condition, waiting for the cesarean section at the appropriate time.

“We were always in the spirit of being able to C-section the baby as soon as there was an emergency launch from the cardiac resuscitators,” recalled Doctor Tran Nhat Thang, Head of the Department of Obstetrics and Gynecology.

After 30 days of almost absolute convalescence in the hospital bed, at the 31st week of pregnancy, the mother was appointed by the doctor to take the initiative to carry out a caesarean section. A baby boy weighing 1.4 kg was born safely but had to be separated from his mother and transferred to the Neonatal Department for three more weeks before discharge.

The mother’s health after surgery worsened, adding complications of kidney failure, requiring continued active treatment for several weeks. Fortunately, after that, she responded to treatment, progressed gradually, complications of heart failure and kidney failure were effectively controlled.

Currently, both mother and child are stable, healthy and discharged from the hospital.  Photo: Provided by the hospital

A healthy mother and daughter pose for a photo with a doctor before being discharged from the hospital, on April 28. Image: Hospital provides

According to Dr. Dung, pulmonary hypertension has many causes, such as congenital heart disease, heart valve disease, coronary artery disease, lung disease, autoimmune disease… This woman, after surgery During pregnancy, doctors did many types of paraclinical tests, including CT of the chest, chest and blood vessels, but could not find the cause of the disease. Her condition is therefore called primary pulmonary hypertension – of unknown cause. In the future, patients still need to maintain monthly medical check-ups for heart failure.

One of the most prevalent diseases in reproductive age adults is cardiovascular disease. Therefore, women need to check their health carefully before becoming pregnant and in the first months of pregnancy, in order to detect potential or existing diseases early. In case of disease, pregnant women need to have a treatment plan from the beginning and throughout pregnancy to ensure safety for both mother and baby. As soon as there are abnormal signs, pregnant women should examine, detect and promptly treat diseases to avoid severe progression as in the above case, Dr. Thang recommended.

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