323. Trigger

Author: Hao Xifeng

323. Trigger

[Many descriptions in this chapter may cause discomfort, so read with caution]

Since the birth of safe cesarean section, it has become the fundamental measure to terminate pregnancy with placenta previa, especially central placenta previa, and to rescue massive bleeding from placenta previa.

If you have a complete plan in advance, choose YD delivery in a prepared manner, and have a plan for fetal traction or fetal destruction to avoid continued heavy bleeding, this is undoubtedly a safety measure that can effectively reduce maternal tissue damage.

After all, cesarean section means physical damage, and central placenta previa often requires a fundal incision, which reduces the strength of uterine contraction and is not good for subsequent pregnancies.

Kawei has tried both options and knows that each has its own pros and cons. Cesarean section is about the convenience of vision and hemostasis, while yd delivery is about less damage and faster recovery. But if the preparations are not complete, there are disadvantages in both.

Small risk. Not to mention

Now that he has chosen to destroy the fetus, Kawei no longer has any worries.

As soon as the words came out, before these people could react, he replaced the obstetrician responsible for helping deliver the baby at the nearby Main Palace Hospital with one of his own: "Damirgang, press the fetal head right here, and press down with the heel of your palm.

, fix the head at the entrance of the pelvis.”

Damirgaon had no worries about the two French doctors. He believed that if he wanted to learn skills, he would have to risk everything. He could do anything: "Is this enough?"

"Push harder."

"Try harder"

"It's almost done." Kawei lay on his stomach and glanced at the fetal head that was forcibly squeezed downwards. Then he pulled Beget over and grabbed two broad-leaf yd hooks and stuffed them into his hands. "Separate the two sides and pull

good."

"good."

"Herman."

"Here we go, the hemostatic forceps." Herman found the most suitable instrument at hand just as Kawei finished talking about how to cut the skull. "Use these forceps to clamp the scalp to fix it."

"kindness."

Two hemostatic forceps clamped the child's scalp up and down, and the exposed middle fontanel was cut 2-3cm with the scalpel in Kawei's hand: "If you can't find the big and small fontanels or the child's head is not in a good position, you can choose cranial suturing.

Pass right through.”

Because there was no cranial piercing device, Kawei could only use oval forceps instead. He used his palms to press the shaft lock between the central handles of the forceps, followed the incision that had been made, and closed it to enter.

There is no skull under the fontanel, and with just a little force, it is easy to penetrate the subcutaneous suture membrane and meninges: "The next step is simple. While fixing the fetal head, we open the forceps, then rotate left and right, stirring

Break the child’s brain”【1】

Kawei's emotionless commentary made everyone tremble. The two obstetricians from the Palace Hospital frantically crossed themselves on their chests and muttered words without daring to look directly.

"I repeat, this is a stillbirth. Haven't you ever seen a stillbirth?" Kawei showed no mercy, and the brain tissue flowed out in a short while, or it could be said that it was forcibly taken out with the brute force of oval forceps. "

What’s more, this result was a decision made by Professor Hugill after everyone discussed and agreed upon it.”

"You don't have to bear the pressure, as long as you don't say anything out loud." Hujir knew that he had gone too far. "I just hope that tomorrow's major newspapers will praise this unexpected birth before the operation, instead of being the same weird and negative thing as before.

"

Their eyes were still full of disgust and fear about abortion, but they had to agree under Hujir's intimidation.

In stark contrast to them is Good Hope.

Without the shackles of religion, he can easily understand the reasons for abortion. In fact, there is no need to understand, abortion has been around for a long time.

What Shanwang really cares about is the abortion process, because compared with the complicated and high-end cesarean section, the fetal destruction technique requires much less learning. For them, it is not easy to come to Paris even if they don't learn a little bit.

How can things go back to meet their ancestors?

"What should I do if the position of the fetal head is not good and the fontanel cannot be found?"

"You can look for bone seams." Kawei always spared no effort in answering his questions. "The skull of the fetus has not yet closed, and the texture is soft, so it is easy to find."

Shanwang nodded, understanding what he meant, but immediately had a new question: "What if the child's head is like this."

He assumed a strange posture, raised his head sharply, and moved his chin forward: "What if the face is too low? There should be no bone seams here."

"That's even simpler." Kawei explained, "The face is all soft, and you don't even need a scalpel to make incisions."

Shanwang had no surgical experience, but he had learned anatomy well from Huang Kuan, and he immediately understood what he meant: "Oh, it turns out it's the eyes and mouth. There are indeed many options available after it's clear that the baby is stillborn." [2]

The two of them spoke in English, and the content was somewhat shocking, but no one could understand it, so the scene seemed very calm.

Shanwang's pen never stopped, and the questions immediately extended from the head position: "It's not difficult to deal with the fetus with the head down, but what if it is breech? How to deal with the head with the butt down?"

"Break the legs first, and then they can come out in batches."

"So this is the idea." Shanwang's eyes lit up, and he seemed to understand the central idea: "If it is horizontal, does it mean cutting it off in the middle?"

"Indeed, if possible, use your hands to introduce a wire saw, which is an instrument used for craniotomy, and then perform transverse truncation." Kawei sighed, "The object can be the body, the neck, or other places,

It depends on the handling habits and specific location."

"understood."

It always sounds very strange for a Chinese-speaking Chinese and a German-speaking Austrian to discuss in English something forbidden by Catholicism in a French operating theatre.

Kawei's miscarriage is still going on, and what she is encountering now is just a disagreement in ideas. The real trouble is actually the possibility of weak uterine contractions later on.

As time passed by, some doctors began to gather at the entrance of the surgical theater.

They all came to appreciate the rare cesarean section, especially today, where placenta previa may cause violent bleeding. Everyone wanted to see how Kawei handled it. There was still nearly an hour before the operation, so this enthusiasm was enough.

Show respect for Kawi.

But when they showed their identities with the badges given by their medical association, they were told that they could not enter.

"What does this mean? We agreed to enter the venue, but why did we suddenly change our minds?"

"I don't know. I'm just a guard at the gate. I just received the order." Although there are gatekeepers here, they are not as overbearing as the surgical theater in Vienna. They are very casual. "Ask the obstetricians for the specific situation.

.”

The two original surgical assistants now appeared at the entrance of the theater, serving as explanations: "The operation may have to be cancelled."

"Cancelled? How could it be canceled?"

"Did something happen to Dr. Carvey?"

"Don't be kidding me. Paris is so safe. How can something go wrong?"

"I mean other situations, such as being unable to get away for a while, or other reasons."

Their reaction at first was like ordinary people. The sense of expectation that had been built up for more than half a year finally collapsed in an instant. But after their medical brains began to work crazily, someone noticed another

Possibility: "Is there something wrong with the mother?"

"Placenta previa, 37 weeks pregnant again."

"Isn't it a sudden labor?"

"It's possible, but that would be troublesome."

The two assistants did not know what was being done in the preparation room, and they were not around when the decision to destroy the tire was made.

The so-called telling the truth is exactly what they said, telling the whole process of the mother from labor bleeding to before. The bleeding does not seem serious, but only obstetricians who have been exposed to placenta previa know that,

If the cervix does not open and the placenta does not descend, it is very dangerous for the child to get stuck in the uterine cavity.

"Doesn't Dr. Kawei have medicine? Isn't it possible to use medicine?"

"I tried it but it didn't work. The bleeding has been more than 700 ml. It took a blood transfusion to barely maintain the normal level!"

"Placenta previa, the month is enough, and there is still bleeding, so what are you waiting for? This should be the perfect opportunity for surgery, just cut open the uterus and take out the baby!"

"Yes, if you can't go down below, then you can go down the belly. Isn't it just a coincidence?"

Most of the people who came here were experienced surgeons, and even obstetricians from many other hospitals. The more they heard about it, the more they felt that there was something fishy about this matter. The assistant didn’t think too much about it, and said that the mother did not want surgery, but just wanted to give birth.

Read it again.

"So the time of the operation cannot be determined, and the final decision of whether to operate or not is entirely up to Dr. Kawei himself."

"This is too messy. Delivering placenta previa depends entirely on luck. If you are not careful, the mother's life will be lost."

"More than that. I saw the operation two days ago. Dr. Kawei's cesarean section was as clean and tidy as picking up the baby. It's definitely an advantage over the slow yd delivery! It's an absolute advantage!!!"

The louder the praise, the more excited those who want to see the operation become, and the more they question the decision not to undergo surgery temporarily: "Since it is the treatment, it is the doctor who has the final say, why should we listen to the mother? If it is the mother who makes the decision from the beginning.

, then what else do we need a doctor for?”

As soon as these words came out, comments abounded. Apparently, they had met some patients who thought they knew a lot: "Only doctors who have undergone rigorous training know how to judge the condition. What do patients know?"

"Even if someone is really fooled, it's just a coincidence. If you can fool one person, can you fool a hundred or a thousand?"

"Some doctors are indeed so benevolent that they ignore the objective reality of medicine."

"I don't think Dr. Carvey would make such a misjudgment."

"But he is too young after all, and it is normal for him to be inexperienced. Coupled with his temper and personality problems, he is likely to be led by some patients."

"Don't forget, you guys, Professor Hugill is also inside. That stubborn old man must be self-centered and would not agree to such a random treatment plan."
To be continued...