Pregnant woman N.T. M. L (born in 2003, residing in Dong Nai) contracted dengue fever while 39 weeks pregnant. At the beginning of August, she suddenly had a high fever, was taken to a nearby hospital and was diagnosed with Dengue fever. Because she was at the end of pregnancy, she was transferred to an obstetrics specialty hospital in Ho Chi Minh City for monitoring.
When there were signs of labor, she was indicated for a cesarean section. However, after giving birth, the condition deteriorated rapidly. The pregnant woman suffered from uterine hemorrhage due to uterine anesthetic, accompanied by severe blood clotting disorder due to acute liver failure. Despite receiving many blood products, platelets and hemostatic surgery, the bleeding situation still lasted.
The patient gradually fell into blood loss shock, infection, uterine damage and multiple organ failure, and was then transferred to the Intensive Care - Poison Control Department, Gia Dinh People's Hospital.
Upon admission, the pregnant woman was in a deep coma, blood pressure dropped, had to have endotracheal intubation and mechanical ventilation. Platelets were only about 17 G/L, blood clotting disorders and severe liver failure caused the risk of bleeding to continue to increase.
Faced with the critical condition, the intensive care team actively performed blood transfusions and blood products, respiratory support, plasma replacement, liver failure treatment, infection control and blood clotting disorder adjustment.
Due to severe uterine damage, infection and prolonged bleeding, doctors were forced to perform a hysterectomy to control the source of bleeding and preserve life. This was a difficult decision because the pregnant woman was young and had just given birth to her first child, but in a dangerous situation, the top priority was to control bleeding and infection.
After surgery, the patient continued to experience deep pelvic bleeding and fell into a blood loss shock.
Including the previous treatment process and at Gia Dinh People's Hospital, the pregnant woman underwent 4 major surgeries and interventions in a short time.
According to BS.CKI Tran Quang Huy, Department of Intensive Care - Poison Control, Gia Dinh People's Hospital, this is a particularly complex case when severe dengue fever, liver failure, blood clotting disorders, postpartum hemorrhage and infection occur simultaneously. After more than 15 days of continuous treatment, Ms. L.'s health improved significantly.
For pregnant women, dengue fever needs special monitoring. When platelets decrease and blood clotting ability is affected, the risk of hemorrhage during labor or postpartum may increase. If a pregnant woman has labor or has surgery at the right stage of severe illness, controlling bleeding becomes even more difficult.
Doctors recommend that pregnant women should proactively prevent mosquito bites, when fever appears during pregnancy, they should not self-treat at home but need to go to a medical facility for examination and timely monitoring.
