Racing against time
On the night of January 13, doctors at the Central Obstetrics and Gynecology Hospital received an emergency call from the Obstetrics Department - Lai Chau Provincial General Hospital. Here, doctors are making efforts to save the life of a pregnant woman in critical condition, who needs urgent professional support from the end-line.
The patient is Ms. T.U.M, 33 years old, residing in Si Lo Lau commune, a remote commune bordering Vietnam - China. The pregnant woman is pregnant for the third time, has a history of giving birth to two children normally, but has not had regular prenatal check-ups throughout her pregnancy. When admitted to the provincial hospital, the pregnant woman fell into severe pre-eclampsia, a complication of HELLP syndrome - one of the most dangerous obstetric complications, which can take the lives of both mother and fetus in a short time.
The examination and test results were urgently transferred to the Central Obstetrics and Gynecology Hospital for the on-duty doctor that night, MSc.BS Dang Anh Linh - Head of the Department of Endocrinology and Gynecology. The figures appearing show the special danger level of the case: high blood pressure of 150/90 mmHg despite using antihypertensive drugs; severely reduced platelets, only 19.1 G/L (while the safe threshold is 150–450 G/L), which means the risk of massive bleeding if surgery or labor is intervened. Liver enzymes increased about 6 times higher than normal, showing severe liver damage; urinary protein is at an alarming level, reflecting that kidney function has been affected.
Meanwhile, the optimal option for the pregnant woman was emergency cesarean section, but Lai Chau Provincial General Hospital did not have platelets for transfusion, making on-site surgery unsafe.
After reporting to the on-duty leaders, the doctors quickly developed handling plans. The distance from Lai Chau to Hanoi lasted 7-8 hours, posing countless risks: the pregnant woman could have a seizure, severe hypertension, premature boiling... at any time.
The first option proposed was to transfer the patient to Lao Cai Obstetrics and Pediatrics Hospital - the nearest provincial level, taking only about two hours of travel - provided that the hospital had platelets available for emergency surgery. However, quick feedback said that this facility also does not have enough platelet reserves.
Faced with that situation, the plan to transfer the pregnant woman directly to the Central Obstetrics and Gynecology Hospital was activated. Three mandatory and life-threatening requirements were also raised: the transfer vehicle must have an obstetrician and resuscitation doctor accompanying it, capable of emergency treatment, tracheostomy, and cardiopulmonary resuscitation if complications occur; if there are abnormalities during transportation, the patient must be immediately taken to the nearest medical facility, absolutely not trying to travel long distances; all records and test results must be scanned and sent immediately to Hanoi so that the hospital can proactively prepare surgery and transfusion of blood to the right group.
Surgery in the dawn
The inpatient alarm system was activated. Obstetrics, anesthesia and resuscitation, hematology, blood transfusion, neonatal... teams were ready for a particularly dangerous surgery - where there was no room for any errors.
At about 5 am on January 14, an ambulance took the pregnant woman to the Emergency Department of the Central Obstetrics and Gynecology Hospital. As soon as the ambulance stopped, the entire team immediately went to the location. The surgery took place urgently, accurately and safely. The baby cried to be born in the ecstasy of the whole operating room. The baby was born in the 36th week of pregnancy, weighing 2.1 kg, slow to develop in the uterus due to the effects of preeclampsia, and was immediately transferred to the Neonatal Department for further monitoring and intensive care.
The pregnant woman was transferred to the Emergency Resuscitation Department for monitoring and active treatment. In parallel with professional work, the hospital also paid special attention to the patient's family situation. Both husband and wife are illiterate, have no stable job, and are in extremely difficult economic circumstances. The Social Work Department promptly approached, visited, encouraged and developed support plans, connecting charity activities to help the family overcome this particularly difficult period.
It's a bit of a bit of a bit of a bit of a bit of a bit.
