Nghe An Obstetrics and Pediatrics Hospital: Saving the life of a newborn with internal organs herniated outside the abdominal cavity

Pregnant woman L. (residing in Con Cuong district) was pregnant for the third time but did not go for a check-up or screening in the first trimester. On July 21, 2022, the pregnant woman went for a check-up at the Center for Prenatal and Newborn Screening and Diagnosis,Nghe An Obstetrics and Pediatrics Hospital. Here, doctors discovered that the 31-week-old fetus had an abdominal wall defect, causing the internal organs to be outside the abdominal cavity. In addition, through amniocentesis, the genetic results of the fetus did not reveal any abnormalities.

Recognizing that the child's malformation was life-threatening and required immediate emergency care after birth, the Center for Prenatal and Neonatal Screening and Diagnosis organized an interdisciplinary consultation with the participation of the Department of Obstetrics, Department of General Surgery, Department of Neonatal Emergency Resuscitation, Surgical Intensive Care, Department of Anesthesia and Resuscitation to prepare the best support and treatment plan for the mother and child after birth... On August 26, the mother showed signs of labor. The mother was assigned an emergency cesarean section with the support of a team of doctors from the Department of Obstetrics, Anesthesia and Resuscitation, and Pediatric Resuscitation.

At birth, the baby weighed 2.2 kg; was malnourished, hypothermic, had signs of dehydration, and respiratory failure. The baby had an abdominal wall defect that caused the stomach, the entire small intestine and colon, gallbladder, and right ovary to protrude out of the abdominal cavity. The baby's stomach and small intestine loops were dilated, and the first part of the ileum had type 3b intestinal atrophy. After providing emergency care to the baby in the operating room, the Pediatric Intensive Care Team quickly transferred the baby to the Surgical Intensive Care Unit for treatment.

Surgeons put the organs back into the child's abdomen. Photo: Hoang Yen

The Intensive Care Surgery doctors quickly consulted with the Department of Surgery. Here, the child continued to receive comprehensive care, warming, intensive resuscitation, mechanical ventilation, intravenous nutrition, and emergency exploratory tests. After 2 hours of intensive resuscitation, the doctors of the General Surgery Department performed surgery to return the internal organs to the child's abdomen. The child's herniated organs were arranged in the abdomen according to the anatomical position and drained the ileum to the skin in the right iliac fossa, treating abdominal wall defects and type 3b intestinal atresia.

Master, Resident Doctor Ta Thi Quynh Anh - Head of the Department of Intensive Care Surgery shared: "The Department of Intensive Care Surgery has received many cases of children with congenital abdominal wall clefts. However, cases of multiple hernias, with most of the digestive organs herniating out like this, are quite rare, requiring comprehensive care and treatment, close assessment to ensure the patient's overall condition."

After surgery and intensive treatment, the child's health improved well. Photo: Viet Ha

After surgery, the child continued to be resuscitated and cared for comprehensively by the medical staff of the Department of Surgical Intensive Care, ensuring sterile procedures. After 10 days, the child was weaned off the ventilator, paired with the mother, and practiced breastfeeding. The child responded to the treatment regimen. Currently, the child is breastfeeding well, the colostomy produces yellow stools, and is in stable condition. The doctors have discharged the child, with an appointment for a follow-up visit in 2 months to close the colostomy.

Thanks to the coordinated diagnosis, treatment support, and timely care throughout the pre-, intra-, and post-natal process of specialized departments,Nghe An Obstetrics and Pediatrics Hospitalhelped the mother give birth successfully, saving the life of a newborn with very complex birth defects. Saving the child's life has once again affirmed: Patients treated at Nghe An Obstetrics and Pediatrics Hospital always receive the most effective, comprehensive and safe care and treatment.