In today’s sudden outbreak of doctor-patient conflicts, media reporters who claim to be “social instruments” and “moral conscience” should be extra cautious when reporting these cases and should not easily and directly conclude that doctors and hospitals are to blame. At the very least, consult with professional doctors and medical scholars first, so as not to make jokes about “why amniotic fluid embolism was not checked out beforehand”. The news that “a woman in Xiangtan died of hemorrhage after a caesarean section” has become the most sensational topic on the Internet in China this Wednesday morning. The news itself and its repercussions will not be described here. I will only briefly explain two issues here. First, when I saw the description, “the pregnant woman died with a mouth full of blood”, I immediately thought of amniotic fluid embolism (the final diagnosis also confirmed this), the most dangerous demon in obstetrics and gynecology, a difficult case that human medicine has not been able to overcome so far. In short, amniotic fluid embolism is the sudden entry of amniotic fluid into the maternal circulation during labor. Since amniotic fluid contains a variety of contaminants (fetal fetal fat, meconium, fur) and procoagulant components, it can both directly obstruct blood vessels and act as a strong coagulant, causing acute pulmonary embolism and severe shock conditions. Diffuse intravascular coagulation, in particular, will cause uncontrollable systemic hemorrhage in the mother, while other contaminants entering the bloodstream can cause widespread acute infection and kidney failure; both of which have a high potential to lead to death. The cause of this emergency is usually a strong contraction of the uterus, resulting in rupture of the membranes and entry of amniotic fluid into the circulation through the uterine incision. To date, prenatal screening in human medicine has not found a way to detect this precursor and has not been able to develop adequate measures to prevent it. The patient then has a rapid and urgent attack after the rupture of the fetal membranes, and it is often too late to resuscitate. Although the rate of amniotic fluid embolism is only about 1 in 20,000, the maternal and fetal mortality rate is as high as 80%, making it the most dangerous complication in obstetrics and the leading cause of maternal death that remains today. Many people are not quite comfortable with the reality that there are maternal deaths in today’s medical boom. But in fact, the risk of maternal delivery, although greatly reduced with the help of contemporary medicine, has a maternal mortality rate of about 10 per 100,000, or one in 10,000, even in developed countries. Among the causes of maternal death in developed countries, nearly half are hemorrhage and acute infections caused by amniotic fluid embolism. And in Africa, where maternal mortality rates are as high as 1,000 per 100,000, or 1 in 100,000, it’s mostly obstructed labor and unsafe abortions. In the case of China, the maternal mortality rate of 2 in 10,000 nationwide and less than 1 in 10,000 in major cities is low enough overall, but it is still a great tragedy that falls on any one family. So far, on this planet, human medicine has not found a way to confirm the risk of amniotic fluid embolism during prenatal examination, which is an unpredictable medical problem that is extremely difficult to save. The author here to say that every pregnant woman is great, tribute to the mother. From the current video report and description of the delivery and resuscitation process, because the fetus is too big, the doctor initially suggested a cesarean section, the family insisted on a normal delivery; later the mother was in too much pain (uterine contractions were too strong) and was forced to turn to a cesarean section, and after the baby was born, it was found that the amniotic fluid had entered the bloodstream and the mother was in danger. A prepared cesarean section is precisely the most effective way to reduce and avoid amniotic fluid embolism. The incision of the uterus instantly attracts the amniotic fluid in the first place, and the incision is safe and controlled because there is a hemostatic forceps clamp that prevents the amniotic fluid from entering the venous vessels. The family’s lack of medical understanding and failure to give timely consent for conversion to cesarean section was the main reason why amniotic fluid embolism was not avoided. The further failure of the family to respond after being informed of the condition was the direct cause of the death of the pregnant woman and failure to save her life. According to the development of the condition, the doctor suggested to remove the uterus to save the adult – this is one of the keys to deal with the severe amniotic fluid embolism and to resuscitate as a last resort, mainly to be able to reduce the contact surface between the amniotic fluid, fetal membrane and the main wound, and to stop the bleeding quickly, in short, to save the life must remove the uterus to stop the bleeding (instead of cutting the uterus to cause hemorrhage as reported by the media). Again, due to the family’s lack of understanding of medicine, the doctor issued a notice of critical illness and recommended that the uterus be removed to protect the adults, the family, especially the daughter-in-law’s mother-in-law, objected, saying, “How can we have a second child after this, we can’t do it and transfer to a hospital. But at this point, can we still transfer the baby to another hospital? According to Dr. Xu Yun Yun, a clinical medicine doctor, there was a case of amniotic fluid embolism at the Union Hospital, where the uterus was removed and more than 10,000 ml of blood was transfused, which is more than twice the amount of human blood, equivalent to all the blood donated by more than 50 blood donors. In the end, the pregnant woman was saved, but the fetus was not preserved. And this was at the Union Medical College Hospital, one of the top hospitals in China, thanks to the resources of multiple blood stations in the mega-city of Beijing. Many small cities don’t have entire blood stations stocked with this much single blood type blood. At this county-level maternal and child health hospital, the doctors exhausted all feasible resuscitation initiatives and brought in city experts for consultation, despite the family’s obstruction of key lifesaving measures. Throughout the incident, the hospital actively resuscitated the patient and informed and communicated about her condition several times. In fact, that afternoon, the entire Xiangtan medical system was working hard to save the pregnant woman, mobilizing blood sources around. The team of experts did their best from 1pm to 9pm, doing their best to save the life of the doctor. If it has been determined that the patient died, the medical staff evacuation is also normal, not to say that the patient has died a bunch of doctors and nurses to stay around to guard the body. Not to mention the emotional situation of the family, are standing there meekly waiting to be beaten? Of course, the family encountered this kind of skyrocketing tragedy, what to say and do, never mind right or wrong, the mood can be understood. But some of the media so reported, is a serious failure. The media is actually a “peculiar existence” (in the words of one of my media colleagues), since it claims to be “responsible for reporting everything”, which requires the reporter to be a generalist. But in reality, generalists have long ceased to exist in this world. Due to the time constraint, many media people who have not even entered the door start to boast about everything in the world based on their very limited knowledge and very narrow knowledge structure (compared to the complex world). There is no shame in not being knowledgeable, no one in this world is a generalist. What is shameful is that in the age of the Internet, some superficial common sense that can be understood in a few minutes is not understood, so they go to clamor for attention and use shocking and explosive news headlines to spark public conversation and create greater social conflicts. The family can not have medical knowledge (of course, it is best if you know beforehand), but a highly educated journalist should not be without it when assuming the sacred status of “social instrument”. It is normal not to know beforehand, so you can learn quickly and briefly, and ask for expert advice. If you want to spread news on the Internet as a “social tool”, why not use the Internet as a tool to learn quickly first? And then consult the multiple views of various experts? With some basic common sense and understanding, and then speak out on the issue, which will not take a few minutes in total. Especially in today’s sudden outbreak of doctor-patient conflicts, media reporters who claim to be “social instruments” and “moral conscience” should be extra cautious when reporting these cases and not easily conclude that doctors and hospitals are to blame. At the very least, they should consult with professional doctors and medical scholars first, so as not to make ignorant jokes about “why amniotic fluid embolism was not detected beforehand”. Not to do this work is a technical failure of the media; not to do it deliberately, to create a topic of sensationalism, to achieve the purpose of speculation, to increase social unrest for no reason, is morally unscrupulous and shameless. The doctor-patient relationship has come to this point, although all parties have a great deal to do with it, but some media irresponsible reporting is also a very important part of it to push the wave and create something out of nothing. Remember the 80 cents to cure colonic atresia, midwives sewing anus, hospital “baked baby” and other dramatic reversals of events? May the deceased rest in peace, may unnecessary strife no longer. May the doctors save lives and help the injured, and may the journalists shoulder justice. May each of us, as a member of society, have professional ethics and moral conscience. The author is a commentator for the Phoenix News client. Related news: A gynecologist and obstetrician about “Xiangtan maternal death on the operating table, doctors and nurses collectively play missing” some science friends have always reminded me not to get involved in the discussion of doctor-patient relationship, because the doctor-patient relationship is the best gap for some people and some bad media to transfer the conflict. However, as an obstetrician and gynecologist, I feel obliged to say something about this misleading tweet from @XinJingDaily with angry emojis, even if I have 40 patients waiting for me in the specialist clinic an hour later! Let’s start with the @XinJingPao tweet that made thousands of people righteously indignant. I have the following to say about this: 1. In the past, women giving birth to children was called the “ghost gate”, and many women lost their precious lives because of human reproduction. The development of modern medicine has made it possible for the majority of women to pass this hurdle with ease, far more than a tenth of the time. However, so far it is not foolproof and there is still a certain probability of death. 2, although in my new book “Womb Affair” to be published in early September, I reassured women that with the escort of modern medical technology, having a child is still relatively safe and women need not worry too much. However, the probability of losing a woman’s life because of childbirth should be higher than the probability of being killed in a traffic accident, and even higher than the probability of winning a lottery ticket. They say that airplanes are the safest means of transportation, but there are always reports of air crashes. Fortunately, not everyone will not fly because of fear of air crashes, because after all, it is a small probability event. 3. There are at least the following cases of maternal death caused by cesarean section: 1. anesthesia accident; 2. cardiovascular accident; 3. amniotic fluid embolism; 4. hemorrhage. Generally speaking, hemorrhage leaves doctors more chances of successful resuscitation, and mothers rarely die on the stage because of uncontrollable bleeding; it is really not possible to remove the uterus, and the bleeding can usually be controlled. 4, anesthesia accidents and cardiovascular accidents are sudden and many times difficult to foresee. Just as a person may normally have no problems, but collapses after running 1500 meters. Since the hospital in question has no authoritative voice, it is not known whether there are these two conditions during the operation. 5, I am more suspicious of another situation, namely amniotic fluid embolism, which is a life-threatening emergency in obstetrics. According to some insider microblogging sources, the mother probably died from amniotic fluid embolism. One could start by saying in layman’s terms that an amniotic fluid embolism is actually the fetus that murders the mother! Why would you say that? 6, because, amniotic fluid embolism is defined as: amniotic fluid suddenly enters the maternal circulation during delivery causing acute pulmonary embolism, anaphylaxis, diffuse intravascular coagulation, renal failure or sudden death, a serious complication during labor, with an incidence of 4/100,000 to 6/100,000. 7. During vaginal delivery or during cesarean section, amniotic fluid enters the blood circulation of the pregnant woman through the placental abruption or surgically incised incision. It is the tangible substances produced by the fetus in the amniotic fluid (fetal fine hair, keratinized epithelium, fetal fat, fetal feces) and procoagulants that cause a series of allergic reactions, leading to rapid maternal death. 8. The mortality rate of amniotic fluid embolism is very high, it used to be said to be 100%, which is too absolute, just as there are occasional survivors in air crashes. But it is generally believed to be at least 80%! Many times, even the best doctors can’t help, and I followed the leader to successfully save a woman with amniotic fluid embolism years ago. But not every time, not every doctor, not every patient has such good luck. 9, for @XinJingBao this show lower limit microblogging, journalist peer @ WangZhiAn commented: “the news of the death of that pregnant woman is surprisingly video, smashing the operating room door when the media reporter was on the scene. If I were a doctor and a nurse would have run, not run waiting to be killed? Now this doctor-patient relationship, as long as the death of people, regardless of the reason, it is not strange to kill a doctor and nurse. But in the reporter’s report, this became a play missing” 10, can be seen, the same media people, responsibility and conscience are very different. Can journalists covering medical news consult a professional before sending out a story? Some of my media friends I know sometimes ask for my opinion when it comes to medical stories, and I’m happy to oblige.