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Abstract: This article refers to a high-risk pregnant woman who underwent regular maternity checkups during her pregnancy. Ultrasound was performed at 12 weeks of early pregnancy, and no abnormal NT results were found.
Basic information】Female, 35 years old
Type of disease】Down syndrome
Hospital】General Hospital of Heilongjiang Agricultural Reclamation Bureau
Date of Consultation】04/2022
Treatment Plan】Amniocentesis
Treatment Period】5 days of hospitalization, outpatient follow up
Effectiveness】Diagnosis of Down’s syndrome was confirmed, and she recovered well after termination of pregnancy.
I. Initial Consultation
A patient came to the outpatient clinic complaining that she had been menopausal for more than 4 months and was now 17 weeks, and had a non-invasive DNA test during the pregnancy test, which indicated a high risk of trisomy 21. The pregnant woman made an informed decision to induce labor.
II. Treatment
The pregnant woman had regular menstruation before her pregnancy, and early intrauterine pregnancy was detected more than 40 days after menopause, and a progesterone test was performed during pregnancy, suggesting low progesterone. After mid-term pregnancy, she still had vaginal bleeding and was treated with bed rest and fetal preservation. The pregnant woman was anxious and asked me: “Doctor, can I still have this baby? What should I do? I told her patiently and reassured her that she needed to have an amniocentesis to see if she had Down’s syndrome or not.
The result of the amniocentesis was a diagnosis of a duplication of chromosome 21, which is associated with Down’s syndrome, and she was diagnosed with Down’s syndrome. The pregnant woman asked me: Doctor, there is something wrong with this baby, and I am now more worried about why this is happening. Will I be able to have a baby next time? I said: first of all, this child can not be wanted, you feel bad hard can understand, but the problem still has to be solved, need to be hospitalized for induction, the longer the damage to you may be greater. If you want to get pregnant again, you need to undergo a pregnancy preparation test and then consider getting pregnant again. This pregnant woman was finally hospitalized and chose to terminate her pregnancy.
III. Treatment outcome
This pregnant woman was found to be at high risk for trisomy 21 during her pregnancy test, and then underwent amniocentesis after being fully informed, and finally terminated the pregnancy knowing that this child had problems, and was relieved that if the maternity test had not been performed there was a risk of having a problematic child, which would have ended up causing a burden and life impact on the family. The patient was discharged 5 days after termination of pregnancy. The patient showed good recovery of the uterus, good mental status, and the outpatient follow-up showed a good prognosis with no complications.
IV. Notes
We are glad that this pregnant woman recovered well after termination of pregnancy, but the following points need to be noted.
1. Consider pregnancy again 6 months after induction of labor, with the aim of allowing the uterus to be better repaired and in good condition for the next pregnancy.
2.Preconception checkups should be conducted before conception. Detailed pregnancy preparation checkups can avoid many congenital diseases of the fetus. And take oral folic acid for 3 months before conception as prescribed by the doctor, which can effectively prevent fetal neural tube malformation.
3. Pay attention to rest, relax your mind, live a regular life and avoid bad habits such as smoking, alcoholism and staying up late. And strengthen nutrition. Eat a balanced diet and more fruits and vegetables.
V. Personal insights
1, the age of pregnancy ≧ 35 years old, that is, advanced maternal age, is a risk factor, to carry out pregnancy tests on time to avoid adverse events. Advanced maternal age is prone to a variety of risks and complications, pregnancy checkups on time during pregnancy, and if abnormalities may increase the number of pregnancy tests.
2, vaginal bleeding symptoms in early pregnancy may be caused by low progesterone, in the middle and late stages to pay attention to, Down’s syndrome may also appear vaginal bleeding without obvious causes, there may also be late fetal movement, low fetal movement, slow development of limbs, wide nasal spacing, large head and other manifestations. This pregnant woman has vaginal bleeding and continuous fetal preservation, so especially for senior pregnant women, it is necessary to be highly alert for abnormalities, timely consultation and examination, and symptomatic treatment.
3, large month induction of labor for pregnant women is a very difficult process, in the treatment process to give correct and positive guidance, to avoid psychological and spiritual factors affecting life.
4, the pregnancy test is different for each time period, so we need to be on time pregnancy test, the pregnant woman 12 weeks of pregnancy check did not see obvious abnormalities, but 17 weeks of pregnancy check found problems, the two time check the content is different, for pregnancy test should pay great attention to, mainly to avoid the occurrence of birth defects.