With a complex case… Chinese Medical Team Saves Pregnant Woman
In a remarkable display of medical collaboration, the China-Sierra Leone Friendship Hospital successfully managed a rare and complex case involving twins.
A 36-week pregnant Sierra Leonean woman was urgently referred to the hospital due to sudden abdominal pain and irregular fetal movement. Upon assessment, doctors discovered that one of the twins had a congenital giant umbilical hernia (omphalocele), coupled with intrauterine growth retardation (IUGR) and fetal distress.
A large portion of this fetus’s liver and intestines had protruded into a hernial sac outside the abdomen, creating a highly risky situation with a significant threat of perinatal mortality.
The 25th Batch of the China (Hunan) Medical Team (CMT) swiftly assembled a multidisciplinary team, which included experts in obstetrics, neonatology, surgery, anesthesiology, and nursing. Led by Dr. Chen Zhihui, the team developed an emergency treatment plan and performed a cesarean section that saved both the mother and her twins.
Upon arrival, Dr. Chen conducted a rapid preliminary assessment and enlisted Dr. Zhang Min, an ultrasound specialist, who confirmed the hernia diagnosis. The ultrasound showed a 7 cm cystic-solid mass containing part of the liver and intestines at the base of the umbilical cord of one twin. The hernia’s thin sac had not ruptured, preserving the organs but still presenting significant risks. The affected fetus was estimated at 32 weeks gestational age with growth restrictions, while the other twin, estimated at 33 weeks, showed no abnormalities.
Umbilical hernia in fetuses is a rare, serious condition where abdominal organs, such as the liver and intestines, extend outside the body. This condition, especially challenging in low-resource settings, increases the risk of complications like membrane rupture, hypoxia, and infection.
Dr. Chen’s team included Dr. Xu Zhijie, a surgical expert who planned the intricate repositioning of the herniated organs, and Dr. Lei Xiang, a neonatologist who assessed the risk of respiratory complications and prepared a plan for resuscitation. Professor Ling Feng, an anesthesiology specialist, devised a safe anesthesia strategy. Together, they decided on an emergency cesarean section while preparing for immediate postoperative care for the infant.
During surgery, Dr. Chen and Dr. Li Hucheng, alongside Sierra Leonean obstetricians, successfully delivered the twins. The first twin was healthy, weighing 2200 grams. The second twin, affected by the hernia, weighed 2000 grams and displayed respiratory distress. Dr. Lei Xiang managed the infant’s airway and provided respiratory support, while Dr. Xu temporarily repositioned the herniated organs. Nurse Zhao Sha’s team ensured aseptic conditions and stable body temperatures throughout the surgery.
After the procedure, the hernia-affected twin was moved to the Neonatal Intensive Care Unit for further care, while the healthy twin and mother recuperated in standard wards. The team’s skilled, coordinated efforts not only saved lives but also demonstrated the expertise and dedication of the China Medical Team in Africa, showcasing a valuable model of cross-continental medical cooperation.
