Good news at the beginning of 2024: Detection of a rare congenital duodenal obstruction during pregnancy, Hai Phong International Obstetrics and Pediatrics Hospital collaborates with specialists to successfully perform surgery and treatment for the newborn patient.
Recently, the doctors at Hai Phong International Obstetrics and Pediatrics Hospital successfully performed surgery to treat a baby boy with congenital duodenal obstruction. This is a rare condition with an incidence rate of 1 in 5,000 to 1 in 10,000 live births.
Ms. K.K.A from Dong Khe, Ngo Quyen, Hai Phong chose Hai Phong International Obstetrics and Pediatrics Hospital for her second pregnancy. However, during the prenatal management at the hospital, through ultrasound results, Dr. Doan Thi Thuy Ha – Head of the Obstetrics and Gynecology Department discovered that the fetus showed signs of congenital duodenal obstruction. This condition has a very high mortality rate if not diagnosed and treated promptly. Understanding the anxiety and concerns of the mother and her family, the doctors provided thorough counseling, developed a birth plan for the mother, and discussed intervention methods after the baby was born. With the encouragement and wholehearted attention of the doctors, Ms. A felt more confident and reassured to monitor and manage her pregnancy at the hospital until the delivery day.
By the 36th week of pregnancy, after assessing the current condition of patient A: with a history of cesarean section, polyhydramnios, twisted umbilical cord, and particularly the fetus having congenital duodenal obstruction, Dr. Doan Thi Thuy Ha – Head of the Obstetrics Department has consulted with Dr. Tran Thi Viet Phuong – Director of the Obstetrics Specialty to admit the patient for monitoring the pregnancy in the Prenatal Department. At the same time, the Obstetrics Department has collaborated with the Pediatric Intensive Care Unit, Pediatric Surgery Department, and Anesthesia Department to plan for a cesarean delivery for the patient and to address the fetal condition immediately after birth. By the 37th week of pregnancy, patient A showed signs of abdominal pain. Due to strict management of the pregnancy throughout and early admission, the patient was quickly examined and underwent various clinical tests. The results indicated that the patient showed signs of preterm labor. To ensure the safety of both the patient and the fetus, Dr. Doan Thi Thuy Ha – Head of the Obstetrics Department consulted with Dr. Pham Thu Xanh – Executive Director of the Hospital and decided on an emergency cesarean section. The baby was born weighing 2400g. The child cried immediately after birth, and health indicators were stable.
Immediately after, the child was transferred for care and monitoring at the Pediatric Intensive Care Unit. After a second consultation among the specialties: Obstetrics – CSSS, Pediatric Intensive Care Unit, and Pediatric Surgery, the doctors confirmed that this was a case of congenital duodenal obstruction caused by annular pancreas leading to external compression resulting in duodenal stenosis, consistent with the prenatal diagnosis. After careful consideration of the premature and low birth weight condition of the patient, the specialists decided that the child would be monitored and cared for in the Pediatric Intensive Care Unit until they were stable enough for surgery. Meanwhile, mother A continued to receive attentive care in the Maternity Department.
The child’s surgery was performed after two days of intensive care, by the pediatric surgical team along with anesthesia and neonatal resuscitation from the hospital. With the diagnosis of duodenal obstruction due to annular pancreas, the child underwent duodeno-duodenostomy using the Kimura method.
Post-surgery, the child continued to be monitored and treated at the Pediatric Intensive Care Unit and the Pediatric Surgery Department. After 11 days of intensive treatment, the child’s health and vital signs stabilized, feeding well, the surgical wound was dry, and bowel movements were normal. On the day of discharge, Dr. Pham Thu Xanh – Executive Director of the Hospital, along with the Obstetrics, Pediatric Intensive Care, and Pediatric Surgery teams, personally visited to inquire and celebrate with the family.
With the development of prenatal diagnostic ultrasound, the extensive expertise of obstetric and pediatric specialists, along with modern 5D ultrasound machines, congenital duodenal obstruction can be detected early during pregnancy and treated surgically immediately after the child is born. Therefore, experts recommend that pregnant women should fully perform all important ultrasound milestones and screening tests to detect any abnormalities in the fetus as early as possible. This allows for a closely monitored pregnancy management plan and timely handling of any potential abnormalities, ensuring safety for both the mother and the fetus.
The complete success of the case marks a new milestone in the professional development of obstetrics and pediatrics at Hai Phong International Obstetrics and Pediatrics Hospital. It is hoped that, with daily training, development, and enhancement of professional skills, along with heartfelt service and care, Hai Phong International Obstetrics and Pediatrics Hospital will always be a trusted destination for the community in the journey of protecting and caring for the health of mothers and children.
