无翼天使

今夜无眠

我在LETHBRIDGE实习的时候, 最喜欢产房门前的横幅上写着"宝宝是没有翅膀的天使". 那里的产科很人性话. 我也参与在各种不同的节日点缀我们的产科. 最近接了这边一家医院的OFFER. 在这两个月, 总觉得缺点,那哈,啥. 有没有姐妹想分享点在这生产经历. 我本人难产, 我的产科医生当天放假, 一利智的医生耽误了我宝贵的时间, 结果产程过长, 产后大出, 那哈, 血呀. 活过来后, 就立志干这行了, 有一个进责的护士和医生, 会让你有完全不同的生产经验.

今夜无眠

谢谢, 物是人非. 但身边的朋友能在加拿大坚持七年的, 生活的都很好. 坚持不下去的, 都回国了. 我想我的朋友一定生活的很好

yueban2007

好题目，期待下文。

今夜无眠

估计题目冷了, 或妈妈们都太忙. 我来抛砖引砖. 砸的时候, 轻点啊, 俺是新人.
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我个人认为在加拿大生小孩, 医院的条件比较好, 没有经济上的烦恼. 例如, 如果新生儿有问题, 二级医院可直接转三级医院, 如果本市的NICU满了, 可直接AIRLIFT 去西雅图. 不会耽误救治的宝贵时间. 我一位朋友的宝宝出生时没有肺动脉, 移植手术是在U OF A 做的, 效果非常好. 这的医疗设备先进, 医疗人员队伍整体素质比较高. ROYAL ALEX 最进新进了一台机器, 可在孕期就查胎儿的心脏, 包括瓣膜和动脉. 如果过去有这台机器的话, 我朋友的宝宝在没出生前, 就可以查出没有肺动脉.

  A) W% v0 M/ P) L0 [* D! L在说说这的不足. 医疗人员紧缺. 姐妹们有没有经历过, 每次去看产科医生, 开了半个小时的车, 两分钟就被打发出来了的. 你还没有说出你的担心和忧虑, 医生已经不耐烦听了. 他们只看指标. 我曾在产前要求做U/S来确认宝宝的大小, 他的头径和我盆骨的比例, 但被拒绝了. 她估计宝宝大小在7磅左右, 结果快10磅, 所以她坚持让我顺产从一开始就是错误的. 再续..

黑金

你说的机器是B超？其实在UA的有专门做儿科心脏的科室， 可以做胎儿，新生儿和儿童。胎儿大部分的心脏畸形都可以查出来。你的朋友不知道做没做20周左右的胎儿常规B超，如果做了，不知道有没有查出心脏有问题？常规检查可以排除80%的心脏畸形。

今夜无眠

普通的B超机可以查心脏畸形, 瓣膜, 和血流量, 但不能查肺动脉.

黑金

你说的这种机器是什么机器？

平安福

今夜无眠

普通的B超只能查出25% 的心脏问题. 我说的机器叫FETAL ECHO. 希望下面可以解释你的疑问. ROYAL ALEX 有一台, 我二月在PRENATAL CLINIC 的时候, 还没有正式投入使用.
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Fetal echo is short for fetal echocardiography. This is a detailed scan of your baby’s heart and all its connecting blood vessels and valves, to look for congenital heart defects.

% P: Z0 @0 k( T& T7 x( t/ v' }About one in a hundred babies have a heart defect. They are the most common of all congenital abnormalities. However, routine scans of the four chambers of the heart at 20 weeks only pick up about 25 per cent of these defects. Many units are now introducing a more detailed examination of the heart which includes looking at the outflow tracts - the major blood vessels carrying blood away from the heart. This doubles the number of problems the scan can pick up, but a specialist fetal echo can detect almost all heart defects.

1 L  _- N! j+ w/ A* [$ WThe best time for a fetal echo is between 18 and 22 weeks. Some major problems can be seen earlier than this using vaginal scans. A fetal echo is usually done by a doctor who is a fetal medicine specialist, or a heart specialist called a cardiologist.
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! R- `. z5 u8 k7 H0 ]Only women considered to be at higher risk than average of having a baby with a heart defect will be referred for the scan. You may be referred if:
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* y- Z; d7 |& F1 t• you were born with a heart defect, or have previously had a baby with a heart defect, as there is an increased risk in subsequent pregnancies

• you are diabetic, as you are slightly more likely to have a baby with a heart defect
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• you take certain drugs that can increase the risk of heart problems, such as some medications for epilepsy
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: ^# [* p# p+ b: P: J• your baby had an increased nuchal translucency at 11-14 weeks, and your CVS or amniocentesis showed normal chromosomes. A heart defect is a possible cause of the increased NT

5 `  l3 w) `; N4 _% y• the sonographer suspects a problem during your routine 20 week scan

) `' s8 `# i# @0 k) p. rThe fetal echo is carried out using sophisticated Doppler and colour scanning machines, allowing the specialist to follow the direction of blood flow through your baby's arteries and veins. They will be able to see holes in the heart, narrowing of arteries, and valves that don’t open and close properly. There are no known risks to the baby from this scan. Read more about scans and safety.

* n% ?2 K0 m( SMost echoes show the baby’s heart is normal, while some show a minor defect which may get better on its own. Small holes tend to close over on their own and don’t need any treatment. If a more serious problem is found, it’s a huge advantage to know about it before birth, because most defects can be successfully repaired.
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7 _8 r( X: g) X# `& a0 F$ sThe baby will be delivered in a specialist unit so surgery can be carried out straight after the birth if necessary.

% U% e8 k# a3 T6 EAlthough most problems will be seen during the scan, some heart abnormalities can't be detected even with a detailed expert examination. These tend to be minor defects, such as small holes in the heart, or mild valve abnormalities. Some cardiac defects don't become evident until after birth.

今夜无眠

建议孕妇如果有糖尿病, 严重的高血压, 先天性心脏病, 或在服用癫痫病药物, 建议看专科医生, 并讨论做FETAL ECHO SCAN BETWEEN 18-22 WKS. 谢谢黑金的提问, 不然还不知自己说的不清楚.

黑金

我想你说的机器就是B超，只是有一个专门的探头可以做胎儿的心脏，这样的设备在UA早就有，因为UA的新生儿心脏手术世界领先，相应带动了相关科室的发展。这个检查不一定必须医生来做，一般的超声技师考过了fetal echo的北美注册考试，就可以做，不过必须有2年的training。以前所有的fetal echo都是推荐到UA做的。Royal的新机器可能是perinitologist用吧？ 因为据我所知， 超声的技师还没有人有资格做，除非他们进了新人。当时我在UA实习的时候，惊诧于这个检查的details，也曾想立志往这方面发展。不过这是个长远的规划了！

今夜无眠

谢黑金, 我的朋友住在LETHBRIDGE. 只有做过普通的B超. 因为没能提前查出心脏有问题, 孩子出生后AIRLIFT 到U OF A 又耽误了几个小时, 现在孩子除了心脏有问题外, 还加脑积水. 小城市的医疗设备和人员还是落后一点. 我们通常会把怀孕32周以下的PTL孕妇转到CALGARY. AMAZED 在这里, 可以接24WKS PRE-TERM BABY. 很高兴, 黑金是行家, 我是新手, 在国内搞进出口, 出了国后, 才对医疗感了兴趣. 在过去几年看到很多不合理的情况, 想写出来, 大家可以很好的保护自己. 我曾经的兴趣在nuclear medicine, 生了孩子后, 转妇产了. 嘿嘿, 关键是没想到当时好事变坏事. 现在宝宝已经会说话了, 一切都是值得的.

黑金

你是在Royal做妇产科的护士吗？

今夜无眠

是的, 我在ROYAL ALEX W48, 新人. 尽管已经过了愤青的年龄, 看到不负责的事, 就有点生气. 更何况每件都关乎人的生死和健康. 当然, 也有很多感人的事, 以后和大家慢慢分享. 新移民在加拿大的医疗体系面前是比较脆弱的. 你在U OF A HOSPITAL 吗? 不知你在那个科? 帮助华人, 共勉啊! 嘿嘿, 只有我们强大了, 才有人把我们当回事.