Chapter 310: Critical Case: The Pregnant Patient’s Hidden Danger

Pregnant women are a unique group of patients—their greatest danger is infection.

Whether it’s an infection during pregnancy or after giving birth, either can be life-threatening.

This woman is thirty-seven weeks along, just a few weeks from delivery, but now she’s developed a severe respiratory infection. Treating it is a real challenge.

Director Zhang looked over the medical file before passing it to the other specialists for review.

Once everyone had finished reviewing, the file made its way back to Professor Hu Wanjun.

“Experts from Tuyu Hospital, do any of you have good suggestions?”

Unable to stay quiet any longer, Professor Hu Wanjun spoke up and asked the group.

“The patient has a high fever and a severe cough. I think we should start by giving her acetaminophen to lower her temperature, then use antibiotics to control the infection. From there, we can rely on her immune system to slowly recover. That would be the safest approach.”

Dr. Luo from the Obstetrics Department was first to offer an opinion.

“That treatment plan sounds reasonable, but what about the baby? And it looks like the upper respiratory infection may be spreading to the lower respiratory tract.”

A serious respiratory infection in a pregnant woman is bad enough.

But now the fetal heart rate is dropping, which is a danger sign.

If they aren’t careful, the baby could die in the womb.

On top of that, if the infection reaches the lower respiratory tract, things will be even harder to handle.

The lower respiratory tract includes everything below the throat—trachea, bronchi, lungs. The worst scenario is a lung infection—in other words, pneumonia during pregnancy.

The severity of this patient’s infection makes it almost certain that her lower respiratory tract is already involved.

Her violent coughing is clear proof of that.

Medication for pregnant women must be chosen with extreme caution—not just checking for allergies, but making sure the baby’s safety isn’t at risk. Any drug that could cause birth defects, death or disability is strictly off-limits.

“It would be best if we could assess the patient firsthand before coming up with a final treatment plan,” Zhang Bihua said, stopping Dr. Luo from continuing.

“The patient is right in the ward. Why don’t I take you all over to see her now?”

Professor Hu Wanjun was particularly eager about this, which suggested that the patient’s condition might be worse than everyone thought.

A flock of specialists headed for the ward. It was already approaching 6:40 in the evening—most doctors were usually off duty by then.

Nearly twenty doctors filed into the ward, startling the two pregnant women and their families inside.

There were four beds in this room, but only two of them were occupied by pregnant women.

This also indirectly reflected the poor running of Xinxiang Maternity and Child Hospital.

Half the beds were empty, something unimaginable at Tuyu Hospital, where every department was packed. In Obstetrics, beds were especially scarce.

Plenty of women in labor with their cervix dilated five centimeters still couldn’t get admitted. Some had to stay in nearby hotels or go home and wait until they reached full dilation before coming to the hospital to give birth.

It couldn’t be helped—beds were in short supply.

Some women had even lied about having high blood pressure or heart disease just to get admitted.

Who knows—maybe they learned that trick from the doctors themselves.

Sometimes doctors exaggerate how serious an illness is to scare patients and their families. The pregnant women took a page out of their book and turned the tables, scaring the doctors and nurses instead.

“If you won’t admit me, fine. But I have high blood pressure, and if anything happens to me, I’m coming for you.”

Most women about to give birth have slightly elevated blood pressure, so this trick actually worked pretty well—at least at first.

It almost always worked.

Eventually the Obstetrics Department had a special meeting, deciding that anyone claiming to have high blood pressure or heart disease had to show proof of previous illness. That finally curbed the trend.

Zhou Can, less experienced than the rest, quietly took up position near the door.

He just watched as Director Zhang and the others asked the patient questions and examined her.

Even standing seven or eight meters away, he could see the skin of the pregnant woman’s neck and abdomen had an unusual hue—a kind of deep brown he couldn’t quite describe.

He couldn’t check her armpits or groin himself.

But he figured those areas probably looked the same.

“Monitor!”

Zhou Can turned to look at Yang Chan, who was also by the door.

“What is it?”

She sounded a little bit sharp.

“Did you notice that pregnant woman’s neck skin is dark and brownish?” Zhou Can asked.

“It’s normal for pregnant women to look worse because of hormone changes, isn’t it?” She didn’t know what Zhou Can was getting at.

“You’re a woman. Could you go over and check her armpits and groin to see if the skin is discolored there too?” He had to ask her for this favor.

“Why don’t you go yourself? You’re the expert, I’m just the backup doctor.” She sounded a little annoyed—maybe Zhou Can’s higher status these days was getting to her.

“I’m a guy. If I go poking around her groin and armpits, people will think I’m some kind of creep.” Zhou Can looked exasperated. If he could do it himself, he wouldn’t have had to ask for help!

“Fine, just wait.”

She pushed to the front of the group.

So she agreed.

Honestly, as long as Zhou Can gave a good reason, she almost always did what he asked.

Not far away, Du Leng was quietly watching Zhou Can. Seeing Zhou take such an interest in the skin discoloration, he tried to figure out the reason behind it.

Every time a weird case came up, Zhou Can solved it and took all the glory. This time, with doctors from two hospitals watching, Du Leng wasn’t about to let his own reputation take another hit.

“What use could Zhou’s observation possibly have?”

Du Leng frowned and pondered.

But no matter how hard he thought about it, he couldn’t see any connection between the skin discoloration and the woman’s respiratory infection and slowing fetal heart.

At the end of the day, book learning isn’t everything in medicine.

You have to actually apply what you know and have real experience to be good at diagnosis.

Yang Chan was one of Director Zhang Bihua’s favorite students, so nobody dared to complain when she squeezed to the front of the group.

After whispering with Director Zhang, she checked with the patient.

With the patient’s consent, she drew the curtain and examined her.

Soon, the curtain pulled back.

Director Zhang was delighted by Yang Chan’s eagerness to learn and gave her full support.

She finished Zhou Can’s task and returned.

“I checked. The skin in her groin was even darker, and her armpits were darker than her neck.”

“Got it. Thanks for helping.”

With confirmation in hand and thinking of other symptoms, Zhou Can started forming his diagnosis.

“Did you already figure something out? Want to share your thinking?”

She only saw the respiratory infection, but the patient’s fever had already dropped from high to low—that meant the hospital had already started treatment.

She had to admit, Zhou Can was a lot sharper than her when it came to diagnosing patients.

Zhou Can was about to tell Yang Chan his thoughts when he noticed Du Leng, standing up front, trying to eavesdrop. Zhou just smiled and pointed at his phone.

Then he started quickly typing a message to her.

While Du Leng was straining to listen, the conversation suddenly went silent.

He instinctively glanced back.

Seeing Zhou Can messaging Yang Chan in private, he muttered that Zhou was too stingy—why hide his diagnosis like it was a treasure?

“Dr. Du seems quite interested in our conversation. Would you like to join us?”

Yang Chan was no fool.

One look at Du Leng’s face, combined with Zhou Can’s sudden switch to messaging, and she understood instantly.

She shot Du Leng a teasing smile.

“Cough, cough… No thanks!”

For someone as proud as Du Leng, lowering himself to “discuss” with Zhou Can was out of the question.

“Dr. Du is a top graduate from a prestigious overseas school. His diagnostic skills far surpass ours. Why would he bother discussing anything with us mere trainees?”

Zhou Can deliberately flattered Du Leng.

If there was ever a chance, he’d happily burst Du Leng’s bubble. Not for any big reason—it just felt satisfying.

Always strutting around with the overseas doctorate like a peacock—was that really necessary?

“No, no, not at all!”

Du Leng gave an awkward laugh and turned back.

Zhou Can and Yang Chan exchanged knowing looks. On this, they were totally on the same side.

By then, Zhou Can had finished typing his diagnosis.

He sent it straight to Yang Chan.

“So mysterious. I’m dying to see your thought process,” Yang Chan muttered as she checked her messages.

After reading, she stared in disbelief.

“Your logic is way out there! The test you’re talking about was done on admission, and it was normal!” Yang Chan said, astonished.

Up front, Du Leng was getting restless.

He felt like everything he’d learned was useless—like a three-year-old with a room full of weapons but no way to fight off a wolf.

He listened to every word of their conversation.

What test did they do on admission?

Du Leng puzzling over it.

And what was the diagnosis Zhou Can gave Yang Chan?

The more he couldn’t figure it out, the more curious he became.

But Zhou Can smiled confidently and said to Yang Chan, “You’re the only one who can speak up to Director Zhang. Suggest the test to her and have the patient do it again. I bet it will turn up something major.”

“I’ll trust you this once! But you have to promise to walk me through your whole reasoning afterward.”

She was basically admitting that Zhou Can was better at this than her.

“No problem! We’ve been classmates forever—if you ever want to discuss a case, just message me.”

Zhou Can chatted about medical topics with Qiao Yu all the time, but he and Yang Chan seldom talked.

He always thought she seemed a bit distant.

If it wasn’t important, he didn’t dare bother her.

He didn’t want to get stonewalled.

But times had changed.

Zhou Can’s skills were now far ahead—now she had to come to him for help. Naturally, her attitude was different too.

Yang Chan squeezed to the front and pitched the test idea to Director Zhang.

The chief physicians had nearly finished discussing the case by then.

But there was still no clear answer.

In an Obstetrics Department case discussion, only a handful like Director Zhang Bihua and Dr. Luo could really make a difference.

Deputy Director Shi from Gastroenterology and Director Jiang from Neurology were simply there to watch and learn.

They were just tagging along for the experience.

“Director, could we check this patient’s blood sugar?” Yang Chan waited for her chance and spoke up.

“She had her blood sugar checked when admitted, it was fine. Did you notice something new?” Director Zhang Bihua was glad to see her star student taking part in the discussion.

“I suspect she’s developed diabetic ketoacidosis!”

Yang Chan bravely continued down the diagnostic path Zhou Can had mapped out.

“But the patient doesn’t have a history of diabetes!” Professor Hu Wanjun looked at her, puzzled.

The other doctors looked the same.

“I pulled the curtain and checked her specifically—her armpits and groin are noticeably darker. Skin discoloration is one symptom of diabetes. Also, just a bit ago when she went to drink water, she missed the cup on her first try, which suggests her vision is failing. That’s another clue pointing to diabetes.”

Even Yang Chan couldn’t believe how Zhou Can noticed things even more subtle than a woman would.

She figured others must’ve noticed the woman missing the cup but chalked it up to weakness from illness.

Only Zhou Can had the keen sense to connect it to blurry vision.

“Can you read the print on this paper from here?”

Director Zhang was still doubtful, so she held up a form about a meter away for the woman to read.

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“I can’t see it!”

The pregnant woman shook her head.

Director Zhang moved it closer, but the woman still shook her head.

“The words and pictures are all blurry. I can’t see them clearly.”

“Have you ever been nearsighted before?”

“No!”

Now everyone believed the woman’s vision really had changed.

“If Dr. Yang’s diagnosis is right, both the patient and her baby are at serious risk. Diabetic ketoacidosis not only endangers the mother’s life but the baby’s as well. Her symptoms are still mild, so we may still have time. Quick—check her blood sugar again!”

Director Zhang’s clinical experience kicked in as she realized the urgency of the situation.

But they still needed to test to be sure.

Normally, diabetic ketoacidosis comes with nausea and vomiting. But in a pregnant woman with a raging respiratory infection, those signs are easily missed.

The nurse drew a blood sample right away.

“Hand the sample to me. This is a life-or-death matter—we need the lab result fast.” Section Chief Tang grabbed the sample and rushed out himself.

Clearly, even the hospital administration was paying close attention to this case consultation.

Whenever necessary, they mobilized all available resources to treat the patient as a top priority.

In less than eight minutes, Section Chief Tang called Professor Hu Wanjun directly.

As soon as she answered and heard the news, Hu Wanjun’s face changed dramatically.

“The lab just reported—the patient’s blood sugar is 17.2 mmol/l.” Professor Hu’s announcement hit everyone like a bolt from the blue.

It was devastating news.

“Her blood sugar was totally normal when she was admitted! Just two days later, it’s this high? That’s insane.” Even though Professor Hu specialized in gynecology, she’d handled plenty of obstetrics cases.

But she had never seen anything like this.

“Ironically, finding the problem now is a good thing. If we hadn’t, and her blood sugar stayed this high, her baby probably wouldn’t survive the night. The mother herself could die, too. Hope it’s not too late yet.”

After the shock and fear, Director Zhang pulled herself together.

Time was now of the essence—they had to bring her blood sugar down immediately.

From this point on, treatment was much more straightforward. There was an endocrinologist among the experts, so correcting the blood sugar was no big deal for them.

The usual treatment was IV fluids mixed with insulin to quickly bring down the glucose level.

“Only the OB doctors and nurses need to stay here now—all of you, it’s been a long day. You can head back to the hotel and rest up for tomorrow’s shift.”

Director Zhang looked around at the other experts as she spoke.

“Wait! Director Zhang, fellow doctors, we have a few other cases that could use your help. Would you mind waiting in the conference room for a while? We’ll be right there.”

Bringing the patient’s blood sugar under control would take a bit of time.

Hu Wanjun wasn’t about to leave yet—she figured in about twenty more minutes they’d see some results.

IV insulin works fast, after all.

“Head to the conference room and rest up!” Director Zhang told the others, then glanced at Yang Chan, who stood out with her striking beauty. “Yang Chan, you did great today! You really impressed me!”

Watching her protégé shine, Director Zhang was as proud and satisfied as she could be.

Every teacher hopes their student will succeed.

Getting praised like that in front of everyone, Yang Chan blushed bright red.

No denying she’d been the star tonight. Dozens of doctors, nurses, even patients and their families all looked at her with admiration.

She was the one who discovered the patient’s blood sugar problem and saved two lives.