Most S., 35

Sima, a 35-year-old devoted housewife, lives with her husband and child in a small rented room, struggling without a home of their own. Her husband earns very little as a day laborer, which barely covers food and daily expenses, leaving nothing for emergency medical care. Despite her strength and kindness, Sima now faces life-threatening risks from her complicated twin pregnancy, where one baby has already been lost. Without urgent treatment, both Sima’s life and the surviving baby are in danger, which would shatter the hopes of her child who dreams of serving the nation one day. Their family’s love and sacrifice keep them strong, but they desperately need support to overcome this critical moment.

Sima, a second gravida patient with a twin pregnancy of 9 months and 1 week, was admitted with a breech presentation. One of the fetuses was found to be alive, while unfortunately, the other was intrauterine dead. Given the high-risk condition—including breech position, full-term pregnancy, and HBsAg-positive status—an immediate caesarean section was performed to ensure the safety of the mother and the surviving baby. The surgery was successfully carried out, and both Sima and her living baby were stabilized post-operation. As part of standard care for Rh-negative mothers (if applicable), Injection Anti-D was administered to prevent future Rh sensitization. Appropriate precautions were also taken to manage her HBs-positive status to reduce the risk of transmission to the newborn. Sima is now in stable condition, and the surviving baby is safe under medical care.

Sima is a second gravida mother with a twin pregnancy at 9 months and 1 week, presenting with one fetus alive and one intrauterine fetal death (IUFD), along with breech presentation and HBsAg-positive status. If left untreated, this condition could lead to serious complications such as maternal infection, sepsis, coagulopathy, and uterine rupture due to the prolonged retention of the dead fetus and obstructed labor from the breech position. These risks could result in multi-organ failure or even maternal death. The living fetus would also be at high risk of fetal distress or death during labor. Additionally, without proper management of her hepatitis B status, there is a significant risk of transmitting the virus to the newborn, potentially leading to chronic liver disease. However, with timely intervention—such as immediate caesarean section, administration of Anti-D (if Rh-negative), and neonatal hepatitis B prophylaxis—these risks can be significantly reduced. Proper treatment will not only save Sima's life and the surviving baby but also improve her overall long-term health and reproductive future.