Yunhua Xu, MD

 Hello, I am Roberta Speyer reporting for  OBGYN.net. I am in Beijing and I have the pleasure of talking to Dr. Bian and  Dr. Xu. Dr. Bian studied under Dr. Xu and they are at the Peking University.
 
 

Peking Union Medical College Hospital.
 
 

 I have to make other people say this because I mess it up  every time. So Dr Bian, please would you say it?
 
 

 Peking Union Medical College Hospital.
 
 

 Thank you. Their interest is in high-risk pregnancies,  that is what we are going to talk about today. You have another hospital here  that handles most of the regular OB cases, is this true?
 
 

Yes. We have a women’s hospital and we have between 900 and  1,000 deliveries per month, so most of the deliveries will go to that hospital.  But our hospital is a specialist hospital so we see most of the complicated  cases and have the pregnancies come to our hospital. We have about 150 to 200  deliveries per month. Most of them are highly complicated.
 
 

 How large is the community that you draw from, that come  in? How far do people come to have their delivery here because you anticipate a  problem? A hundred miles? Or just in the greater Beijing area?
 
 

And I imagine you utilize a lot of the pack systems to  look at the ultrasound scans and determine whether or not, how do you get the  cases here? How do they decide? Do the local doctors refer them in?
 
 

Some cases come from other provinces and stay in Beijing  temporarily and give birth in our hospital. They have high risk.
 
 

 What is the most common cause for the high risk? Is there  anything in particular or could there be a number of things?
 
 

 For example, maternal mother and fetal blood incompatibility.
 
 

 So that would cause a problem. What happens with the  early pregnancy if they seem to be going into labour too soon? That is probably,  do they try to bring them into the hospital then because they can get better  care, I presume?
 
 

 I think for the pre-term, you know, we prefer the mother is  referred when the baby is still in delivery, we forward the patient to a general  hospital which has a good NICU, so people can choose. Sometimes they know the  hospital’s name but PUMC is a good hospital and so they just drive to here.
 
 

 You have a large team, don’t you, to support you? Tell us  about that.
 
 

 Yes, we have a strong ICU and NICU and we work very well, we  have good cooperation with pediatricians and the staff.
 
 

 General hospitals, so you have a broad base. You were one  of the ones that started early on with this specialty, with this peri-natology  and now maternal fetal medicine. How long have you been, now girls do not like  to tell our ages, you know, but you have been doing this for a long time and  trained many people?
 
 

Yes. I started to work with Dr Xu in 1978.
 
 

Yes, as a resident, then as a chief attending and associate  professor and professor, then under Dr. Xu as a director of our division and  after that.
 
 

 Was she tough? She taught you a lot.
 
 

 Yes, absolutely, of course our duration becomes stronger and we  have more and more doctors and we have more staff and also we have a lot of  patients referred here with very special complications so it is not so common.  On occasions like that, it can appear to probably not be necessary to come to  our hospital, but there are some, and also we have a very strong genetic centre,  so we have a lot of patients who have genetic problems where they have some  babies with birth defects so that is their pre-natal care early in our hospital.  So then we have another doctor who is a Professor, Su Nehu, he is the head of  genetic consultant and the pre-natal diagnosis in our hospital since 1978.
 
 

 And you are getting a lot more success with the survival  rates.
 
 

 And from the sounds of her phone going off, I think there  might be a case waiting for you.
 
 

 Even as we speak, they are calling her. So you have seen  over time that the application of maternal fetal medicine and different  inter-disciplinary approach has increased the success rate, the survival rate.  From what age? What do you say now in your career, how many weeks of gestation  can you have a success outcome compared to, let’s say, 30 years ago?
 
 

 20, 30 years ago. What was it like then?
 
 

30 years ago? It was probably like 34, 31 weeks.
 
 

And better outcomes, also, for the babies?
 
 

Well, it is wonderful to hear about what you are doing  and we appreciate your taking the time. I think you had better go take that call  because there could be a baby being born at this very moment. Thank you very  much.
 
 

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OBGYN.net Conference CoverageOBGYN.net visits China-OBGYN.net in a meeting underwritten by InSightecMarch 2006

High-risk pregnancy in China

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Yunhua Xu, MD

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High-risk pregnancy in China

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