[Health "new housekeeper" is here ④] Don't prescribe medicine and focus on "talk therapy", "life quality inspector" guards the first level of health

　　Birth defect prevention and control consultants need to have comprehensive professional capabilities such as theoretical and clinical examinations, research and analysis, and communicate and explain the situation of fetuses suffering from chromosomal diseases in a way that patients can understand, and give reasonable suggestions.

　　In the Prenatal Diagnosis Center of the Second Hospital of Jilin University, there are a group of doctors who do not prescribe medicine but make appointments.

They usually help patients with examination and "talk therapy", and play the role of frontier "gatekeeper" and quasi-"general practitioner" in prenatal diagnosis.

　　In February 2022, the Ministry of Human Resources and Social Security, the State Administration for Market Regulation and the National Bureau of Statistics jointly released 16 new occupations to the society.

This is the second batch of new occupations released since the promulgation of the 2015 edition of the "Occupational Classification Ceremony of the People's Republic of China". Birth defect prevention and control consultants are officially included in the national occupational classification catalogue.

　　Wang Yuhui, a doctor at the Prenatal Diagnosis Center of the Second Hospital of Jilin University, is one of the birth defect prevention and control consultants.

"What this profession is most afraid of is missed diagnosis. All possibilities must be considered. The goal is to make the childbearing family less regretful."

　　"Veterans" take on "new roles"

　　This year is Wang Yuhui's 33rd year of practicing medicine and her 10th year of working in the prenatal diagnosis center.

Every working day, Wang Yuhui will receive patients from the whole province and even other provinces in the outpatient clinic, with an average of 20 to 30 patients per day.

　　According to statistics, the total incidence of birth defects in my country is about 5.6% at present, and a defective baby is born about every 30 seconds, and the total number of new birth defects is about 900,000 every year.

Among the more than 80 million disabled people in my country, 70% are caused by birth defects.

　　In Wang Yuhui's view, birth defect prevention and control consultants need to have comprehensive professional capabilities such as theoretical and clinical examination, research and analysis.

"It is best to have the foundation of an obstetrics clinician, understand genetics, embryology, and be able to perform ultrasound and puncture."

　　In his daily work, Wang Yuhui will perform "sheep piercing" and "umbilical piercing" for pregnant women in the first, second, and third trimesters to check whether the fetus has major birth defects such as chromosomal abnormalities.

　　At present, most of the birth defect prevention and control consultants in Jilin Province are doctors from professional medical institutions.

"Because the analysis of the patient's condition requires some professional medical diagnosis as a basis, and these diagnoses need to be completed in professional medical institutions." Wang Yuhui explained.

　　Professional medical testing methods plus "talk therapy"

　　Apart from professional medical testing methods, what Wang Yuhui uses the most is "talk therapy".

　　"Through screening, we can evaluate the probability of abnormalities in the fetus and what the pregnancy outcome will be in the future." Wang Yuhui said, taking chromosomal abnormalities as an example, birth defects caused by chromosomal abnormalities can cause clinical manifestations such as mental retardation in children. It is "preventable, controllable but not curable".

　　Once the fetus is diagnosed with a chromosomal disease during pregnancy, the doctor needs to give reasonable advice and communicate and explain it well, so that young parents can choose to have the child or not.

　　In the actual consultation, many parents find it difficult to accept this fact and struggle with how to make a decision.

"What I hear the most during my consultations is, doctor, tell me whether I can have this child or not." Wang Yuhui said that birth defect prevention and control consultants cannot make decisions for patients, but they must take care of the child to the greatest extent. Useful information is provided to them.

　　Through the accumulation of daily cases for many years and referring to relevant literature and guidelines, birth defect prevention and control consultants tell patients the probability of a normal or abnormal fetus in this situation, and help patients make choices to the greatest extent.

　　In his daily work, Wang Yuhui is more like a teacher and emotional counselor who helps students solve problems, explaining the problems they face and providing solutions in a way that patients can understand.

　　"Sometimes patients don't understand after the lecture, or they do understand, but they don't want to believe it. At this time, we need to answer their questions more carefully and patiently until they fully understand." Wang Yuhui said, there are still many mothers-to-be. When communicating, she will be emotionally out of control, and she needs to appease her emotions first.

　　Pregnancy is not easy for every mother. Wang Yuhui found in the consultation that a certain proportion of expectant mothers had recurrent miscarriages.

"Many of them passed the test tube and finally got pregnant, and then deformed again. This is a big blow to them. I have to tell them clearly what I know."

　　The knowledge base needs to be constantly updated

　　During the 10 years of working in the prenatal diagnosis center, Wang Yuhui deeply felt the rapid development of the field of birth defect prevention and control.

　　"After the completion of the Human Genome Project, high-throughput sequencing technology has developed rapidly, providing more comprehensive technical support for this industry." Wang Yuhui said, "At first we drew amniotic fluid to observe the number and structure of chromosomes through a microscope. Now we can Using chip and high-throughput sequencing technology to detect micro-deletions and micro-duplications of chromosomes."

　　High-end detection technology will have more complex detection results, which puts forward higher requirements for practitioners, and needs to continuously update the existing knowledge system.

Wang Yuhui and his colleagues will participate in multiple trainings every year, both in the province and across the country, in order to keep up with the pace of industry development through continuous learning.

　　A mother with skeletal deformity was found to have the same skeletal deformity as the mother during her pregnancy many years ago, so the pregnancy was terminated.

Since then, she has been afraid to have children, fearing that the bad luck of hereditary disease will come again.

　　"Her left hand has only two fingers, a short forearm and a missing radius." Wang Yuhui found during the consultation that although the patient is disabled, she is very smart and has good comprehension.

She suggested that patients should first find out what their problem is, which gene problem it is, and the dominant gene problem has a 50% possibility of giving birth to a normal child.

　　After confirming the test results, Wang Yuhui made a pregnancy plan for her.

During this period, the patient has also maintained communication with Wang Yuhui.

Not long ago, the patient called to thank him, saying that he had given birth to a normal child.

　　"This is the most fulfilling moment in my work." Wang Yuhui said bluntly.

　　Peng Bingliu Shanshan