产后出血2011八年制.pptx

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,#,Postpartum Hemorrhage,Zhu Jieping,Shanghai Jiaotong University Affiliated Sixth Peoples Hospital,Dept of Obs&Gyn,Definition,A blood loss of 500 ml or more in the first 24 hours after delivery,A description,not a diagnosis,The primary cause of maternal mortality,Predisposing factors and causes,Uterine atony,Placenta abnormity,Trauma to the genital tract,Coagulation defects,1.Uterine Atony(,子宫收缩乏力,),Obstetric factor,Prolonged labor,滞产,Precipitate delivery(delivery 50%,Diagnosis,Cause analysis,Uterine Atony:a soft,boggy uterus,正常胎儿娩出后宫底位置？,Placental factors,正常胎盘娩出时间？,如何检查？,Diagnosis,Cause analysis,Trauma,Perineal laceration,Vaginal laceration,hematoma,Cervical trauma,Coagulation disorders,History,Lab test,Management,Organization of the multidisciplinary team,组织抢救,Restoration of blood volume,补充血容量,Correction of defective coagulation with blood products and factors,纠正凝血功能,Evaluation of response to treatment by haemodynamic and laboratory assessment,评估,Remedying of the underlying cause,治疗原发病,Management,Etiological treatment,Homostasis(,止血,),Anti-shock:blood transfusion,Antibiotic prophylaxis,Uterine Atony,Emptying of the bladder,Stimulating uterine muscle tone,bimanual compression,uterine massage,Uterotonic agents,Oxytocin,Ergometrine,麦角新碱,Prostaglandins,Tamponade,填塞,Uterine Atony,Uterine compression sutures,：,B-lynch,Angiographic arterial embolization,动脉栓塞,Arterial ligation,Hysterectomy,Placental factors,Manual removal,Curetage:Ring curet,刮宫术,Placenta increta or percreta:hystorectomy,Trauma,Lacerations,Surgical repair:upper angle,Hematomas,Small:expectantly,incision and suture,Enlarged:prompt incision,drainage,Coagulation defects,Transfusion therapy,Red blood cells(RBCs),Platelets,Fresh-frozen plasma,Coagulation factors,Cryoprecipitate(,冷沉淀物，凝血第,因子,),Precautions?,Pregnancy health care,Labor monitoring,Improve delivery technique,Postpartum observation,Thank You!,