Ramanathan Gowri, Arulkumaran Sabaratnam
Department of Obstetrics and Gynaecology, St George's Hospital Medical School, London UK.
J Obstet Gynaecol Can. 2006 Nov;28(11):967-973. doi: 10.1016/S1701-2163(16)32308-8.
Postpartum hemorrhage (PPH) is the most important single cause of maternal death in both developing and developed countries. It arises from abnormalities in one of four basic processes, with uterine atony being the most common. A multidisciplinary approach to management is important. The value of oxytocin and prostaglandins, including misoprostol, in treatment is discussed. Recently developed, less invasive treatment options, namely uterine tamponade and compression sutures, are fast becoming valuable alternatives to the traditional options of pelvic devascularization and hysterectomy. With a stark contrast in maternal mortality from PPH between the developing and developed countries, public health strategies and medical interventions intended to minimize this are further discussed.
产后出血(PPH)是发展中国家和发达国家孕产妇死亡的最重要单一原因。它源于四个基本过程之一的异常,其中子宫收缩乏力最为常见。多学科管理方法很重要。讨论了催产素和前列腺素(包括米索前列醇)在治疗中的价值。最近开发的侵入性较小的治疗选择,即子宫压迫止血法和压迫缝合术,正迅速成为盆腔血管离断术和子宫切除术等传统选择的有价值替代方案。鉴于发展中国家和发达国家因产后出血导致的孕产妇死亡率存在鲜明对比,进一步讨论了旨在将其降至最低的公共卫生策略和医疗干预措施。