Karoshi Mahantesh, Keith Louis
Department of Obstetrics and Gynecology, Kingston Hospital, Galsworthy Road, Kingston Upon Thames, Surrey, United Kingdom.
Clin Obstet Gynecol. 2009 Jun;52(2):285-98. doi: 10.1097/GRF.0b013e3181a4f737.
Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood.
产后出血的管理部分取决于要有充分的思想准备、一批训练有素的同事以及能够充分利用现代治疗方法。后两个因素在资源匮乏地区很少见，而气候不稳定和缺乏基本交通条件可能会加剧这种情况。在资源匮乏地区，让未经培训的助产人员更多地采用积极的第三产程管理和使用米索前列醇，将有助于降低出血率。进一步的改善措施包括提高公众意识、协助现有非政府组织开展社区相关工作、提升传统助产人员的培训水平、为偏远地区的工作人员提供手机通讯，以及改善血液供应。
