Kamaya Aya, Ro Kyung, Benedetti Nancy J, Chang Pauline L, Desser Terry S
Stanford University Medical Center, Palo Alto, CA 94304, USA.
Ultrasound Q. 2009 Sep;25(3):151-62. doi: 10.1097/RUQ.0b013e3181b5451e.
Postpartum complications can be broadly divided into 4 categories: postpartum hemorrhage, obstetrical trauma, thromboembolic complications, and puerperal infections. Postpartum hemorrhage is most commonly caused by uterine atony, abnormal placentation, or genital tract trauma. Secondary causes of hemorrhage include retained products of conception and, rarely, subinvolution of the placental implantation site. Uterine dehiscence or rupture may be occult on ultrasound examination and may be better visualized on sagittal computed tomography or magnetic resonance imaging. Obstetric trauma during prolonged vaginal or cesarean delivery may lead to fistula formation, ureteral injury, or bowel injury. Later potential complications of cesarean delivery include cesarean delivery scar ectopic, endometrial implants in the cesarean scar, and placenta accreta. Thromboembolic complications can include pulmonary embolism and deep vein thrombosis as well as ovarian vein thrombosis, the latter of which can be difficult to clinically differentiate from appendicitis in the postpartum female.
产后并发症大致可分为4类：产后出血、产科创伤、血栓栓塞性并发症和产褥感染。产后出血最常见的原因是子宫收缩乏力、胎盘异常或生殖道创伤。出血的次要原因包括妊娠物残留，以及很少见的胎盘植入部位复旧不全。子宫裂开或破裂在超声检查中可能不明显，而在矢状位计算机断层扫描或磁共振成像上可能更易显示。长时间阴道分娩或剖宫产时的产科创伤可能导致瘘管形成、输尿管损伤或肠道损伤。剖宫产术后潜在的并发症包括剖宫产瘢痕异位、剖宫产瘢痕处子宫内膜植入和胎盘植入。血栓栓塞性并发症可包括肺栓塞、深静脉血栓形成以及卵巢静脉血栓形成，后者在临床上很难与产后女性的阑尾炎相鉴别。
