Benz R, Malär A-U, Benz-Wörner J, Scherer M, Hodel M, Gähler A, Haberthür C, Konrad C
Klinik für Anästhesie, chirurgische Intensivmedizin, Rettungsmedizin und Schmerztherapie, Luzerner Kantonsspital, 6000, Luzern 16, Schweiz.
Anaesthesist. 2012 Oct;61(10):901-5. doi: 10.1007/s00101-012-2084-3. Epub 2012 Sep 16.
Trauma in pregnancy is infrequent and a systematic primary strategy constitutes a real challenge for the interdisciplinary team. With a high fetal mortality rate and a substantial maternal mortality rate traumatic placental abruption is a severe emergency which every anesthetist should be aware of. After hemodynamic stabilization of the mother and control of the viability of the fetus the therapy of traumatic placental abruption consists mostly of an immediate caesarean section. Coagulopathy by depletion of coagulation factors as well as disseminated intravascular coagulation (DIC) have to be expected and consequently a massive blood loss must be anticipated. Thrombelastography provides assistance for fast differential diagnosis and goal-directed treatment of the disturbed sections of the coagulation cascade.
妊娠期创伤并不常见，制定系统的初级治疗策略对跨学科团队来说是一项真正的挑战。创伤性胎盘早剥是一种严重的紧急情况，胎儿死亡率高，孕产妇死亡率也很高，每位麻醉医生都应有所了解。在母亲血流动力学稳定且胎儿存活情况得到控制后，创伤性胎盘早剥的治疗主要是立即进行剖宫产。必须预计到因凝血因子消耗导致的凝血病以及弥散性血管内凝血（DIC），因此必须预见到大量失血。血栓弹力图可为凝血级联反应受干扰部分的快速鉴别诊断和目标导向治疗提供帮助。
