Sanyu Research Unit, Department of Women's and Children's Health, Liverpool Women's Hospital, University of Liverpool, Liverpool, UK.
BJOG. 2015 Jan;122(2):202-10. doi: 10.1111/1471-0528.13098. Epub 2014 Oct 7.
Postpartum haemorrhage (PPH) remains a major cause of maternal deaths worldwide, and is estimated to cause the death of a woman every 10 minutes. This review presents the latest clinical advice, including new evidence on controlled cord traction, misoprostol, and oxytocin. The controversy around the diagnosis of PPH, the limitations of universal prophylaxis, and novel ways to provide obstetric first aid are also presented. It ends with a call to develop high-quality front-line obstetric services that can deal rapidly with unexpected haemorrhages as well as minimising blood loss at critical times: major abruption, placenta praevia, and caesarean for prolonged labour.
产后出血（PPH）仍然是全世界产妇死亡的主要原因，据估计，每 10 分钟就有一名妇女因此死亡。本综述介绍了最新的临床建议，包括关于控制性脐带牵引、米索前列醇和缩宫素的新证据。还介绍了围绕 PPH 诊断的争议、普遍预防的局限性以及提供产科急救的新方法。最后呼吁开发高质量的一线产科服务，以便在关键时期迅速应对意外出血，并最大限度地减少大出血：主要的胎盘早剥、前置胎盘和因产程延长而行剖宫产。
