Ducloy-Bouthors Anne-Sophie, Susen Sophie, Wong Cynthia A, Butwick Alex, Vallet Benoit, Lockhart Evelyn
From the *Pole d'Anesthésie-Réanimation, Academic Hospital Lille, Lille, France; †Pole d'Hématologie Transfusion, Academic Hospital Lille, Lille, France; ‡Université Lille Nord de France, Lille, France; §Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; ∥Department of Anesthesia, Stanford University School of Medicine, Stanford, California; and ¶Duke Transfusion Service, Department of Pathology, DUMC, Durham, North Carolina.
Anesth Analg. 2014 Nov;119(5):1140-7. doi: 10.1213/ANE.0000000000000450.
Postpartum hemorrhage (PPH) is a leading cause of maternal mortality worldwide. Recent advances in the management of severe bleeding for trauma patients may provide insight into PPH management, but must be applied with caution considering the significant differences between trauma and obstetric patients. In this review, we summarized evidence for current management strategies for patients with major obstetric hemorrhage, including (1) rapid laboratory assessment of coagulopathy, (2) early transfusion of plasma and high plasma-to-red blood cell transfusion ratios in massive PPH, and (3) use of tranexamic acid and fibrinogen concentrates in the setting of PPH complicated by coagulopathy.
产后出血（PPH）是全球孕产妇死亡的主要原因。创伤患者严重出血管理方面的最新进展可能为产后出血的管理提供思路，但鉴于创伤患者和产科患者之间存在显著差异，必须谨慎应用。在本综述中，我们总结了目前对严重产科出血患者的管理策略的证据，包括：（1）对凝血功能障碍进行快速实验室评估；（2）在大量产后出血时早期输注血浆以及高血浆与红细胞输注比例；（3）在合并凝血功能障碍的产后出血情况下使用氨甲环酸和纤维蛋白原浓缩剂。
