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妊娠合并腹膜后血肿相关的孕产妇发病率和死亡率。

Maternal morbidity and mortality associated with retroperitoneal haematomas in pregnancy.

作者信息

Rafi Junaid, Khalil Haroona

机构信息

Ipswich Hospital NHS Trust, IP4 5PD, UK.

出版信息

JRSM Open. 2018 Jan 8;9(1):2054270417746059. doi: 10.1177/2054270417746059. eCollection 2018 Jan.

Abstract

Retroperitoneal haematomas in obstetrics are uncommon. The causes and pathogenesis of retroperitoneal haematomas lack clarity and the aim of this review is to recognise retroperitoneal haematomas as a separate entity from commonly seen vaginal and pelvic haematomas. It is time to raise awareness among obstetricians to recognise retroperitoneal haematomas as an important cause of maternal morbidity and mortality which requires high clinical suspicion and multidisciplinary input. As retroperitoneal haematomas are rare but can cause serious threat to maternal wellbeing, resources should be directed towards their management. Existing guidelines of maternal collapse and morbidity during pregnancy and puerperium need to include retroperitoneal haematomas as one of the important causes of maternal shock or morbidity. New learning pathways should be opted for to increase awareness of retroperitoneal haematomas among obstetricians enabling them to reflect on their implications while managing retroperitoneal haematomas. Management of retroperitoneal haematomas is complex and continues to improve with advancements in the investigative strategies, treatment options and multidisciplinary involvement.

摘要

产科腹膜后血肿并不常见。腹膜后血肿的病因和发病机制尚不清楚,本综述的目的是将腹膜后血肿视为一种与常见的阴道和盆腔血肿不同的独立病症。现在是时候提高产科医生的认识,将腹膜后血肿视为孕产妇发病和死亡的重要原因,这需要高度的临床怀疑和多学科的参与。由于腹膜后血肿虽然罕见,但会对孕产妇健康构成严重威胁,因此应将资源用于其管理。现有的关于孕期和产褥期孕产妇虚脱和发病的指南需要将腹膜后血肿列为孕产妇休克或发病的重要原因之一。应选择新的学习途径,以提高产科医生对腹膜后血肿的认识,使他们在处理腹膜后血肿时能够思考其影响。腹膜后血肿的管理很复杂,随着检查策略、治疗选择和多学科参与的进展,其管理也在不断改进。

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