Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA.
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA.
Transfus Med Rev. 2018 Oct;32(4):249-255. doi: 10.1016/j.tmrv.2018.05.003. Epub 2018 May 31.
Obstetric hemorrhage is one of the leading, as well as one of the most treatable, causes of maternal morbidity and mortality worldwide. As obstetric hemorrhage often occurs in patients without risk factors, there is virtually unanimous agreement from obstetric professional societies to establish obstetric hemorrhage protocols in anticipation of these emergencies. These protocols involve multidisciplinary teams in which the transfusion service plays an essential and vital role. This manuscript will examine the epidemiology of obstetric hemorrhage, risk factors that may be present, and recommendations for these protocols, with a focus on massive transfusion protocols, laboratory testing, cell salvage and use of pharmacologic adjuvant therapy including tranexamic acid and factor concentrates.
产科出血是全球孕产妇发病率和死亡率的主要原因之一，也是最可治疗的原因之一。由于产科出血通常发生在没有危险因素的患者中，因此产科专业协会几乎一致同意制定产科出血方案，以应对这些紧急情况。这些方案涉及多学科团队，其中输血科发挥着重要和至关重要的作用。本文将探讨产科出血的流行病学、可能存在的危险因素以及这些方案的建议，重点介绍大量输血方案、实验室检测、细胞回收以及使用氨甲环酸和因子浓缩物等药物辅助治疗。
