Thurn Lars, Wide-Swensson Dag, Hellgren-Wångdahl Margareta
med dr, överläkare, obstetrik och gynekologi, Skånes universitetssjukhus Lund.
docent, överläkare, obstetrik och gynekologi, Skånes universitetssjukhus Lund.
Lakartidningen. 2021 Mar 15;118:20147.
Postpartum hemorrhage is responsible for one fourth of the maternal mortality worldwide. In high resource countries there is an increasing trend in frequency of postpartum hemorrhage and need of blood transfusions. The reason for this increase is probably multifactorial. Major bleeding requires massive blood transfusion (MT), defined as transfusion of >10 units of erythrocytes within 24 hours. In Sweden the incidence of MT due to obstetric hemorrhage is reported to be 53 per 100 000 deliveries and the majority of the cases are due to placental complications, such as placenta previa and placenta accreta. These placental complications have increased over the past years as a consequence of a higher rate of cesarean deliveries. To reduce the number of deliveries requiring blood transfusion postpartum, prophylactic measures such as identification of women at increased risk, optimizing management of hemorrhage and evaluating the effect of every transfused unit of erythrocytes is important.
产后出血是全球孕产妇死亡的四分之一原因。在资源丰富的国家，产后出血的发生率和输血需求呈上升趋势。这种增加的原因可能是多方面的。大出血需要大量输血（MT），定义为在24小时内输注超过10单位红细胞。在瑞典，据报道因产科出血导致的大量输血发生率为每10万例分娩中有53例，大多数病例是由于胎盘并发症，如前置胎盘和胎盘植入。由于剖宫产率上升，这些胎盘并发症在过去几年中有所增加。为了减少产后需要输血的分娩数量，采取预防性措施，如识别高危女性、优化出血管理以及评估每单位输注红细胞的效果非常重要。
