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全球产后出血的流行病学及定义

Epidemiology and definition of PPH worldwide.

作者信息

Bláha Jan, Bartošová Tereza

机构信息

Department of Anaesthesiology and Intensive Care Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 08, Prague 2, Czech Republic.

出版信息

Best Pract Res Clin Anaesthesiol. 2022 Dec;36(3-4):325-339. doi: 10.1016/j.bpa.2022.11.001. Epub 2022 Nov 13.

Abstract

Postpartum/peripartum hemorrhage (PPH) is an obstetric emergency complicating 1-10% of all deliveries and is a leading cause of maternal mortality and morbidity worldwide. However, the incidence of PPH differs widely according to the definition and criteria used, the way of measuring postpartum blood loss, and the population being studied with the highest numbers in developing countries. Despite all the significant progress in healthcare, the incidence of PPH is rising due to an incomplete implementation of guidelines, resulting in treatment delays and suboptimal care. A consensus clinical definition of PPH is needed to enable awareness, early recognition, and initiation of appropriate intensive treatment. Unfortunately, the most used definition of PPH based on blood loss ≥500 ml after delivery suffers from inaccuracies in blood loss quantification and is not clinically relevant in most cases, as the amount of blood loss does not fully reflect the severity of bleeding.

摘要

产后/围产期出血(PPH)是一种产科急症,在所有分娩中占比1%-10%,是全球孕产妇死亡和发病的主要原因。然而,根据所使用的定义和标准、产后失血量的测量方法以及所研究的人群不同,PPH的发生率差异很大,发展中国家的发生率最高。尽管医疗保健取得了显著进展,但由于指南执行不完整,PPH的发生率仍在上升,导致治疗延误和护理不佳。需要一个PPH的共识临床定义,以提高认识、实现早期识别并启动适当的强化治疗。不幸的是,最常用的基于产后失血≥500毫升的PPH定义在失血量量化方面存在不准确之处,并且在大多数情况下与临床无关,因为失血量并不能完全反映出血的严重程度。

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