University of South Dakota Sanford School of Medicine.
Department of Obstetrics and Gynecology, University of South Dakota Sanford School of Medicine.
S D Med. 2023 Apr;76(4):174-177.
Postpartum hemorrhage (PPH) continues to be one of the leading causes of maternal morbidity and mortality worldwide. The four main causes of PPH are uterine atony, lacerations, retained placenta, and bleeding diathesis. In the patient with PPH, immediate evaluation is needed to diagnose and treat the underlying cause of hemorrhage. Uterotonic agents such as oxytocin remain first line for prevention and treatment of uterine atony. Studies have evaluated the antifibrinolytic tranexamic acid (TXA) as an adjunctive therapy in the prevention and treatment of PPH. TXA has been shown to reduce blood loss, bleeding-associated mortality, and transfusion rates in a variety of clinical settings and thus may serve a role in treating PPH. Current studies have demonstrated that TXA is an effective treatment option with limited risk of adverse events in appropriately selected patients; however, additional studies are needed to further clarify the role of TXA in the prevention of PPH.
产后出血（PPH）仍然是全球孕产妇发病率和死亡率的主要原因之一。PPH 的四个主要原因是子宫收缩乏力、裂伤、胎盘滞留和出血素质。对于 PPH 患者，需要立即进行评估以诊断和治疗出血的根本原因。缩宫素等子宫收缩剂仍然是预防和治疗子宫收缩乏力的一线药物。研究评估了抗纤维蛋白溶解剂氨甲环酸（TXA）作为预防和治疗 PPH 的辅助治疗。TXA 已被证明可减少各种临床环境中的出血量、出血相关死亡率和输血率，因此可能在治疗 PPH 中发挥作用。目前的研究表明，TXA 是一种有效的治疗选择，在适当选择的患者中具有有限的不良事件风险；然而，还需要进一步的研究来进一步阐明 TXA 在预防 PPH 中的作用。
