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产后出血:通过有效管理改善母亲结局

Postpartum Hemorrhage: Enhancing Outcomes for Mothers by Effective Management.

作者信息

Patel Madhuri

机构信息

Clinical Associate, Nowrosjee Wadia Maternity Hosp, Mumbai, India.

Mahatma Gandhi Memorial Hospital, Parel, Mumbai, India.

出版信息

J Obstet Gynaecol India. 2024 Jun;74(3):191-195. doi: 10.1007/s13224-024-02022-3. Epub 2024 Jun 27.

Abstract

Postpartum hemorrhage (PPH) remains a significant contributor to maternal morbidity and mortality worldwide. In India, PPH affects approximately 12% of women. The prevention and management of PPH are the significant challenges in obstetrics, with accurate assessment of blood loss and timely intervention being critical. Active Management of the Third Stage of Labor is a gold standard strategy for prevention. Recent advancements in PPH management include the use of recombinant activated factor VIIa, which has shown promise in decreasing the need for invasive procedures and second-line therapies. Additionally, surgical and radiological interventions have been effective in cases of refractory PPH. Overall, ongoing research and advancements in PPH management continue to enhance the quality of care and maternal outcomes experiencing this potentially life-threatening complication of childbirth. This editorial explores prevention and management of Atonic PPH with encompassing medical and surgical strategies, to enhance understanding and optimize clinical care for mothers at risk of this obstetric emergency.

摘要

产后出血(PPH)仍然是全球孕产妇发病和死亡的一个重要原因。在印度,约12%的女性受产后出血影响。产后出血的预防和管理是产科面临的重大挑战,准确评估失血量和及时干预至关重要。积极处理第三产程是预防的金标准策略。产后出血管理的最新进展包括使用重组活化凝血因子VIIa,它在减少侵入性操作和二线治疗需求方面显示出前景。此外,手术和放射介入在难治性产后出血病例中已取得成效。总体而言,产后出血管理方面持续的研究和进展不断提高护理质量以及经历这种潜在分娩危及生命并发症的孕产妇结局。这篇社论探讨了宫缩乏力性产后出血的预防和管理,涵盖医疗和手术策略,以增进理解并优化对面临这种产科急症风险的母亲的临床护理。

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Postpartum Hemorrhage: Enhancing Outcomes for Mothers by Effective Management.产后出血:通过有效管理改善母亲结局
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本文引用的文献

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Epidemiology and definition of PPH worldwide.全球产后出血的流行病学及定义
Best Pract Res Clin Anaesthesiol. 2022 Dec;36(3-4):325-339. doi: 10.1016/j.bpa.2022.11.001. Epub 2022 Nov 13.
4
Management of Postpartum Haemorrhage.产后出血的管理
Turk J Anaesthesiol Reanim. 2022 Dec;50(6):396-402. doi: 10.5152/TJAR.2022.21438.
6
Prevention of postpartum hemorrhage.预防产后出血。
Semin Fetal Neonatal Med. 2020 Oct;25(5):101129. doi: 10.1016/j.siny.2020.101129. Epub 2020 Jul 15.
8
Tranexamic acid for post-partum haemorrhage: What, who and when.氨甲环酸治疗产后出血:是什么,谁用,何时用。
Best Pract Res Clin Obstet Gynaecol. 2019 Nov;61:66-74. doi: 10.1016/j.bpobgyn.2019.04.005. Epub 2019 Apr 30.

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