Department of Surgery, Regions Hospital, Saint Paul, Minnesota.
Department of Surgery, University of Texas Health Science Centre at Tyler, UT Health East Texas, Tyler, Texas.
Shock. 2024 Nov 1;62(5):620-627. doi: 10.1097/SHK.0000000000002455. Epub 2024 Aug 20.
Postpartum hemorrhage is the leading cause of preventable maternal illness and death globally and carries a disproportionately high burden of mortality in low- to middle-income countries. Tranexamic acid, an antifibrinolytic drug, has been widely adopted to control bleeding in trauma and other surgical conditions. Within the last decade, the World Health Organization updated their guidelines for the treatment of postpartum hemorrhage to include the use of tranexamic acid in all cases of postpartum hemorrhage. However, despite these guidelines and the proven utility of tranexamic acid to treat postpartum hemorrhage, widespread adoption of tranexamic acid into global standards of care across professional organizations has not been achieved. It is important for healthcare providers to understand the etiologies of postpartum hemorrhage, the mechanism of action and adverse effect profile of tranexamic acid, and the available literature regarding the use of tranexamic acid to prevent and treat postpartum hemorrhage to provide the best care for the pregnant patient.
产后出血是全球可预防的产妇发病和死亡的主要原因，在中低收入国家的产妇死亡率中占比过高。氨甲环酸是一种抗纤维蛋白溶解药物，已被广泛用于控制创伤和其他外科手术中的出血。在过去十年中，世界卫生组织更新了其产后出血治疗指南，将氨甲环酸用于所有产后出血的情况。然而，尽管有这些指南以及氨甲环酸治疗产后出血的有效性已得到证实，但在专业组织的全球护理标准中广泛采用氨甲环酸尚未实现。医护人员了解产后出血的病因、氨甲环酸的作用机制和不良反应特征，以及关于使用氨甲环酸预防和治疗产后出血的可用文献，对于为孕妇提供最佳护理非常重要。
