Cohen W R, Olivennes F
I. Belfer Educational Center, Bronx, New York 8461, USA.
Rev Prat. 1995 Sep 15;45(14):1777-81.
Postpartum hemorrhages are observed in 2 to 10% of all deliveries. They are severe in 1% of the pregnancies. However, they remain a major cause of maternal morbidity and mortality. Post-partum hemorrhages are generally separated in 2 categories. Acute hemorrhage occurs in the 24 hours following the delivery and is mainly caused by uterine atony, retained secondines, placenta accreta, birth canal trauma and uterine inversion. The delayed hemorrhage occurs after 1 day to 6 weeks after the delivery and is often related to uterine infection or abnormal involution of the placental bed. The management requires uterine massage and ocytocine or prostaglandins. Surgical or radiological selective ligation or embolization of the internal iliac arteries can be required. The hysterectomy is proposed in the most severe cases.
产后出血在所有分娩中发生率为2%至10%。其中1%的妊娠会出现严重产后出血。然而，产后出血仍是孕产妇发病和死亡的主要原因。产后出血通常分为两类。急性出血发生在分娩后的24小时内，主要由子宫收缩乏力、胎膜残留、胎盘植入、产道创伤和子宫内翻引起。延迟性出血发生在分娩后1天至6周，通常与子宫感染或胎盘床复旧异常有关。治疗需要子宫按摩以及使用缩宫素或前列腺素。可能需要进行手术或放射学选择性结扎或栓塞髂内动脉。在最严重的情况下建议进行子宫切除术。
