Akins S
Parkland Memorial Hospital, Dallas, Texas.
J Nurse Midwifery. 1994 Mar-Apr;39(2 Suppl):123S-134S. doi: 10.1016/0091-2182(94)90070-1.
Severe hemorrhage occurs in less than 1% of all pregnancies; however, it remains one of the important causes of maternal morbidity and mortality. Although the importance of hemorrhage has been recognized in obstetric circles for years, in the last decade or so, research has been conducted that has disproven long-held beliefs. Nurse-midwives must be knowledgeable about the etiology, management, and treatment of postpartum hemorrhage. This article presents an overview of postpartum hemorrhage and its pharmacologic and nurse-midwifery management. The overview includes definitions of postpartum hemorrhage, identifies risk factors for hemorrhage, and addresses problems associated with estimation of blood loss. The mechanisms of action of ergots, oxytocin, and prostaglandins are described, and criteria for selecting a medication are presented. Herbal remedies for hemorrhage are discussed briefly. Also discussed are the optimal time for drawing the hematocrit and what this laboratory value can tell the nurse-midwife.
严重出血在所有妊娠中发生率不到1%；然而，它仍然是孕产妇发病和死亡的重要原因之一。尽管出血的重要性在产科领域已被认识多年，但在过去十年左右的时间里，所开展的研究已推翻了一些长期以来的观念。助产士必须了解产后出血的病因、管理和治疗方法。本文概述了产后出血及其药物治疗和助产管理。概述内容包括产后出血的定义、确定出血的危险因素，并探讨与失血估计相关的问题。描述了麦角、催产素和前列腺素的作用机制，并给出了选择药物的标准。简要讨论了用于止血的草药疗法。还讨论了测定血细胞比容的最佳时间以及该实验室值能为助产士提供的信息。
