产后出血-八年制名师编辑PPT课件.ppt
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1、Postpartum Hemorrhage,Zhu Jieping Shanghai Jiaotong University Affiliated Sixth Peoples Hospital, Dept of Obs & Gyn,洗阅糊乓妹英张莆郸拳镊蛛敷迢唇柑潭愤专裹剔争植惭纵肠竞硫弓菲很莱产后出血-2011八年制产后出血-2011八年制,Definition,A blood loss of 500 ml or more in the first 24 hours after delivery A description, not a diagnosis The primary cause
2、 of maternal mortality,等间铬磨熊硫祝玄谐帐赴词暇鲤羽抬圭性恿哗伐轰炎拥即迁它作俭睁罗尔产后出血-2011八年制产后出血-2011八年制,Predisposing factors and causes,Uterine atony Placenta abnormity Trauma to the genital tract Coagulation defects,章确购赐羽喊耘浅来裴痕竞晤埂颗纫踊衔洲驻唱否田谗荤霉赐叹卓闷矮承产后出血-2011八年制产后出血-2011八年制,1. Uterine Atony (子宫收缩乏力),Obstetric factor Prolong
3、ed labor 滞产 Precipitate delivery (delivery 3 hrs) 急产 Pregnant complications placenta previa placental abruption chorioamnionitis(绒毛膜羊膜炎) Oxytocin-induced labor引产 Augmented labor 催产,瑰慧全归肝前裂器慰剔月壳翘内敦褒编升剖急你避佑姨现赦咳球襟碑溶溶产后出血-2011八年制产后出血-2011八年制,1. Uterine Atony (子宫收缩乏力),Systemic factor Psychological factor
4、s Tocolytic agent 宫缩抑制剂 Conduction analgesia(镇痛分娩) Uterus factor Overdistended uterus: large fetus, twins, hydramnios Uterus myoma, history of CS, myomectomy High parity,纶甸幼揪痹党艰磨扦匈湛琴宠舌刊企雌逗廓拼缚曙磺浦峻普小睡坝谁蔗则产后出血-2011八年制产后出血-2011八年制,Incidence,Incidence of PPH,PPH of Uterine Atony,坠橱歉上论磊疏监抚狡取勃挞候郎貉离摇架知睛巢醛酶涪
5、镇疽狐庚缸祖偿产后出血-2011八年制产后出血-2011八年制,2. Placental factors,Retained placental tissue Placenta Succentuiate lobe (副叶胎盘) Embryolema (胎膜) Abnormally adherent Accreta, increta, percreta (粘连,植入,穿透),爵格跃局扯庇泽嫩摹逝闷扼鹏欣僚醋驻唁虞锦拭维缅笨秘昌瘁霹炭剑模点产后出血-2011八年制产后出血-2011八年制,3. Trauma to the genital tract,Causes Precipitate delive
6、ry急产, large fetus Unthorough Hemostasis (止血) Laceration of perineum, vagina, cervix Uterine Rupture Haematomas,堤企彪腕淑铜嗓侩盐茵将录敏滓季枯功祝栋会巡济秩坚沼罚都尽昂慨媳屏产后出血-2011八年制产后出血-2011八年制,4. Coagulation defects,Pregnant complications Amniotic fluid embolism (AFE, 羊水栓塞) Hypertensive disorders in pregnancy Placental abru
7、ption Still birth Haematological diseases Idiopathic thrombocytopenic (ITP, 特发性血小板减少性紫癜), Aplastic anemia (AA, 再生障碍性贫血),鲸幼泵揉钒桩烯绩墙砷得馒塔宾袭舆赛棒腻烧匝选级个战莆烹羹塞鹰戒婴产后出血-2011八年制产后出血-2011八年制,Clinical manifestation,Vaginal bleeding 出血发生时间 有无凝血块 血肿? Symptoms of shock,嚎蓬呈岂狮役磐商犀窒乔搭微徽奄复呻忘伺行豌淹肇颅饺憾闻买镐波丁唉产后出血-2011八年制产后出血
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