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产后出血
Postpartum Hemorrhage


Jessica L. Bienstock ... 妇产科和儿科 • 2021.04.29
相关阅读
• 热稳定型卡贝缩宫素与催产素预防阴道分娩后出血的比较 • 氨甲环酸预防阴道分娩后失血 • 侵入性胎盘

产后出血仍然是全球孕产妇主要的可预防病因和死因1,2。在全世界范围内,产后出血占发达地区孕产妇死亡原因的8%,占发展中地区孕产妇死亡的20% 2。美国是孕产妇死亡率最高的发达国家,约11%的孕产妇死亡与产后出血相关3。1993—2014年,美国需要输血4的产后出血(定义为阴道分娩或剖宫产后失血>1,000 mL)发生率从约每10,000例分娩中8例增加至每10,000例分娩中40例5

随着产后出血发生率的增加,开展精心设计的队列研究和随机临床试验仍然是我们工作的重中之重,从而评估对预测、预防和治疗产后出血至关重要的干预措施6。然而,由于失血量难以测定、产后出血的定义各异以及在结局报告方面的差异,相关随机临床试验的数据难以解读且难以对不同研究进行比较6。此外,产后出血的预防和治疗指南在各国主要妇产科组织(包括美国妇产科医师学会[American College of Obstetricians and Gynecologists]7、加拿大妇产科医师学会[Society of Obstetricians and Gynaecologists of Canada]、法国妇产科医师学会[French College of Gynecologists and Obstetricians]、英国皇家妇产科医师学会[Royal College of Obstetricians and Gynaecologists{United Kingdom}],以及澳大利亚和新西兰皇家妇产科医师学会[Royal Australian and New Zealand College of Obstetricians and Gynaecologists])之间有很大差异8。本综述讨论了产后出血的原因、鉴别、治疗、预防和预测。





作者信息

Jessica L. Bienstock, M.D., M.P.H., Ahizechukwu C. Eke, M.D., Ph.D., and Nancy A. Hueppchen, M.D.
From the Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore. Address reprint requests to Dr. Bienstock at the Division of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD 21287, or at jbienst@jhmi.edu.

 

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