資源描述：
《產(chǎn)后出血(postpartum hemorrhage)》由會員上傳分享，免費在線閱讀，更多相關(guān)內(nèi)容在教育資源-天天文庫。
1、教學(xué)內(nèi)容胎兒窘迫、子宮破裂、產(chǎn)后出血——約2學(xué)時臍帶異常、羊水量異常、早產(chǎn)、 胎膜早破、過期妊娠、多胎妊娠——約1學(xué)時＋自學(xué)王正平浙江大學(xué)醫(yī)學(xué)院附屬婦產(chǎn)科醫(yī)院產(chǎn)科Tel：87061501－2061PostPartumHemorrhage UterineRupture,FetalDistressWomenHospital,SchoolofMedical,ZheJiangUniversityWangZhengPingPostpartumhemorrhagePostpartumhemorrhagePastpartumhemorrhage
2、denotesexcessivebleeding(≥500mlinvaginaldelivery)duringthefirst24hoursafterdeliveryCommoncauseofdeathanddiseasesinpregnantwomengloballyLeadingcauseofdeathinpregnantwomeninChinaIncidence2%-3%oftotalnumberofdeliveriesEtiologyUterineatony:70%Obstetriclacerations:20%Retai
3、nedplacentaltissue:10%Coagulation:1%UterineatonyGeneralfactors:extremenervousness,sedative,anesthesia,tocolytics,weakObstetricfactors:prolongedlabour,fatigue,placentaprevia,placentaabruptio,severeanemiaUterinefactors:uterinemuscularfiberunderdevelopment,suchasuterined
4、eformityormyoma;uterineoverstretched,suchasmacrosomia,multiplepregnancy,polyhydramniosPlacentalfactorsIncompleteplacentalseparationRetainedplacentaPlacentalincarceration（嵌頓）PlacentaladhesionPlacentalimplantation(accreta,increta,percreta)Residualplacentaandamnioticmemb
5、raneBirthcanalinjuryLacerationduringlabourareusuallyassociatedwith:PoorvulvalelasticityStronglabourforce,emergencydelivery,macrosomiaInadequateskillsatassistedvaginaldeliveryInadequatecessationofbleedingduringepisiotomyrepair,missingouttearsatcervixorfornicesCoagulati
6、ondisorderComplicationsassociatedwithobstetric:amnioticfluidembolism,pregnancyinducedhypertensivediseases,placentaabruptioandintrauterinedemisePregnancyliverdisease:acutefattyliver,severehepatitisHematologydiseases:primarythrombocytopenicpurpura,aplasticanemiaetcClini
7、calpresentationVaginalbleeding:Ifbleedingoccursimmediatelyafterdeliveryofbaby,considerbirthcanalinjuryIfbleedingoccursminutesafterdeliveryofbaby,considerplacentafactorsIfbleedingoccursminutesafterdeliveryofplacenta,mainreasonsareuterineatonyorretainedproductsofconcept
8、ionPersistentbleedingandblooddonotcoagulate,considercoagulationdisordercausingPPHClinicalpresentationVaginalhematomaShock:di
