Postpartale H盲morrhagie

详细信息    查看全文

• 作者：Univ.-Prof. Dr. W. Rath (1)
  M.K. Bohlmann (2)
  
• 关键词：Postpartale H盲morrhagie ; Uterotonika ; Konservative Ma脽nahmen ; Operative Therapie ; Gerinnungsst枚rungen ; Postpartum hemorrhage ; Uterotonics ; Conservative measures ; Surgical therapy ; Coagulation disorders
• 刊名：Der Gyn?kologe
• 出版年：2011
• 出版时间：July 2011
• 年：2011
• 卷：44
• 期：7
• 页码：538-548
• 全文大小：651KB
• 参考文献：1. ACOG Practice Bulletin (2006) Clinical management guidelines for obstetricians-gynecologists No. 76: Postpartum hemorrhage. Obstet Gynecol 108:1039鈥?047 CrossRef
  2. Ahonen J, Stefanovic V, Lassila R (2010) Management of post-partum haemorrhage. Acta Anaesthesiol Scand 54:1164鈥?178 CrossRef
  3. Anderson JM, Etches D (2007) Prevention and management of postpartum hemorrhage. Am Fam Physician 75:875鈥?82
  4. AWMF-Leitlinie 015/063 (2008) Diagnostik und Therapie der peripartalen Blutung. http://www.leitlinien.net/
  5. Beekhuizen HJ, Ahosua NJA, Groot JA de et al (2006) Sulprostone reduces the need for the manual removal of the placenta in patients with retained placenta: a randomized controlled trial. Am J Obstet Gynecol 194:446鈥?50 CrossRef
  6. Blum J, Winihoff S, Raghavan I et al (2010) Treatment of post-partum haemorrhage with sublingual misoprostol versus oxytocin in women receiving prophylactic oxytocin: a double-blind, randomized, non-inferiority trail. Lancet 375:217鈥?23 CrossRef
  7. Bonnar J (2000) Massive obstetric haemorrhage. Baillieres Best Pract Res Clin Obstet Gynaecol 14:1鈥?8 CrossRef
  8. Bundes盲rztekammer (B脛K) (2008) Querschnitts-Leitlinien zur Therapie mit Blutkomponenten und Plasmaderivaten, (4. Aufl.) zuletzt ge盲ndert Januar 2011. http://www.bundesaerztekammer.de/page.asp?his=0.6.3288.8906
  9. Cabero RL, Keith LG (2009) Post-partum haemorrhage: diagnosis, prevention and management. J Matern Fetal Neonatal Med 22(Suppl 2):38鈥?5 CrossRef
  10. Carroli G, Cuerta C, Abalos E, G眉lmezoglu AM (2008) Epidemiology of postpartum haemorrhage: a systematic review. Best Practice & Research Clin Obstet Gynaecol 22:999鈥?012
  11. CMACE (2011) Saving mother鈥檚 lives: the 8th report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. BJOG 118(Suppl 1):1鈥?03
  12. Comstock CH (2005) Antenatal diagnosis of placenta accreta: a review. Ultrasound Obstet Gynecol 26:89鈥?6 CrossRef
  13. Cotter AM, Ness A, Tolosa JE (2001) Prophylactic oxytocin for the third stage of labour. Cochrane Database Syst Rev 4:CD 001808
  14. Crombach G (2000) Operative Behandlung schwergradiger postpartaler Blutungen. Gyn盲kologe 33:286鈥?97 CrossRef
  15. Doumouchtsis SK, Papageorhiou AT, Arulkumaran S (2007) Systematic review of conservative management of postpartum hemorrhage: what to do when medical treatment fails. Obstet Gynecol Surv 62:540鈥?47 CrossRef
  16. Driessen M, Bouvier-Colle MH, Dupont C et al (2011) Postpartum hemorrhage resulting from uterine atony after vaginal delivery: factors associated with severity. Obstet Gynecol 117:21鈥?1 CrossRef
  17. Eller AG, Porta TF, Soisson P, Silver RM (2009) Optimal management strategies for placenta accreta. BJOG 116:648鈥?54 CrossRef
  18. Ford JB, Roberts CL, Bell JC et al (2007) Postpartum haemorrhage occurrence and recurrence: a population-based study. MJA 187:391鈥?93
  19. Franchini M, Franchi M, Bergamini V et al (2010) The use of recombinant activated FVII in postpartum hemorrhage. Clin Obstet Gynecol 53:219鈥?27 CrossRef
  20. Fuller AJ, Bucklin BA (2010) Blood product replacement for postpartum hemorrhage. Clin Obstet Gynecol 53:196鈥?08 CrossRef
  21. G眉lmezoglu AM, Widmer M, Merialdi M et al (2009) Active management of the third stage of labour without controlled cord traction: a randomized, non-inferiority controlled trial. Reproductive Health 6.2. doi 101186/1742鈥?755鈥?鈥?
  22. Khan KS, Wojdyla D, Say L et al (2006) WHO analysis of causes of maternal death: a systematic review. Lancet 367:1066鈥?074 CrossRef
  23. Knight M, Callaghan WM, Berg C et al (2009) Trends in postpartum hemorrhage in high resource countries: a review and recommendations from the International Postpartum Hemorrhage Collaborative Group. BMC Pregnancy Childbirth 9:55 CrossRef
  24. Lier H, Rath W (2011) Aktuelle interdisziplin盲re Handlungsempfehlungen bei schweren peri (post)-partalen Blutungen. Geburtsh Frauenheilk 71
  25. Mathai M, G眉lmezoglu AM, Hill S (2007) Saving womens lives: evidence-based recommendations for the prevention of postpartum haemorrhage. Bull World Health Organ 85:322鈥?23
  26. Mc Donald D (2007) Management of the third stage of labor. J Midwifery Womens Health 52:254鈥?61 CrossRef
  27. Mc Donald SJ, Middleton P (2008) Effect of timing of umbilical cord clamping of term infants on maternal and neonatal outcome. Cochrane Database Syst Rev 2:CD 004674
  28. McLintock C (2009) Obstetric haemorrhage. Thromb Res 123:24(Suppl 2):S30鈥揝34
  29. Mousa HA, Alfirevic Z (2007) Treatment for primary postpartum haemorrhage. Cochrane Database Syst Rev 1:CD 003249
  30. Mousa HA, Walkinshaw S (2001) Major postpartum haemorrhage. Curr Opin Obstet Gynecol 13:595鈥?03 CrossRef
  31. Mukherjee S, Arulkumaran S (2009) Post-partum haemorrhage. Obstet Gynaecol Reprod Med 19:121鈥?26 CrossRef
  32. Palacious-Jaraquemeda JM (2008) Diagnosis and management of placenta accreta. Best Pract Res Clin Obstet Gynaecol 22:1133鈥?148 CrossRef
  33. Peters NCJ, Duvekot JJ (2009) Carbetocin for the prevention of postpartum hemorrhage: a systematic review. Obstet Gynecol Surv 64:129鈥?35 CrossRef
  34. Prendiville W, Elbourne D, Mc Donald S (2000) Active versus expectant management in the third stage of labour. Cochrane Database Syst Rev 3:CD 000007
  35. Rajan PV, Wing DA (2010) Postpartum hemorrhage: evidence-based medical interventions for prevention and treatment. Clin Obstet Gynecol 53:165鈥?81 CrossRef
  36. Rath W (2004) Pr盲vention lebensbedrohlicher peripartaler Blutungskomplikationen. Frauenarzt 45:20鈥?0
  37. Rath W (2009) Prevention and postpartum haemorrhage with the oxytocin analogue carbetocin. Eur J Obstet Gynecol Reprod Biol 147:15鈥?0 CrossRef
  38. Rath W, Gogarten W (2008) Oxytocin und Methylergometrin nach der Geburt 鈥?Vorsicht bei der Anwendung! Frauenarzt 49:498鈥?03
  39. Rath W, Schneider M (2010) Definitionen und Diagnostik postpartaler Blutungen (PPH): Untersch盲tzte Probleme! Geburtsh Frauenheilk 70:36鈥?0 CrossRef
  40. Rossen J, Okland I, Nilsen OB et al (2010) Is there an increase of postpartum hemorrhage, and is severe hemorrhage associated with more frequent use of obstetric interventions? Acta Obstet Gynecol Scand 89:1248鈥?255 CrossRef
  41. Rossi AC, Lee RH, Chmait RH (2010) Emergency postpartum hysterectomy for uncontrolled postpartum bleeding: a systematic review. Obstet Gynecol 115:637鈥?44 CrossRef
  42. Royal College of Obstetricians and Gynecologists (ROCG 2009) Postpartum Haemorrhage, Prevention and Management (Green-top 52) http://www.rcog.org.uk/womens-health/clinical-guidance/prevention-and-management-postpartum-haemorrhage-green-top-52
  43. Said S, Geary M (2007) Prevention of obstetric haemorrhage. Fetal Matern Med Rev 18:257鈥?88
  44. Skupski DW, Lowenwirt IP, Weinbaum FI et al (2006) Improving hospital systems for the care of women with major obstetric hemorrhage. Obstet Gynecol 107:977鈥?83 CrossRef
  45. SOGC Clinical Practice Guidelines (2009) Active management of the third stage of labour: prevention and treatment of postpartum hemorrhage. Int J Gynaecol Obstet 108:258鈥?67
  46. Soltani H, Hutchon DR, Poulose TA (2010) Timing of prophylactic uterotonics for the third stage of labour after vaginal birth. Cochrane Database Syst Rev 8:CD 006173
  47. Upadhyay K, Scholefield H (2008) Risk management and medicolegal issues related to postpartum haemorrhage. Best Pract Res Clin Obstet Gynaecol 22:1149鈥?169 CrossRef
  48. Warshak CR, Eskander R, Hull AD et al (2006) Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta. Obstet Gynecol 108:573鈥?81 CrossRef
  49. Weeks AD (2008) The retained placenta. Best Pract Res Clin Obstet Gynaecol 22:1103鈥?117 CrossRef
  50. Weeks AD, Alla G, Vernam G et al (2010) Umbilical vein oxytocin for the treatment of retained placenta (Release study): a double-blind, randomized controlled trial. Lancet 375:141鈥?47 CrossRef
  51. Winograd RH (2008) Uterine artery embolization for postpartum hemorrhage. Best Pract Res Clin Obstet Gynaecol 22:1119鈥?132 CrossRef
  52. Winter C, Macfarlane A, Deneux-Tharaux C et al (2007) Variations in policies for management of the third stage of labour and the immediate management of postpartum haemorrhage in Europe. BJOG 114:845鈥?54 CrossRef
  53. Wise A, Clark V (2008) Strategies to manage major obstetric haemorrhage. Curr Opin Anaesthesiol 21:281鈥?87 CrossRef
  
• 作者单位：Univ.-Prof. Dr. W. Rath (1)
  M.K. Bohlmann (2)
  
  1. Gyn盲kologie und Geburtshilfe, Medizinische Fakult盲t des Universit盲tsklinikum (RWTH) Aachen, Wendlingweg 2, 52074, Aachen, Deutschland
  2. Klinik f眉r Frauenheilkunde und Geburtshilfe, Universit盲tsklinikum Schleswig-Holstein, Campus L眉beck, L眉beck, Deutschland
  

文摘

Important proactive strategies are anticipating risk factors, active management of third stage labour and prophylactic oxytocin. Nearly 70% of maternal deaths caused by obstetric hemorrhage are considered preventable. Immediate treatment of the cause by drugs or surgery, resuscitation and timely correction of coagulopathy is the key to the management of postpartum hemorrhages (PPH). If medical therapy (oxytocin, sulprostone) fails uterine balloon tamponade and, if bleeding persists, uterine compression sutures successfully arrest bleeding in more than 80% of cases. Failure of all the procedures is an indication for hysterectomy. Uterine artery embolization may be useful in patients with placenta accreta/increta or ongoing bleeding after surgery. Manual removal of the placenta is mandatory, if the placenta is not separated within 30聽min after birth. If coagulopathy is suspected clinically, intravenous tranexamic acid and fibrinogen should be given in a timely fashion. Activated recombinant factor VIIa should only be considered in patients refractory to adequate surgical and hemostasis-stabilizing procedures.