产后出血(英文)-课件.ppt

1、Postpartum Hemorrhage1ppt课件DefinitionPostpartum hemorrhage denotes excessive bleeding(500mL in vaginal delivery)following delivery.2ppt课件Incidence 58%Postpartum hemorrhage is the most common cause of excessive blood loss in pregnancy.3ppt课件Etiology Uterine atony Obstetric lacerations Retained placen

2、tal tissue Coagulation deffects4ppt课件Uterine atony Uterine atony exists when the myometrium cannot contract Atony is the most common cause of postpartum hemorrhage(50%of cases)5ppt课件 excessive manipulation of the uterus general anesthesia uterine overdistention prolonged labor uterine leiomyomas.6pp

3、t课件Obstetric lacerations Uterus cervix vagina vulva hematomas7ppt课件Retained placental tissue Placenta accreta in manual removal of the placenta in mismanagement of the third stage of labor in unrecognized succenturiate placenta8ppt课件Coagulation deffects Abruptio placentae excess thromboplastin from

4、a retained dead fetus amniotic fluid embolism severe preeclampsia eclampsia sepsis9ppt课件Prevention Predelivery preparation delivery third stage of normal labor(placenta separation)10ppt课件Evaluation of persistent bleeding Manually compress the uterus obtain assistance if not already done,obtain blood

5、 for typing and cross-matching observe blood for clotting to rule out coagulopathy carefully explore the uterine cavity11ppt课件Measures to control bleeding12ppt课件 Manual exploration of the uterus Bimanual compression curettage Oxytocin Radiographic embolization of pelvic vessels Operative management

6、13ppt课件Operative management Pressure occlusion of the aorta Uterine artery ligation Internal iliac artery ligation B-lynch brace suture Hysterectomy14ppt课件Postpartum puerperium infections15ppt课件Definition Puerperal morbidity due to infection has occurred if the patients temperature is higher than 38

7、0C on 2 separate occasions at least 24 hours apart following the first 24 hours after delivery.16ppt课件Incidence 2-8%undergone operative delivery premature rupture of the membranes long labors multiple pelvic examinations17ppt课件Morbidity and motality Contribute to the death of about 8%of all pregnant

8、 women who die each year.18ppt课件Pathogenesis Aerobic bacteria Anaerobic bacteria Mycoplasma Ureaplasma19ppt课件Mechanisms to prevent overt infection Acidity of the normal vagina thick,tenacious cervical mucus maternal antibodies to most vaginal flora20ppt课件Etiology Cesarean section undergone operative

9、 delivery premature rupture of the membranes long labors multiple pelvic examinations21ppt课件Clinical findings Endometritis Urinary tract infection Generalized sepsis septic pelvic thrombophlebitis pelvic abscess22ppt课件Symptoms and signs Fever Uterine tenderness23ppt课件Laboratory findings Leukocytosis urinalysis bacterilogic findings(Aerobic bacteria,Anaerobic bacteria,Mycoplasma,Ureaplasma)24ppt课件Differential diagnosis Involuntary chills extragenital infections25ppt课件Treatment The use of antibiotics Physical treatment Chinese medicine26ppt课件