1、Postpartum Hemorrhage1ppt课件DefinitionPostpartum hemorrhage denotes excessive bleeding (500mL in vaginal delivery) following delivery. 2ppt课件Incidence58%Postpartum hemorrhage is the most common cause of excessive blood loss in pregnancy.3ppt课件EtiologyUterine atonyObstetric lacerationsRetained placent
2、al tissueCoagulation deffects4ppt课件Uterine atonyUterine atony exists when the myometrium cannot contractAtony is the most common cause of postpartum hemorrhage (50% of cases)5ppt课件excessive manipulation of the uterusgeneral anesthesiauterine overdistentionprolonged laboruterine leiomyomas.6ppt课件Obst
3、etric lacerationsUteruscervixvaginavulvahematomas7ppt课件Retained placental tissuePlacenta accretain manual removal of the placentain mismanagement of the third stage of laborin unrecognized succenturiate placenta8ppt课件Coagulation deffectsAbruptio placentaeexcess thromboplastin from a retained dead fe
4、tusamniotic fluid embolismsevere preeclampsiaeclampsiasepsis9ppt课件PreventionPredelivery preparationdelivery third stage of normal labor (placenta separation)10ppt课件Evaluation of persistent bleedingManually compress the uterusobtain assistanceif not already done, obtain blood for typing and cross-mat
5、chingobserve blood for clotting to rule out coagulopathycarefully explore the uterine cavity11ppt课件Measures to control bleeding12ppt课件Manual exploration of the uterusBimanual compression curettageOxytocinRadiographic embolization of pelvic vesselsOperative management 13ppt课件Operative managementPress
6、ure occlusion of the aortaUterine artery ligationInternal iliac artery ligationB-lynch brace sutureHysterectomy14ppt课件Postpartum puerperium infections15ppt课件DefinitionPuerperal morbidity due to infection has occurred if the patients temperature is higher than 380C on 2 separate occasions at least 24
7、 hours apart following the first 24 hours after delivery.16ppt课件Incidence2-8%undergone operative deliverypremature rupture of the membraneslong laborsmultiple pelvic examinations17ppt课件Morbidity and motalityContribute to the death of about 8% of all pregnant women who die each year.18ppt课件Pathogenes
8、isAerobic bacteriaAnaerobic bacteriaMycoplasmaUreaplasma19ppt课件Mechanisms to prevent overt infectionAcidity of the normal vaginathick, tenacious cervical mucusmaternal antibodies to most vaginal flora20ppt课件EtiologyCesarean sectionundergone operative deliverypremature rupture of the membraneslong la
9、borsmultiple pelvic examinations21ppt课件Clinical findingsEndometritisUrinary tract infectionGeneralized sepsisseptic pelvic thrombophlebitispelvic abscess22ppt课件Symptoms and signsFeverUterine tenderness23ppt课件Laboratory findingsLeukocytosisurinalysisbacterilogic findings (Aerobic bacteria, Anaerobic bacteria, Mycoplasma, Ureaplasma)24ppt课件Differential diagnosisInvoluntary chillsextragenital infections25ppt课件TreatmentThe use of antibioticsPhysical treatmentChinese medicine26ppt课件
