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Postpartum Hemorrhage1ppt课件Postpartum Hemorrhage1ppt课件DefinitionPostpartum hemorrhage denotes excessive bleeding(500mL in vaginal delivery)following delivery.2ppt课件DefinitionPostpartum hemorrhagIncidence58%Postpartum hemorrhage is the most common cause of excessive blood loss in pregnancy.3ppt课件Incidence58%3ppt 课件EtiologyUterine atonyObstetric lacerationsRetained placental tissueCoagulation deffects4ppt课件EtiologyUterine atony4ppt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Uterine atonyUterine atony exiexcessive manipulation of the uterusgeneral anesthesiauterine overdistentionprolonged laboruterine leiomyomas.6ppt课件excessive manipulation of the Obstetric lacerationsUteruscervixvaginavulvahematomas7ppt课件Obstetric lacerationsUterus7ppRetained placental tissuePlacenta accretain manual removal of the placentain mismanagement of the third stage of laborin unrecognized succenturiate placenta8ppt课件Retained placental tissuePlaceCoagulation deffectsAbruptio placentaeexcess thromboplastin from a retained dead fetusamniotic fluid embolismsevere preeclampsiaeclampsiasepsis9ppt课件Coagulation deffectsAbruptio pPreventionPredelivery preparationdelivery third stage of normal labor(placenta separation)10ppt课件PreventionPredelivery preparatEvaluation of persistent bleedingManually compress the uterusobtain assistanceif not already done,obtain blood for typing and cross-matchingobserve blood for clotting to rule out coagulopathycarefully explore the uterine cavity11ppt课件Evaluation of persistent bleedMeasures to control bleeding12ppt课件Measures to control bleeding12Manual exploration of the uterusBimanual compression curettageOxytocinRadiographic embolization of pelvic vesselsOperative management 13ppt课件Manual exploration of the uterOperative managementPressure occlusion of the aortaUterine artery ligationInternal iliac artery ligationB-lynch brace sutureHysterectomy14ppt课件Operative managementPressure oPostpartum puerperium infections15ppt课件Postpartum puerperium infectioDefinitionPuerperal morbidity due to infection has occurred if the patients temperature is higher than 380C on 2 separate occasions at least 24 hours apart following the first 24 hours after delivery.16ppt课件DefinitionPuerperal morbidity Incidence2-8%undergone operative deliverypremature rupture of the membraneslong laborsmultiple pelvic examinations17ppt课件Incidence2-8%17ppt 课件Morbidity and motalityContribute to the death of about 8%of all pregnant women who die each year.18ppt课件Morbidity and motalityContribuPathogenesisAerobic bacteriaAnaerobic bacteriaMycoplasmaUreaplasma19ppt课件PathogenesisAerobic bacteria19Mechanisms to prevent overt infectionAcidity of the normal vaginathick,tenacious cervical mucusmaternal antibodies to most vaginal flora20ppt课件Mechanisms to prevent overt inEtiologyCesarean sectionundergone operative deliverypremature rupture of the membraneslong laborsmultiple pelvic examinations21ppt课件EtiologyCesarean section21ppt课Clinical findingsEndometritisUrinary tract infectionGeneralized sepsisseptic pelvic thrombophlebitispelvic abscess22ppt课件Clinical findingsEndometritis2Symptoms and signsFeverUterine tenderness23ppt课件Symptoms and signsFever23ppt课件Laboratory findingsLeukocytosisurinalysisbacterilogic findings(Aerobic bacteria,Anaerobic bacteria,Mycoplasma,Ureaplasma)24ppt课件Laboratory findingsLeukocytosiDifferential diagnosisInvoluntary chillsextragenital infections25ppt课件Differential diagnosisInvoluntTreatmentThe use of antibioticsPhysical treatmentChinese medicine26ppt课件TreatmentThe use of antibiotic
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