教学内容?胎儿窘迫、子宫破裂、产后出血——约2学时?脐带异常、羊水量异常、早产、胎膜早破、过期妊娠、多胎妊娠——约1学时+自学?王正平浙江大学医学院附属妇产科医院产科 Tel : 87061501 - 2061 Post Partum Hemorrhage Uterine Rupture, Fetal Distress Women Hospital , School of Medical, ZheJiang University Wang Zheng Ping Post partum hemorrhage Post partum hemorrhage ? Past partum hemorrhage denotes excessive bleeding (≥ 500ml in vaginal delivery) during the first 24 hours after delivery ? Common cause of death and diseases in pregnant women globally ? Leading cause of death in pregnant women in China ? Incidence 2%-3% of total number of deliveries Etiology ? Uterine atony : 70% ? Obstetric lacerations: 20% ? Retained placental tissue: 10% ? Coagulation:1% Uterine atony ? General factors: extreme nervousness, sedative, anesthesia, tocolytics , weak ? Obstetric factors: prolonged labour , fatigue, placenta previa , placenta abruptio , severe anemia ? Uterine factors: uterine muscular fiber underdevelopment, such as uterine deformity or myoma ; uterine overstretched, such as macrosomia , multiple pregnancy, polyhydramnios Placental factors ? plete placental separation ? Retained placenta ? Placental incarceration (嵌顿) ? Placental adhesion ? Placental implantation ( accreta , increta , percreta ) ? Residual placenta and amniotic membrane
