阴道分娩后胎盘因素性产后出血的处理与思考  

Management and reflection on placental factor induced postpartum hemorrhage after vaginal delivery

作　　者：陈练[1] 赵扬玉[1] CHEN Lian;ZHAO Yang-yu(Department of Obstetrics and Gynecology,Peking University Third Hospital&National Clinical Research Center for Gynecology and Obstetrics&National Center for Healthcare Quality Management in Obstetrics,Beijing 100194,China)

机构地区：[1]北京大学第三医院妇产科,国家妇产疾病临床医学研究中心,国家产科专业医疗质量控制中心,北京100191

出　　处：《中国实用妇科与产科杂志》2024年第4期399-402,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：国家重点研发计划(2021YFC2701502);国家自然科学基金(82101821);北京市科技新星人才项目(Z211100002121045)。

摘　　要：产后出血仍然是全球性问题,在孕产妇死亡原因中占近1/4。宫缩乏力一直是产后出血的首要原因,但近年来随着孕产妇疾病谱的变化、妊娠年龄后移、辅助生殖技术的应用和宫腔操作的增加,胎盘因素导致的产后出血呈现上升趋势。其中,第三产程胎盘滞留是阴道分娩后胎盘因素性产后出血最为关键的临床问题,如处理不恰当,可能会导致严重产后出血、多脏器功能损害甚至产妇死亡。文章就如何针对胎盘滞留的原因进行鉴别并给予正确的处理进行了探讨,同时提出了未来进一步研究的方向。Postpartum hemorrhage remains a global issue,accounting for nearly one-fourth of maternal mortality causes.Uterine atony has always been the primary cause of postpartum hemorrhage,but in recent years,with changes in the spectrum of maternal comorbidities,an increase in maternal age at childbirth,increased use of assisted reproductive technologies,and a rise in uterine procedures,postpartum hemorrhage due to placental factors has shown an upward trend.Among these factors,retained placenta in the third stage of labor is a crucial clinical concern for postpartum hemorrhage following vaginal delivery.If improperly managed,it may lead to severe postpartum hemorrhage,multi-organ dysfunction,and even maternal death.This article explores the identification and proper management of the causes of retained placenta,proposing directions for future research.

关 键 词：阴道分娩 胎盘滞留 产后出血 处理 分型 

分 类 号：R714.461[医药卫生—妇产科学]