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产后出血大致分为产后24小时内的早期产后出血和产后24小时以后的晚期产后出血。多数发生在产后2小时,又称第四产程内,故对第四产程更需加强监护。其关键是产后当时须首先注意子宫缩复与出血状态,并严密观察:(1)有无软产道裂伤;(2)有无子宫缩复;(3)有无胎盘胎膜残留;(4)有无凝血障碍;(5)随时计测出血量;(6)重视血压、脉搏、呼吸等生命指征的变化。预测产后出血的孕期状态一、预测产后出血的孕妇:(1)多孕、多产及曾有多次宫腔手术史者。(2)高年初产妇。(3)低龄孕妇。(4)合并子宫疾病,有子宫肌瘤剔除或宫颈裂伤史者。(5)性器官发育不全、畸形。(6)软产道异常。(7)妊娠中毒症。
Postpartum hemorrhage is roughly divided into early postpartum hemorrhage within 24 hours after childbirth and late postpartum hemorrhage 24 hours after childbirth. Most occur in 2 hours after delivery, also known as the fourth stage of labor, so the fourth stage of labor need to be strengthened guardianship. The key is postpartum was the first to pay attention to the status of uterine contractions and bleeding, and close observation: (1) with or without soft birth canal laceration; (2) with or without uterine contraction; (3) with or without placental fetal membrane residual; (4) coagulation disorders; (5) measured blood volume at any time; (6) attention to changes in blood pressure, pulse, respiration and other life indications. Predict postpartum hemorrhage state of pregnancy one, predict the postpartum hemorrhage of pregnant women: (1) more pregnancy, prolific and have multiple uterine surgery history. (2) high early primipara. (3) young pregnant women. (4) with uterine disease, uterine fibroids or cervical laceration history. (5) sexual organs hypoplasia, deformity. (6) soft birth canal abnormalities. (7) Gestational poisoning.