产科出血预防专用课件.pptVIP

产后出血定义 严重产后出血是指胎儿娩出后24 h内出血量≥1 000 mL 难治性产后出血是指胎儿娩出后24 h内，阴道分娩者出血量≥500 mL、剖宫产分娩者出血量≥ 1 000 Ml 经宫缩剂、持续性子宫按摩或按压等保守措施无法止血，需要外科手术、介入治疗甚至切除子宫的严重产后出血 重症产后出血情况包括：出血速度150 mL/min；3 h内出血量超过总血容量的50％；24 h内出血量超过全身总血容量 各种止血方法的有效性评价：英国（经筛选后纳入46个研究）水囊填塞84.0%，B-Lynch及其他保守缝合法91.7%，髂内动脉结扎或子宫血供阻断84.6%，动脉栓塞90.7%，各种方法有效性比较差异无统计学意义； 目前尚无证据证明哪种保守性方法的效果最好，以创伤性最小且最快速、掌握最熟练的方法为首选！ * This section will now provide an overview on the product characteristics of Pabal? along with its clinical efficacy and safety in preventing PPH. * * Therapeutic Indication Carbetocin is indicated for the prevention of uterine atony following delivery of the infant by caesarean section under epidural or spinal anaesthesia.1(/p28/para1) Carbetocin is currently indicated for the prevention of uterine atony after caesarean delivery under spinal or epidural anaesthesia in 23 countries.2(/p3/col2/para3). Carbetocin is approved for the prevention of uterine atony following vaginal deliveries in Mexico, Russia and Kazhakstan.3 Drug Formulation Carbetocin is available in 1 mL ampoules for IV bolus injection, each containing 100 μg/mL carbetocin.1(/p28/para1) Drug Chemistry Carbetocin is a long-acting structural analogue of human oxytocin. Chemical structures displayed on the screen represents the structural similarity and differences between oxytocin and carbetocin.1(/p12/fig3) Reference Pabal [product monograph]. Ferring International Centre, Switzerland: 2010. Su L-L, Chong Y-S, Samuel M. Carbetocin for preventing postpartum haemorrhage. Cochrane Database Syst Rev 2012; (4): CD005457. van Dongen PW, Verbruggen MM, de Groot AN, van Roosmalen J, Sporken JM, Schulz M. Ascending dose tolerance study of intramuscular carbetocin administered after normal vaginal birth. Eur J Obstet Gynecol Reprod Biol. 1998;77(2):181-187. * * A single IV dose of carbetocin must be administered slowly over 1 minute only after the delivery of the infant has been completed by caesarean section under epidural or spinal anaesthesia. Carbetocin