Treatment and prevention of postpartum hemorrhage.docVIP

 PAGE \* MERGEFORMAT 20 Treatment and prevention of postpartum hemorrhage Postpartum hemorrhage is still a serious obstetric complications and maternal mortality one of the main. Successful prevention and control of postpartum hemorrhage, reduce the incidence rate is the key to reducing maternal mortality. Postpartum hemorrhage is defined as the amount of fetal hemorrhage 2h post-DI ≥ 400ml or until the baby is delivered, after 24h the amount of bleeding ≥ 500ml [1]. The main reasons for postpartum hemorrhage uterine contraction fatigue, soft birth canal injury, retained placenta, followed by the reproductive tract hematoma, uterine rupture or uterine inversion, placenta accreta, and coagulation disorder. Uterine atony which accounted for 90% of postpartum hemorrhage. Uterine inertia caused by the risk factors to extend the production process, the placenta and fetal membranes residues, sheep meningitis, oxytocin, pre-eclampsia and eclampsia, multiple pregnancy, fetal macrosomia, polyhydramnios, inhalation anesthesia and the previous history of postpartum uterine atony et al [2]. A mechanism for post-partum hemorrhage Postpartum bleeding is uterine muscle fibers of the structural characteristics and blood coagulation mechanisms for joint decision. Uterine contraction motivation comes from the endogenous oxytocin and prostaglandin release, intracellular free calcium ion is excited muscles - contraction coupling of active agents, oxytocin can be released and the promotion of calcium ions to flow to the muscle cells, while the prostate Su is a calcium ionophore, and calcium ions to form a composite body, will carry into the cells of calcium into the muscle cells of calcium ions and actin, sarcoplasmic protein, the combination of uterine contraction and retraction on the palace walls played the role of vascular hemostasis. At the same time due to muscle contractions circuitous blood vessels, blocking blood flow is conducive to thrombosis, sinus closed. Uter