美国ACOG产后大出血治疗策略方案.pptVIP

Recombinant Activated Factor VIIa Tx of bleeding disorders Dose up to 120mcg/kg q2h until hemostasis Promising but needs more studies $10,000/mg Risk thromboembolism Step 1 – Initial Assessment Resuscitation Large bore iv’s O2 Vitals ±foley catheter Dx Etiology -explore uterus (tone/tissue) -explore genital tract (trauma) -review history (thrombin) -observe clots Labs -CBC -coag profile -cross match Step 2 – Directed Therapy Tone -massage -compress -drugs Tissue -manual removal -curettage Trauma -correct inversion -repair laceration -identify rupture Thrombin -reverse anticoagulation -replace