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胎盘滞留是产后大失血的主要原因之一。凡胎儿娩出后半小时,胎盘尚未娩出者,统称胎盘滞留。根据胎盘与子宫壁之间的关系,可分为:1胎盘全部剥离留滞;2.胎盘嵌顿;3.胎盘粘连;4.胎盘植入;5.胎盘部分残留。Akiyama 认为,胎儿娩出后2分钟内胎盘剥离,10分钟之内娩出。所以,如果胎儿娩出后10分钟胎盘尚未娩出,应检查子宫底高度,膀胱是否充盈,压迫耻骨上方脐带有否向外移动等胎盘剥离征象。如已剥离可将拇指放在子宫体前方,另四指于子宫后方,沿产道轴向下推压子宫,胎盘即可娩出。如胎儿娩出后有活动性出血或半小时后尚无胎盘剥离征象,应及时进行人工剥离胎盘手术。对有流血者应有输血的准备
Placental retention is one of the major causes of postpartum hemorrhage. Where the fetus is delivered half an hour after the placenta has not been delivered, collectively referred to the placenta stranded. According to the relationship between the placenta and the uterine wall, can be divided into: 1 Placenta all detachment lag; 2. Placenta incarceration; 3. Placental adhesion; 4. Placenta accreta; Akiyama believes that within 2 minutes after delivery of the fetus, the placenta is stripped and delivered within 10 minutes. So if the placenta has not been delivered 10 minutes after the baby is delivered, check for signs of placental abruption, such as the height of the uterus, bladder filling, compression of the umbilical cord above the umbilical cord for outward movement. If stripped thumbs can be placed in front of the uterus, the other four fingers behind the uterus, along the birth canal axis down to push the uterus, the placenta can be delivered. Such as the fetus after delivery of active bleeding or half an hour after the absence of signs of placental detachment, manual dissection should be promptly placenta accreta. Blood transfusion should be prepared for blood transfusion