Postpartum Hemorrhage 产后出血,The Third Affiliated Hospital of Sun Yat-sen University,Xuyao Li, Obstetrics and Gynecology Nursing The first section of the eleventh chapter Master,Know,What？ Definition Why？ Etiologies How？ Treatment Prevention,Learning Goals,Definition,Blood loss of 500 ml or more within 24 hours after delivery,Etiologies,Uterine atony,Placental factors,Soft birth canal laceration,Coagulation disorders,uterine atony,Systemic factors,Local factors,70%-80%,psychentonia,weakness,chronic disease,multifetation,giant baby,fibroid,Implantation,placental factors,Adhesion,Incomplete separation,Residual,10%,Completely stripping,Exclude blocked,Incarceration,Retention,spasm of internal cervical os,placental factors,Unable to exclude filling of bladder,10%,Perineum,Vagina,Cervical,soft birth canal laceration,Hemostasis,Increased blood volume,Prevention of infection,Prescribed medication,Treatment,The weakness of uterine contraction,massage method uterine contraction drugs,To strengthen the contraction,other,balloon tamponade oppressed artery ligation or embolization of pelvic arteries. hysterectomy,Suture of soft birth canal,Remove the residual of placenta and fetal membrane,According to the etiology,hemostasis,Prevention,1. Should pay attention to prenatal care ： Early treatment related diseases, timely termination of pregnancy Make contraception work, reduce the times of artificial abortion operation For high risk pregnant women with postpartum hemorrhage, strengthen inspection and to delivery in hospital,2. Correctly deal with the labor process First stage ： Pay attention to rest and diet, to prevent fatigue and extend the production process, the reasonable application of oxytocin and Sedatives Second stage ： Pay attention to the protection of perrineum, gentle operation specification, using the right abdominal pressure,Prevention,prevention,2. Correctly deal with the labor process Third stage： (key) correct extraction of the placenta and carefully check; if bleeding, should find out the cause and timely treatment; check the soft birth canal,3. Strengthening postpartum observation Carefully observe 2H Time to empty the bladder The early lactation,prevention,Why？,What？,Now do you have the answer?,How？,Summary,Questions,Definition：Blood loss of or more within 24 hours after delivery,2. Treatment principle is： 、 increased blood volume、prevention of infection,500ml,hemostasis,Next class,Nursing assessment,Nursing diagnosis,Mental nursing,Health education,Clinical manifestation,Thank you,Massage method,Ergometrine,Oxytocin,Prostaglandin,uterine contraction drugs,Ligation of internal iliac arteries,Ligation of uterine arteries,Close dead cavity,Over the top,Suture of soft birth canal,p,Manual removal of placenta,The I degree Skin and mucous membrane injury,The II degree Muscle layer damage,The III degree Fracture of external anal sphincter,The degree : Anal rectum vagina completely through,Perineal laceration,