中国医科大学妇产科学英文课件 postpartum hemorrhage and infection, puerperium infection.pptVIP

Postpartum hemorrhage Page 244 Definition Postpartum hemorrhage has been defined as the loss of 500ml or more blood after the delivery of the fetus (completion of the third stage of labor). Hemorrhage after the first 24 hours is designated late postpartum hemorrhage. Sheehan syndrome Severe intrapartum or early postpartum hemorrhage is on rare occasions followed by sheehan syndrome, which in the classical case is characterized by failure in laceration, amenorrhea, atrophy of the breasts, loss of pubic and axillary hair, superinvolution of the uterus, hypothyroidism and adrenal cortical insufficiency. Sheehan syndrome In some but not all instances of sheehan syndrome, varying degrees of anterior pituitary necrosis with impaired secretion of one or more trophic hormones account for endocrine abnormalities. Some cases imply impaired hypothalamic function. Etiology Uterine atony(uterine inertia) Genital tract lacerations Placenta factors Impaired coagulation mechanism Clinical manifestation and diagnosis Bleeding shock., infection uterine atony genital tract lacerations placenta factors Placenta factors Retained placenta fragments placenta adherence placenta accreta, increta and percreta placenta accreta is used to describe any placental implantation in which there is abnormally firm adherence to the uterine wall.Placenta villi are attached to the myometrium in placenta accreta; actually invade the myometriumin placenta increta, or penetrate through the myometrium in placenta percreta Puerperal Infection Page 257 definition Puerperium: is the postpartum period during which the pelvic organs return to their prepregnant conditions puerperium infection is a general term used to describe any bacterial infection of the genital tract after delivery puerperium morbidity: Puerperium morbidity Temperature 38.0 or higher, the temperature to occur on any 2 of the first 10days postpartum, exclusive of the first 24 hours, and to be taken by mouth by a stand