[Postpartum hemorrhage].
キーワード
概要
Postpartum hemorrhages are observed in 2 to 10% of all deliveries. They are severe in 1% of the pregnancies. However, they remain a major cause of maternal morbidity and mortality. Post-partum hemorrhages are generally separated in 2 categories. Acute hemorrhage occurs in the 24 hours following the delivery and is mainly caused by uterine atony, retained secondines, placenta accreta, birth canal trauma and uterine inversion. The delayed hemorrhage occurs after 1 day to 6 weeks after the delivery and is often related to uterine infection or abnormal involution of the placental bed. The management requires uterine massage and ocytocine or prostaglandins. Surgical or radiological selective ligation or embolization of the internal iliac arteries can be required. The hysterectomy is proposed in the most severe cases.