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在postpartum hemorrhage這個產品中，有3篇Facebook貼文，粉絲數超過2萬的網紅威廉氏後人 - 李毅評醫師，也在其Facebook貼文中提到， < 生產時避無可避的生死危機：3000cc的產後大出血 > 各位好 我是威廉氏後人 – 李毅評醫師 - 這是一位33歲的產婦，小語 小語是一個健康的孕婦 自然懷孕， 本身沒有任何疾病或異常 產檢過程也一切順利 直到39週多時來院待產 - 看似一切正常、平凡無奇的產婦小語 卻在...
　同時也有10000部Youtube影片，追蹤數超過62萬的網紅Bryan Wee，也在其Youtube影片中提到，...

postpartum hemorrhage 在 威廉氏後人 - 李毅評醫師 Facebook 八卦

威廉氏後人 - 李毅評醫師 By 威廉氏後人 - 李毅評醫師

2021-02-03 22:16:49 有 1,580 人按讚
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< 生產時避無可避的生死危機：3000cc的產後大出血 >

各位好

我是威廉氏後人 – 李毅評醫師

-

這是一位33歲的產婦，小語

小語是一個健康的孕婦

自然懷孕，

本身沒有任何疾病或異常

產檢過程也一切順利

直到39週多時來院待產

-

看似一切正常、平凡無奇的產婦小語

卻在生產時面對了一個醫師與產婦都不願碰到的生死關頭

-

小語待產過程並不算順利

待產兩天多還是無法順利生產

子宮頸全開後

持續用力了數個小時但胎頭仍卡在上端

最後

由於產程遲滯

小語接受剖腹產。

剖腹產出一個女嬰，3000多克，

剖腹產過程一切順利，

小孩子狀況也不錯

-

然而

就在剖腹產完成30分鐘左右

已經轉送到術後恢復室的小語

忽然從陰道掉出一個400公克的大血塊

並且持續快速地出血

小語當時心跳加速到每分鐘170下

血壓掉到80/50 mmHg,

瀕臨出血性休克的危機

-

經過我們立即的檢查

小語並沒有內出血或其他出血點

但子宮就是鬆軟無力

陰道持續快速而大量的湧出血來

-

經過各種強力宮縮藥物的使用及子宮按摩術

雖然出血有稍微緩解

但仍舊持續出血不斷

-

最終，我拜託本院放射科團隊

進行體外子宮動脈栓塞術 (TAE)

並於半小時後

就順利完成了子宮動脈栓塞術

也就止住了產後大出血。

-

根據國際的定義

生產出血超過1000cc定義為產後大出血

小語生產的總預估出血量超過3000cc.

後來，

小語前前後後一共接受2500cc的輸血

幾乎是換了全身一半以上的血液之後

小語才逐漸從蒼白的臉色中恢復

-

產後大出血是一個很難預測、

也無法完全預防的產科急症

發生率大約在3%左右

也就是平均每33個產婦

就會有一位發生產後大出血。

-

產後大出血最常見的原因是子宮收縮不良

本來子宮在生產之後

要能夠緊緊縮成一球

才能夠讓子宮裡面的血管被收縮的子宮肌肉壓迫住

因而停止生產後的出血

然而，

若產後子宮收縮不良

就可能造成子宮持續且快速的出血

-

懷孕後期的子宮血流量非常豐富

大約每分鐘會有600cc的血液流進子宮

因此

子宮的出血往往來的又急又快

如果沒有辦法迅速的止血

產婦恐有生命危險。

-

儘管在醫療發達的21世紀

產後大出血仍是先進國家孕產婦死亡的前三名原因之一

-

面對子宮收縮不良

除了給予大量的子宮收縮藥物之外

在過去，唯一救命的解方就是把子宮切除

即使在今日

子宮切除仍為治療產後大出血的一個標準治療方案之一

-

然而

面對一位只生一胎，33歲的產婦來說

如果能夠選擇的話

誰又不希望能夠保留自己健康的子宮呢？

-

因此

這個時候

放射科醫師透過醫學影像技術

藉由腹股溝附近的血管將導管放置到子宮動脈處

將子宮動脈做暫時性的栓塞

就可以有效地止血

也可以保留子宮

對後續的第二胎、第三胎也不會有不良影響

-

附圖畫面中的黑色顯影處

就是骨盆腔的血管

暈開的黑色區域

就是持續出血的子宮動脈

透過放射科血管導管的技術

將出血的血管進行栓塞

就可以完成快速而有效的止血。

-

我在此必須再次感謝新光醫院放射科全團隊

因為他們的技術跟努力

才能救回一個子宮

救回一條命

更救回一個家庭

-

參考資料：UpToDate : Overview of postpartum hemorrhage

-

“生產有時會變得極為兇險，面對生死一線的絕境，我們需要的不是一個一騎當千的英雄，而是一個有設備、有組織、有紀律、有經驗的團隊。”

”接生猶如千里荊棘之路，所幸，我有你們同行。”

-

~ 威廉氏後人 – 李毅評醫師 ~

臉書蒐尋 : 威廉氏後人 – 李毅評醫師

粉絲專頁 : https://www.facebook.com/mrwilliams999

個人網站 : https://haveababy.tw/

Instagram： https://www.instagram.com/mr_williams_li/......

-

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提供最新最正確的網路婦產科知識。
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postpartum hemorrhage 在 Dr 文科生 Facebook 八卦

Dr 文科生 By Dr 文科生

2020-07-10 22:16:04 有 672 人按讚
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《點解經血可以亂咁嚟？》子宮肌瘤篇

今日同大家講講子宮肌瘤的形成、徵狀和治療。

何謂子宮肌瘤（Fibroid/Leiomyoma）

在了解子宮肌瘤前，我們要先了解子宮的構造，子宮主要分為兩層 — 子宮內膜（Endometrium）和子宮肌膜（Myometrium）。

當我們從陰道去到盡頭時會看到子宮頸，而子宮頸打開後便可以進入子宮內膜，一般宮腔鏡（Hysteroscopy）檢查的便是子宮內膜。而子宮肌膜則在內膜後的深層。

子宮肌瘤是一種於子宮肌膜裡肌肉組織的增生，並會對雌激素（Estrogen）有生長反應，所以所有有月經的女性都有機會患上。

一般來說患上子宮肌瘤的多為四十歲左右，已月經良久的婦女，因子宮肌膜長期受到月經時雌激素急升的影響而形成子宮肌瘤。

【子宮肌瘤病徵】
🎯一般來說細小的子宮肌瘤沒有病徵，大部分的子宮肌瘤都是婦科檢查或超聲波造影時剛巧發現的

🎯巨大的子宮肌瘤如5-6cm以上的，可以導致月經劇痛（Dysmenorrhea）、月經大量出血（Menorrhagia）、長期盤腔感覺沉重、因尿道被壓的徵狀如經常需要小便等

🎯可引起性愛時的痛楚（Dyspareunia）或腰痛

🎯對懷孕婦女來說，巨型的子宮肌瘤有引起懷孕後段的小產或早產（Uncommon）；生產後嚴重出血（Postpartum Hemorrhage）的風險

如長期嚴重經痛、經血過量、盤腔長期不適的話或擔心患上嚴重的子宮肌瘤，建議諮詢家庭醫生和婦科醫生意見進行婦科檢查和盤腔超聲波檢查。

【子宮肌瘤種類】
子宮肌瘤大致分為三類
1. Submucosal：肌瘤生長到子宮內腔裡
2. Intramural：整顆肌瘤都在子宮組織裡
3. Subserosal：肌瘤生長在子宮外層，盤腔裡面

子宮肌瘤的治療方案取決於肌瘤的大小、患者的病徵、年齡和健康狀況等等。

【一般來說子宮肌瘤有以下治療方案】

🎯謹慎觀察：適合肌瘤細小而且沒有病徵的患者，一般等到更年期後便會因缺少雌激素而縮細

🎯子宮肌瘤切除手術
- 子宮內腔內窺鏡（Hysteroscopy）切除Submucosal的子宮肌瘤（Myosure myometectomy）
- 腹腔內窺鏡（Laparoscopy）切除Intramural或subserosal的子宮肌瘤

🎯全子宮切除手術（Total hysterectomy）

到底選擇哪一種治療方案取決於眾多臨床因素和病人喜好，如有疑問請諮詢家庭或婦科醫生。

子宮肌瘤是非常非常非常之常見的婦科病，不用太過擔心，及早求醫、及早發現、及早治療可以讓婦女們盡快重拾有品質的生活素質，謹記別諱疾忌醫啊！

*注：以上內容只作公共衛生教學用途，並非正式醫療諮詢，如有疑問請尋求你的家庭醫生或婦科醫生協助。所有網上診症問題均不會回答，敬請留意。

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90後香港男生 Patreon專欄： https://www.patreon.com/user?u=32901195 Blogger in Meducia 你的健康夥伴 https://www.meducia.com/
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postpartum hemorrhage 在 加護病房查房日誌 Facebook 八卦

加護病房查房日誌 By 加護病房查房日誌

2018-05-10 08:28:16 有 315 人按讚
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加護病房查房日誌20180510
大家應該都知道Tranexamic acid吧，就是transamine，可以用來止血，也有用來美白(這個可能比較少人知道，只是老師覺得也沒啥用)。
今天是要講transamine用在處理postpartum hemorrhage(產後出血)。
UpToDate中建議，女性若生產完，三個小時內，診斷產後出血，建議使用transamine作為治療之一。如果已經超過三個小時，仍建議用transamine，只是證據就比較不清楚了。
Transamine是一個抗纖維蛋白溶解的藥品，可減少手術和創傷病人的出血。
在一個隨機試驗中，收入來自20個國家以上，超過2萬個產後出血的女性(the World Maternal Antifibrinolytic Randomized Trial [WOMAN])，用transamine和安慰組相比，減少因為出血死亡的相對風險約20-30%，也減少為了控制出血而做的剖腹手術，而且也不會增加副作用。不過總死亡率是沒有減少的。
文獻來源: https://www.thelancet.com/…/PIIS0140-6736(17)30638…/abstract

媽媽真的很辛苦，生產其實是有一定風險的，而且相當辛苦，母親節也快到了，各位媽媽同學，老師在這邊祝大家母親節快樂，家人都平平安安。也歡迎大家在底下留言，祝自己的媽媽或另一半母親節快樂喔。
#Transamine
#母親節快樂

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這是一個分享加護病房中查房心得，醫藥新知的地方。以簡單的方式呈現給大家，希望對大家有所幫助。
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postpartum hemorrhage 在 Bryan Wee Youtube 的評價

Bryan Wee By Bryan Wee

2017-11-23 14:29:05 有 208,914,766 人看過 有 345,617 人喜歡
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Bryan Wee

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?Banana女神? ?关注➕保证让你爱上我? ----------------------------------- Facebook➕BryanWee Instagram➕bryan.weee
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postpartum hemorrhage 在 Travel Thirsty Youtube 的評價

Travel Thirsty By Travel Thirsty

2018-04-20 21:03:42 有 105,187,459 人看過 有 487,823 人喜歡
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Travel Thirsty

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Follow us as we explore our way through the world, feasting on interesting sights and amazing food! New videos every week. Don't forget to subscribe!
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postpartum hemorrhage 在 スキマスイッチ - 「全力少年」Music Video : SUKIMASWITCH / ZENRYOKU SHOUNEN Music Video Youtube 的評價

スキマスイッチ - 「全力少年」Music Video : SUKIMASWITCH / ZENRYOKU SHOUNEN Music Video By スキマスイッチ - 「全力少年」Music Video : SUKIMASWITCH / ZENRYOKU SHOUNEN Music Video

2008-12-08 16:27:04 有 71,179,683 人看過 有 185,567 人喜歡
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社群媒體上有些相關的討論：

postpartum hemorrhage 在 Postpartum hemorrhage - causes, symptoms, treatment ... 的八卦

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What is postpartum hemorrhage? Postpartum hemorrhage is severe bleeding after giving birth and is the leading cause of maternal morbidity ... ... <看更多>

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Post-partum hemorrhage, or PPH, is heavy blood loss after a baby is born (more than 500 ml or 1000 ml). Every day approximately 830 women die from ...

#43. An expert's answer to 6 common postpartum hemorrhage ...

The American College of Obstetrics and Gynecology recently redefined postpartum hemorrhage as any bleeding greater than or equal to 1,000 milliliters (1 liter) ...

#44. Postpartum complications: What you need to know - Mayo Clinic

Excessive bleeding after giving birth (hemorrhage); A disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body ( ...

#45. Postpartum Haemorrhage. PPH Condition information | Patient

Postpartum Haemorrhage is excessive bleeding following delivery and is described as primary and secondary. Primary postpartum haemorrhage ...

#46. Postpartum Hemorrhage - Cancer Therapy Advisor

Postpartum hemorrhage (PPH) is any excessive bleeding after delivery. It occurs in about 5% of all deliveries. Up to 25% of all pregnancy-related deaths are ...

#47. Pregnancy Complications: Common Causes of Hemorrhage

Postpartum hemorrhaging occurs when a woman loses 500 milliliters or more of blood after giving birth. It's estimated that 18 percent of births ...

#48. 8.2 Early postpartum haemorrhage - MSF Medical Guidelines

Early postpartum haemorrhage is defined as bleeding that occurs within 24 hours (usually immediately) after delivery of the placenta.

#49. Labour and Delivery Care Module: 11. Postpartum ...

Postpartum Haemorrhage. Study Session 11 Postpartum Haemorrhage. Introduction. Worldwide, every year, an estimated 127,000 women die as a result of blood loss ...

#50. Postpartum hemorrhage: prevention, diagnosis and non ...

Postpartum haemorrhage (PPH) is defined as the cumulative blood loss of 1,000 mL or more, accompanied by signs or symptoms of hypovolemia within 24 hours ...

#51. Incidence and Risk Factors of Postpartum Hemorrhage in China

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide but the incidence and its risk ...

#52. Prevention and Management of Postpartum Haemorrhage

Postpartum haemorrhage : its contribution to maternal mortality. Midwifery. ... Factors associated with postpartum hemorrhage with vaginal birth.

#53. Postpartum Hemorrhage (PPH) - AWHONN

In preparation for the 2021 Joint Commission New Standards for Perinatal Safety, AWHONN has updated its Postpartum Hemorrhage Education ...

#54. Heavy Bleeding After Birth (Postpartum Haemorrhage)

Postpartum haemorrhage (PPH) is heavy bleeding after birth: • Primary PPH is when you lose more than. 500ml of blood within the first 24hrs after birth. It is ...

#55. TREATMENT OF SUDDEN SEVERE POSTPARTUM ...

Even placenta previa and eclampsia, the other two furies of obstetric practice, do not demand such preparedness for complications as does postpartum hemorrhage.

#56. Understanding Secondary Postpartum Hemorrhage

Experienced labor and delivery nurse, Lynn Hill, outlines etiology and symptoms of secondary postpartum hemorrhage, risk factors, and treatment plans.

#57. The 4 T's of Postpartum Hemorrhage - Academic Life in ...

Postpartum hemorrhage is defined as > 500 cc of blood after a normal standard vaginal delivery (NSVD) or >1000 cc after a C-section. It occurs ...

#58. Postpartum Hemorrhage - Assessment

(PSBC, 2011; AWHONN, Johnson & Johnson, 2006). □ Decreased level of consciousness. Nursing Diagnosis. • Excessive postpartum blood loss due to uterine atony, ...

#59. Primary Post-Partum Haemorrhage - Management

Primary post-partum haemorrhage is the loss of >500 ml of blood per-vagina within 24 hours of delivery. It can be classified into two main types:.

#60. Protecting New Moms From Postpartum Hemorrhage and Stroke

PPH happens when you bleed more than you should after giving birth. Bleeding can occur because of injury or other problems with your cervix, vagina, uterus ( ...

#61. Tranexamic acid for postpartum haemorrhage: a major advance

If tranexamic acid reduced blood loss from postpartum haemorrhage in general, one would surely see an effect on the morbidity of all women in ...

#62. Postpartum Hemorrhage | Winchester Hospital

Postpartum hemorrhage is when a woman loses too much blood after giving birth. It is called primary when it happens in the first 24 hours after giving birth ...

#63. Management of Postpartum Haemorrhage - Medsafe

Postpartum haemorrhage (PPH) remains an important complication of childbirth and contributes significantly to maternal mortality. In the most recent triennial ...

#64. Misoprostol for the Treatment of Postpartum Hemorrhage

Postpartum hemorrhage (PPH) remains a major cause of maternal deaths worldwide. Misoprostol offers several advantages over oxytocin and ergometrine, the drugs ...

#65. Prevention of Postpartum Hemorrhage - MCHIP

Postpartum Hemorrhage (PPH) is excessive vaginal bleeding of greater than 500 ml after childbirth. However, even a small amount of blood loss can be ...

#66. Postpartum hemorrhage | Osmosis

Postpartum hemorrhage is a significant loss of blood after giving birth, and it's the number one reason for maternal morbidity and maternal death around the ...

#67. Prevention and Management of Postpartum Haemorrhage

High maternal mortality is largely associated with preventable causes that require. Emergency Obstetric Care (EmOC), such as Postpartum Hemorrhage (PPH), high.

#68. Obstetrical Hemorrhage - Paul Ogburn, MD, Stony Brook ...

If heavy bleeding continues after the cesarean section, treat as postpartum hemorrhage. Page 9. “Obstetrics is Bloody Business”*. Postpartum Hemorrhage:.

#69. Workshop to Contain Postpartum Hemorrhage in Peru - PAHO

PAHO/WHO trains health professionals from seven countries in the Americas to prevent and manage obstetric hemorrhage, a leading cause of maternal death in ...

#70. Temporal trends of postpartum haemorrhage in Switzerland

Postpartum haemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide [1, 2]. The World Health Organization (WHO) ...

#71. (PDF) Postpartum Hemorrhage: New Insights for Definition ...

A stronger definition of postpartum hemorrhage should include both blood loss and clinical signs of cardiovascular changes after delivery, ...

#72. Postpartum Hemorrhage - Penn Medicine Lancaster General ...

Postpartum hemorrhage (sometimes abbreviated as PPH) is when a person has heavy bleeding after giving birth. While it's normal to lose blood during and after ...

#73. Postpartum haemorrhage occurrence and recurrence - The ...

Objective: To determine the risk of occurrence and recurrence of postpartum haemorrhage (excessive bleeding after childbirth) among women ...

#74. Management of postpartum hemorrhage - First10EM

A guide to the intial management of postpartum hemorrhage for emergency medicine. Do you have a plan for the first 10 minutes?

#75. 8 Postpartum Hemorrhage Nursing Care Plans - Nurseslabs

Postpartum hemorrhage is defined as any blood loss from the uterus of more than 500ml during or after delivery. It may occur either early ...

#76. Postpartum Haemorrhage (PPH) Prevention and Management

Postpartum-Haemorrhage-(PPH)_2019-05-22.docx. Page 1 of 26. Postpartum Haemorrhage (PPH) Prevention and Management. Unique Identifier.

#77. Machine learning approach for the prediction of postpartum ...

Postpartum hemorrhage is the leading cause of maternal morbidity. Clinical prediction of postpartum hemorrhage remains challenging, ...

#78. Uterus Removal for Postpartum Bleeding Is Too Common

Postpartum Hemorrhage (PPH) or Excessive Bleeding Threatens the Lives of Mothers. The most likely cause of death during pregnancy and at the ...

#79. Fibrinogen and postpartum hemorrhage – Association or ...

Postpartum hemorrhage (PPH) is the leading cause of maternal death worldwide, accounting for one in four maternal deaths. Despite efforts in public health ...

#80. Approach to Postpartum Hemorrhage - EMRA

Postpartum hemorrhage is the leading cause of maternal mortality worldwide. Knowing the risk factors can help make sure you're prepared ...

#81. Postpartum hemorrhage risk factors (mnemonic) - Radiopaedia

A mnemonic to remember the basic risk factors of postpartum hemorrhage is: PARTUM Mnemonic P: prolonged labor / polyhydramnios / previous ...

#82. Postpartum Hemorrhage - What to Expect

Postpartum bleeding is normal, but excessive bleeding or large blood clots after birth need attention. Learn the symptoms of postpartum ...

#83. Postpartum Hemorrhage Nursing CEU Course | CEUfast

Uterine atony (lack of uterine tone) is the largest cause of hemorrhage, accounting for 70-80% of all postpartum hemorrhages. Trauma should be ...

#84. Postpartum Hemorrhage | Concise Medical Knowledge

Postpartum hemorrhage is one of the most common and deadly obstetric complications. Since 2017, postpartum hemorrhage has been defined as ...

#85. Postpartum Hemorrhage Animation - CAST PHARMA

This is followed by an animation that illustrates the characteristics of postpartum hemorrhage and the conditions under which it develops. The bleeding and the ...

#86. Postpartum Hemorrhage - Western New York Urology ...

Definition. Postpartum hemorrhage is when a woman loses too much blood after giving birth. It is called primary when it happens in the first 24 hours after ...

#87. Uterotonic agents for first‐line treatment of postpartum ...

Postpartum haemorrhage (PPH), defined as a blood loss of 500 mL or more after birth, is the leading cause of maternal death worldwide.

#88. Postpartum Hemorrhage - Causes, Symptoms, Diagnosis ...

The foremost sign of PPH postpartum hemorrhage is hemorrhage from vagina after delivery. Usually, the bleeding is slow trickle from the vagina.

#89. Post-Partum Hemorrhage - Core EM

Post-Partum Hemorrhage. Definition: Blood loss > 500 ml after a delivery (or > 250 ml after an abortion). The management of post ...

#90. Postpartum hemorrhage or excessive blood loss after delivery ...

What Causes Postpartum Hemorrhaging? Uterine atony, or the inability of the uterus to contract, is the cause of most cases of excessive bleeding ...

#91. Postpartum Haemorrhage - The Royal Women's Hospital

Primary postpartum haemorrhage (PPH) is traditionally defined as blood loss greater than or equal to 500. mL, within 24 hours of the birth of a ...

#92. Study of management of postpartum hemorrhage and its ...

Background: Postpartum hemorrhage (PPH) is globally one of the most common causes of maternal death, especially in developing country like India.

#93. Postpartum Haemorrhage 4-Stage Approach: Practical Guide

Welcome to this practical guide to using the 4-stage approach to postpartum haemorrhage (PPH). The risk of obstetric haemorrhage is present in every ...

#94. Postpartum hemorrhage and maternal mortality in Nigeria

Uterine atony was the most common cause of postpartum hemorrhage, accounting for 183. (53.8%) of the cases, the same as was noted in a study from the same ...

#95. Stop using rectal misoprostol for the treatment of postpartum ...

Most authorities recommend that, following delivery, all women should receive a uterotonic medication to reduce the risk of postpartum hemorrhage (PPH).