在高资源环境中产后出血:临床管理的变化和未来的研究方向,基于对国家指导方针的比较研究
Pauline L M de Vries1,2, Catherine Deneux-Tharaux3, David Baud4
1Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
概括
对于产后出血 (PPH) 管理的指导方针在高收入国家之间有很大差异,突出了对标准化,基于证据的协议的需要. 进一步的研究对于改善母亲的结果和PPH预防策略至关重要.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 基于证据的医学基于证据的医学.
背景情况:
- 产后出血 (PPH) 仍然是全球孕产妇死亡的主要原因.
- 现有的PPH预防和管理指南显示出相当大的差异.
- 高收入国家有不同的方法来解决严重的PPH.
研究的目的:
- 进行八个高收入国家的PPH指南的系统比较.
- 识别PPH预防和管理策略的变化.
- 突出缺乏强有力的证据和标准化的需要的领域.
主要方法:
- 八个高收入国家的PPH指南的比较分析.
- 对PPH定义,预防,血液损失测量,初始管理,二线治疗,非药物干预和输血协议的指导的系统审查.
- 评估组织方面的质量和指导方针.
主要成果:
- 在PPH定义,预防性子宫激素,血液损失测量技术和二线治疗建议中观察到显著的异质性.
- 在管理子宫缩和输血策略方面,注意到不同的方法,包括值和血液静止剂的使用.
- 修订后的指导方针的质量和方法严谨性差异很大.
结论:
- 对于PPH的普遍定义和关于量化血液损失的共识至关重要,以便及时识别.
- 进一步的研究应该集中在PPH管理的最佳时间和干预顺序上.
- 需要共同努力,制定标准化,基于证据的PPH指导方针,以改善母亲的结果.
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