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1、Epidemiology and Risk FactorsEpidemiology and Risk FactorsIncidence:varies from country to country 1:30001:18500A life-threatening obstetric complication of laborUnderlying factorsdelays in seeking appropriate care at the onset of labora poor referral systemnon-attendance of antenatal caredelayed in
2、terventions during delivery lack of skilled human resources and medical consumables第1页/共10页Etiology Scarred uterusCesarean section 剖宫产Myomectomy肌瘤切除术Obstructed labourContracted pelvis,CPD(头盆不称)Abnormal fetal positionAbnormal fetusIatrogenic factors(医源性因素)Uterotonics(宫缩剂):Prostaglandins,OxytocinSurgi
3、cal injury:midforceps delivery,breech extraction,internal version第2页/共10页Clinical Manifestation Threatened uterine rupturePathologic retraction ring 病理性缩复环Lower abdominal pain Dysuria排尿困难,hematuria 血尿Fetal anoxia第3页/共10页Clinical Manifestation Uterine ruptureIncomplete ruptureComplete rupture第4页/共10页
4、Diagnosis History Scarred uterusObstructed labourUterotonicsSigns and symptoms Abdominal painTenderness Fetal distress第5页/共10页Defferential DiagnosisPlacental abruptionHistoryAbdominal signUltrasound Intrauterine infection HistoryFeverElevated WBC count第6页/共10页Management(1)Threatened uterine rupture
5、To inhibit uterine contractionTocolysisSedatives:Pethidne,anaesthetic 镇静剂Cesarean section delivery,immediately第7页/共10页Management(2)Uterine ruptureAnti-shock treatmentIntravenous infusionBlood transfusionOperation 破口修补或子宫切除（次全）第8页/共10页Precautions?Perinatal health careHigh risk populationLabor observationUterotonic 宫缩剂第9页/共10页感谢您的观看。第10页/共10页