Acil Müdahale ve Yaşam Desteği

Yazarlar

Özet

Postpartum kanama (PPK) tüm doğumların %1-10’ unu komplike hale getiren obstetrik bir acil durumdur. Etkin müdahale; doğumun üçüncü evresinin aktif yönetimi, uterotonikuygulanması, uterin masaj, kan kaybının erken tanısı ve multidisipliner yaklaşımı içerir. Oksitosin ilk tercih edilen uterotoniktir; yanıt alınamazsa metilergonovin, prostaglandin veya misoprostol kullanılabilir. Gereğinde kan ve kan ürünleri, balon tamponad, kompresyon sutürleri veya histerektomi uygulanır. Kardiyopulmoner resüsitasyonda (CPR) 30:2 kompresyon–ventilasyon oranı, dakikada 100–120 bası önerilir. Erken defibrilasyon ve uygun medikal tedavi hayatta kalma şansını artırır. Şok yönetiminde kristaloidlerle hızlı sıvı replasmanı, hemodinamik izlem, gerekirse kan transfüzyonu ve vazopressör desteği esastır. Elektrolit dengesizlikleri ve koagülopati riski açısından yakın takip önem taşır. Sonuç olarak, PPK ve kardiyak acillerde erken tanı, protokole uygun tedavi ve etkin ekip koordinasyonu anne sağkalımı için kritik öneme sahiptir.

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