Klinik Rehberler ve Gelecek Perspektifi
Özet
Postpartum kanama (PPK) dünya genelinde maternal morbidite ve mortalitesinin önde gelen nedeni olmaya devam etmektedir. Ciddi bir obstetrik acil olan PPK’ nin etiyolojisinde uterus atonisi, travma, rest plasenta ve koagülopati yer almaktadır. PPK önleme, takip ve tedavi için birçok ülkede klinik rehberler hazırlanmış, stratejiler ve algoritmalar oluşturulmuştur. PPK profilaksi veya erken tanı koyulması, tanı ve tedavi yaklaşımlarının geliştirilmesi için klinik araştırmalar gereklidir. Ancak PPK müdahalesinin kritik dakikalar içinde yapılması, acil durumlar için gecikmiş onam durumu, kanama nedenlerinin farklı risk gruplarından dolayı homojenize edilememesi, merkezler arası uygulama farklılıkları gibi nedenlerle yapılan klinik deneyler dikkatli etik değerlendirmeler gerektirir ve subjektif sonuçlar içerebilir. Günümüzde yapay zekânın kullanılabilirliği artması ile jinekoloji ve obstetrikte kullanım sıklığı artmaktadır. Bu sebeple PPK’ yı öngörme, önleme ve tedavi gibi hızlı karar verme gibi alanlarda kullanımı düşünülebilir. Ek olarak, biyobelirteçler erken müdahele, kanamanın şiddeti veya komplikasyonların tahmin edilmesi için önem arz etmektedir. Hemostaz göstergeleri, kardiyak markerlar, hipoperfüzyon belirteçleri ve sistemik inflamatuvar parametreler gibi biyobelirteçler yapay zeka algoritmalarına entegre edilmesi ile PPK yönetiminde kolaylık sağlamaktadır.
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