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Die lebensbedrohliche gynäkologische und geburtshilfliche Blutung

Life-threatening gynaecological and obstetric haemorrhage

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Zusammenfassung

Bei der lebensbedrohlichen gynäkologischen oder geburtshilflichen Blutung muss der Ersthelfer oder der diensthabende Arzt in der Rettungsstelle schnell entscheiden, ob die Patientin in eine gynäkologische Klinik verlegt werden kann oder ob eine sofortige Therapie vor Ort notwendig ist. Dieser Text soll ein kurzer Handlungsleitfaden zur Diagnostik und Therapie sowie eine Entscheidungshilfe für den nicht gynäkologisch ausgebildeten Rettungsstellenarzt sein. Anhand von einfachen Abbildungen und Flussdiagrammen wird ein kurzer und prägnanter Überblick über das Thema gegeben.

Abstract

When confronted with a patient with severe gynaecological or obstetric haemorrhage the attending doctor has to decide whether to treat the patient immediately or whether to refer her to a hospital with a gynaecology service. This article is a short guide to the diagnostics and therapy options. The simplified pictures and flowcharts give a concise overview on the topic of gynaecological and obstetric haemorrhage.

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Literatur

  1. Abbasi S, Jamal A, Eslamian L, Marsousi V (2008) Role of clinical and ultrasound findings in the diagnosis of retained products of conception. Ultrasound Obstet Gynecol 32:704–707

    Article  CAS  PubMed  Google Scholar 

  2. Besinger R, Moniak C, Paskiewicz L et al (1995) The effect of tocolytic use in the management of symptomatic placenta previa. Am J Obstet Gynecol 172(6):1770–1775

    Article  CAS  PubMed  Google Scholar 

  3. Buckingham K, Fawdry A, Fothergill D (1999) Management of vaginal bleeding presenting to the accident and emergency department. J Accid Emerg Med 16:130–135

    CAS  PubMed  Google Scholar 

  4. Chamberlain G, Steer P (1999) ABC of labour care: Obstetric emergencies. BMJ 318:1342–1345

    CAS  PubMed  Google Scholar 

  5. Dudenhausen JW (2008) Blutungen in der Schwangerschaft und während der Geburt. In: Dudenhausen JW (Hrsg) Praktische Geburtshilfe. Walter de Gruyter, Berlin New York, S 354–356

  6. Guise J-M, Segel S (2008) Teamwork in obstetric critical care. Best Pract Res Clin Obstet Gynaecol 22:937–951

    Article  PubMed  Google Scholar 

  7. Henrich W, Surbeck D, Keiner F et al (2008) Diagnosis and treatment of peripartum bleeding. J Perinat Med 36:467–478

    Article  CAS  PubMed  Google Scholar 

  8. Hull A, Resnik R (2009) Placenta Previa, Placenta Accreta, Abruptio Placentae, and Vasa Previa. In: Creasy R, Resnik R (eds) Maternal-Fetal Medicine Principles and Practices. Saunders Elsevier, Philadelphia, pp 727

  9. Husslein P (1997) Postpartale Blutungen. Gynäkologe 30:769–774

    Article  Google Scholar 

  10. Jones K, Pearce C (2009) Organizing an acute gynaecology service: equipment, setup and a brief review of the likely conditions that are managed in the unit. Best Pract Res Clin Obstet Gynaecol 23:427–438; doi:10.1016/j.bpobgyn2008.12.008

    Article  PubMed  Google Scholar 

  11. Kurata H, Aoki Y, Tanaka K (2003) Delayed, massive bleeding as an unusual complication of laser conization. A case report. J Reprod Med 48(8):659–660

    PubMed  Google Scholar 

  12. Leitlinien der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG) (2008); URL:// http://www.dggg.de/leitlinien/aktuelle-leitlinien/

  13. McWilliams G, Hill M, Dietrich CH (2008) Gynecologic Emergencies. Surg Clin North Am 88:265–283

    Article  PubMed  Google Scholar 

  14. Romao S, Dumesch V, Dengler A et al (2008) Cervical Ectopic Twin Pregnancy: Conservative Management in the First Trimenon. Geburtsh Frauenheilk 68:393–396

    Article  Google Scholar 

  15. Royal College of Obstetricians and Gynaecologists (2005) Placenta praevia and Placenta praevia accrete: Diagnosis and Management; URL: http://www.rcog.org.uk/files/rcog-corp/uploaded-files/GT27PlacentaPreviaAccreta2005.pdf

  16. Royal College of Obstetricians and Gynaecologists (2009) Prevention and Management of Postpartum Haemorrhage; URL: http://www.rcog.org.uk/files/rcog-corp/Guideline%2052.pdf

  17. Royal College of Obstetricians and Gynaecologists (2004) The Management of Tubal Pregnancy; URL: http://www.rcog.org.uk/files/rcog-corp/uploaded-files/GT21ManagementTubalPregnancy2004.pdf

  18. Subtil D, Sommé A, Ardiet E, Depret-Mosser S (2004) Postpartum hemorrhage: frequency, consequences in terms of health status, and risk factors before delivery. J Gynecol Obstet Biol Reprod (Paris) 33:4S9–4S16

    Google Scholar 

  19. Valentin L (2009) Characterising acute gynaecological pathology with ultrasound: an overview and case examples. Best Pract Res Clin Obstet Gynaecol 23:577–593; doi:10.1016/j.bpobgyn.2009.02.005

    Article  PubMed  Google Scholar 

  20. Wenderlein J (2005) Altenpflege: Defizit und kein Ende? Dtsch Arztebl 102(37)

  21. World Health Organisation (2004) Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF and UNFPA. WHO, Geneva; URL: http://www.who.int/whosis/mme_2005.pdf

  22. Confidential Enquiry into Maternal and Child Health (CEMACH): Why mothers die 2000–2002. The Sixth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. (2004) RCOG Press, London.

  23. Oyelese Y, Scorza W, Mastrolia R, Smulian J (2007) Postpartum hemorrhage. Obstet Gynecol Clin North Am 34:421–444

    Article  PubMed  Google Scholar 

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Correspondence to S.A.M. Michaelis.

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Grum, A., Michaelis, S. Die lebensbedrohliche gynäkologische und geburtshilfliche Blutung. Notfall Rettungsmed 12, 507–512 (2009). https://doi.org/10.1007/s10049-009-1186-1

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