分娩过程中使用缩宫素对产后出血的影响

Oxytocin Exposure during Labor and Risk of Postpartum Hemorrhage

目前,产后出血仍是孕产妇死亡的主要原因之一,研究证实分娩过程中使用缩宫素增加了产后出血的发生风险,尤其是在缩宫素使用时间过长、浓度过高或未积极管理第三产程时。缩宫素受体的脱敏反应是其主要病理生理学机制,临床上表现为后续缩宫素诱导的子宫收缩反应性降低,进而引起宫缩乏力和产后出血。综述使用缩宫素与产后出血的相关性研究进展,帮助临床医生建立合理的缩宫素管理方案,减少宫缩乏力性产后出血的发生。

Postpartum hemorrhage is still one of the main causes of maternal death.Some studies have confirmed that oxytocin administration during labor is associated with a higher risk of postpartum hemorrhage,especially when the dose used during labor is high,the duration of time is long,or the woman does not receive active management in the third stage of labor.The desensitization sequence in oxytocin receptors is one of the pathophysiologic hypotheses,and clinically this can manifest as a reduction in oxytocin-induced contractility,resulting in uterine atony and postpartum hemorrhage.This paper reviews the research progress of the association between oxytocin during labor and risk of postpartum hemorrhage,so as to contribute to the establishment of a reasonable oxytocin administration and decrease the incidence of postpartum hemorrhage secondary to uterine atony.