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中华妇幼临床医学杂志(电子版) ›› 2020, Vol. 16 ›› Issue (01) : 23 -31. doi: 10.3877/cma.j.issn.1673-5250.2020.01.004

所属专题： 指南与规范； 文献； 指南共识；

标准·方案·指南

《孕期和产褥期孕产妇衰竭指南(2019)》要点解读
张佳妮1, 牟祎2, 刘娜1, 梁娟2, 王晓东1,†()   
  1. 1. 四川大学华西第二医院妇产科、出生缺陷与相关妇儿疾病教育部重点实验室，成都　610041
    2. 四川大学华西第二医院中国出生缺陷监测中心，成都　610041
  • 收稿日期:2020-01-03 修回日期:2020-01-25 出版日期:2020-02-01
  • 通信作者: 王晓东

Interpretation of Maternal Collapse in Pregnancy and the Puerperium: Green-Top Guideline No. 56

Jiani Zhang1, Yi Mu2, Na Liu1, Juan Liang2, Xiaodong Wang1,†()   

  1. 1. Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2. National Center for Birth Defects Monitoring of China, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
  • Received:2020-01-03 Revised:2020-01-25 Published:2020-02-01
  • Corresponding author: Xiaodong Wang
  • About author:
    Corresponding author: Wang Xiaodong, Email:
  • Supported by:
    Key Project of R&D of Science and Technology Department of Sichuan Province(2018SZ0265)
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张佳妮, 牟祎, 刘娜, 梁娟, 王晓东. 《孕期和产褥期孕产妇衰竭指南(2019)》要点解读[J]. 中华妇幼临床医学杂志(电子版), 2020, 16(01): 23-31.

Jiani Zhang, Yi Mu, Na Liu, Juan Liang, Xiaodong Wang. Interpretation of Maternal Collapse in Pregnancy and the Puerperium: Green-Top Guideline No. 56[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2020, 16(01): 23-31.

2019年12月，英国皇家妇产科医师学会(RCOG)发布《孕期和产褥期孕产妇衰竭指南(2019)》(Maternal Collapse in Pregnancy and the Puerperium: Green-Top Guideline No. 56)，总结孕期和产褥期孕产妇衰竭(MCPP)的相关循证医学证据，详细探讨如何早期识别发生MCPP高风险与导致MCPP的病因、影响MCPP孕产妇复苏的孕期生理与解剖生理变化，以及如何进行MCPP最佳初始和持续管理，并对其围死亡期剖宫产术(PMCS)进行深入描述。该指南还特别强调MCPP救护的多学科团队人员组成与职责。笔者拟结合我国产科临床实践，对该指南涉及的MCPP风险如何早期识别及其病因、影响复苏的孕期生理与解剖生理变化、最佳初步处理措施、PMCS、持续管理、对于母儿的影响、多学科救护团队人员组成等产科临床关注的相关问题要点，进行解读、讨论。

关键词: 妊娠，高危, 孕期与产褥期孕产妇衰竭, 改良早期预警评分, 围死亡期剖宫产术, 产后出血, 心肺复苏术, 呼吸窘迫综合征，成人, 呼吸窘迫综合征，新生儿, 栓塞，羊水

The Royal College of Obstetricians and Gynaecologists (RCOG) recommends the second edition of Maternal Collapse in Pregnancy and the Puerperium: Green-Top Guideline No. 56 on December 2019. This guideline summarizes the evidence-based medical evidence related to maternal collapse in pregnancy and puerperium (MCPP), discusses how to identify pregnant women with high risk of MCPP and the different causes of MCPP, and the physiological and anatomical changes during pregnancy that affect the recovery of collapse in detail, and describes how to carry out the best initial and continuous management of MCPP and perimortem cesarean section (PMCS). In addition, it also emphasizes composition and responsibilities of a multidisciplinary rescue team for MCPP. In this article, with the combination of clinical practice of obstetrics in China, we intend to interpret and discuss key issues related to obstetrics in this guideline, such as how to identify the risks and causes of MCPP, the physiological and anatomical changes during pregnancy that affect recovery of collapse, the best initial management measures, PMCS, continuous management, the impacts of MCPP on mothers and children, the rescue team and so on.

Key words: Pregnancy, high-risk, Maternal collapse in pregnancy and puerperium, Modified early warning score, Perimortem caesarean section, Postpartum hemorrhage, Cardiopulmonary resuscitation, Respiratory distress syndrome, adult, Respiratory distress syndrome, newborn, Embolism, amniotic fluid
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