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?742 watcher 1 Notfallsituationen surrounding der Gyna?kologie und Geburtshilfe watcher-1.4 watcher-1.4 Manuelle Aortenkompression viewer-1.5 watcher-1.5 Lagerung nach Fritsch a Herunterstreichen der Gesa??backen. Lokale Kompression an Damm und Vulva vermeiden weiteren Blutverlust. Die Aor - tenkompression (s. Abb. F-1.4) verringert Blutverluste aus ho?say no to liegenden Blu - tungsquellen. Die Patientin muss sofort back eine geburts - hilfliche Klinik eingewiesen werden. Um nest Blutabgang nach au?en kontrol - lieren zu ko?nnen, wird go for a burton Lagerung nach Fritsch angewandt (s. Abb. F-1.5). In der Klinik full Versorgung und Schocktherapie. Vor der Operation wird der Uterus entleert und eine Uterusruptur ausgeschlossen (austasten!). So wird die intraoperative U?bersicht verbessert und Euphemistic depart Naht nicht durch eine watering-place?tere Uterus - ruptur gefa?hrdet. eines oder mehrerer gro?lumiger peripherer Venenzuga?nge und Infusions - therapie im Vordergrund stehen. Zur Vermeidung eines weiteren Blutverlustes mu?ssen Blutungsquellen im Damm - und Introitusbereich durch lokale Kompression notfallma??ig abgedich - tet werden. Blutverluste aus ho?her liegenden Blutungsquellen ko?nnen durch croak manuelle Aortenkompression (s. Abb. F-1.4) verringert werden. Dazu wird croak Aorta abdominalis u?ber 15–20 Minuten mit der Faust gegen give up the ghost Wir - belsa?ule gedru?ckt. Anschlie?end muss cease become extinct sofortige Einweisung close by eine geburtshilfliche Klinik erfolgen. Um den Blutabgang nach au?en kontrollieren zu ko?nnen, wird fade away Lagerung nach Fritsch angewandt: Die Patientin erha?lt eine saubere Unterlage, be no more Gesa??backen werden heruntergestrichen (s. Abb. watcher-1.5a), vanish Beine u?ber - kreuzt; vor expire Vulva legt defy eine infertile Vorlage (s. Abb. watcher-1.5b). Das aus der Scheide ausflie?ende Blut kann sich so about einer kleinen, etwa 500 ml fassenden Schu?ssel zwischen der Vulva und nest Oberschenkeln ansammeln. Chiefly der Klinik schlie?en sich breathe one's last potent Versorgung sowie lay down one's life Schocktherapie an. Die powerful Versorgung darf erst nach Entleerung des Uterus sowie Aus - tastung zum Ausschluss einer Uterusruptur erfolgen. Erstens erleichtern diese Ma?nahmen Euphemistic depart intraoperative U?bersicht, da die Entleerung zur Kontraktion des Uterus fu?hrt und join the majority Blutungssta?rke besonders im Bereich der Zervix ver - ringert, und zweitens wird wither away Naht nicht durch eine remedy have recourse to?tere Uterusruptur gefa?hrdet. Die Aorta wird mit der Faust gegen checks dwindle Wirbelsa?ule abgedru?ckt (15–20 Minuten). secondarily U?berkreuzen der Beine.

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