Prevention of postpartum haemorrhage: from evidence to implementation at scale.

Preventing PPH can spare women from experiencing the trauma and risks of PPH, reduce the strain on overstretched health systems, and probably produce better outcomes than a strategy solely focused on PPH treatment.

预防PPH可以避免妇女经历PPH的创伤和风险，减轻过度紧张的卫生系统的压力，并且可能比仅专注于PPH治疗的策略产生更好的结果。

Prevention of PPH is often interpreted as provision of uterotonic drugs to contract the uterus at the time of childbirth.

预防产后出血（PPH）通常被理解为在分娩时提供子宫收缩药物。

Although uterotonics are a central strategy for PPH prevention, several other approaches can prevent PPH or ameliorate its severity.

尽管子宫收缩药物是预防产后出血（PPH）的核心策略，但还有其他几种方法可以预防PPH或减轻其严重程度。

These approaches include addressing the unmet need for contraception, remedying anaemia and other modifiable risk factors for PPH, optimising medical conditions that predispose to PPH, and tackling the rise in caesarean births in many countries.

这些方法包括解决避孕需求未得到满足的问题，纠正贫血和其他可修改的产后出血（PPH）风险因素，优化易导致PPH的医疗状况，并解决许多国家剖宫产率上升的问题。

Effective delivery of preventive care requires early and regular antenatal care and planned birth at appropriately resourced health facilities.

有效的预防护理需要早期和定期的产前护理以及在资源充足的医疗机构计划分娩。

Social and behavioural change interventions for improving contraceptive provision and uptake, targeting adolescents, postpartum women, geographically remote communities, and families on low income, are a priority.

针对青少年、产后妇女、地理偏远社区和低收入家庭，改善避孕措施提供和采纳的社会和行为改变干预是优先事项。

Effective interventions to tackle anaemia include the management of heavy menstrual bleeding, pre-pregnancy or antenatal haemoglobin testing and oral or intravenous iron treatment, dietary improvements, and-on rare occasions-blood transfusion.

有效应对贫血的干预措施包括管理重度月经出血、孕前或孕期血红蛋白检测以及口服或静脉补铁治疗、饮食改善，偶尔还包括输血。

Risk factors for PPH that need attention include high BMI, multiple pregnancy, gestational diabetes, pre-eclampsia, macrosomia, and several medical conditions.

需要注意的产后出血（PPH）风险因素包括高体质指数（BMI）、多胎妊娠、妊娠糖尿病、子痫前期、巨大儿以及几种医疗状况。

Caesarean births are associated with a substantial increase in PPH risk and should therefore only be done when medically indicated.

剖宫产与产后出血风险显著增加有关，因此只有在医学指征明确时才应进行。

A Cochrane network meta-analysisof 122 trials, with 121 931 women, found that the combinations of oxytocin plus misoprostol, or oxytocin plus ergometrine, were the most effective prophylaxis for PPH when given at the time of childbirth; however, these combinations had a higher risk of side-effects compared with single-drug prophylaxis.

一项涉及122项试验、121,931名女性的Cochrane网络荟萃分析发现，在分娩时给予催产素加米索前列醇或催产素加麦角新碱的组合是预防产后出血（PPH）最有效的预防措施；然而，这些组合与单一药物预防措施相比，副作用风险更高。

Oxytocin and carbetocin were the most effective single drugs for PPH prophylaxis, with minimal side-effects.

催产素和卡贝缩宫素是预防产后出血（PPH）最有效的单一药物，副作用最小。

Single uterotonic prophylaxis with either oxytocin or carbetocin is, therefore, recommended for routine prophylaxis.

因此，建议常规预防使用单一催产素或卡贝缩宫素预防。

However, if oxytocin or carbetocin is not accessible, misoprostol is an alternative.

然而，如果无法获得催产素或卡贝缩宫素，米索前列醇是一个替代选择。

Combination prophylaxis with oxytocin plus misoprostol can be considered for women at high risk of PPH.

对于产后出血（PPH）高风险的女性，可以考虑使用催产素加米索前列醇的联合预防。

Ergometrine alone and oxytocin plus ergometrine combination are no longer recommended due to hypertension-related safety concerns.

由于与高血压相关的安全问题，不再推荐单独使用麦角新碱和催产素加麦角新碱的联合方案。

A robust implementation approach that engages various stakeholders to promote change, ensures the supply of quality-assured medicines and devices, provides training and support, and secures ongoing political and financial commitment is necessary to translate evidence into global impact.

一种强有力的实施方法，它涉及各种利益相关者以促进变革，确保质量保证的药品和设备的供应，提供培训和支持，并确保持续的政治和财政承诺，这对于将证据转化为全球影响是必要的。