Avtor/Urednik		Takač, Iztok; Gavrić-Lovrec, Vida; Mujezinović, Faris; Ogrizek-Pelkič, Ksenija
Naslov		Nujna stanja v ginekologiji in porodništvu na terenu
Tip		članek
Vir		In: Fokter SK, editor. Zbornik predavanj 15. Ažmanovih dni Gorske reševalne zveze Slovenije; 2008 maj 17-18; Logarska dolina. Ljubljana: Gorska reševalna služba Slovenije, Komisija za medicino,
Leto izdaje		2008
Obseg		str. 15-38
Jezik		slo
Abstrakt		Emergencies in gynecology include a sudden occurence of pain, bleedings from reproductive organs, and injuries. Gynecologic reasons for acute pain in the pelvis are ovarian cysts, adnexal torsion, ovulatory pain, endometriosis, leiomyoma, dysmenorrhea, pelvic inflammation, ectopic pregnancy, and hyperstimulation of ovaries. Bleeding is one of the most frequent gynecologic problmens among women in their reproductive period. It is less frequent in the postmenopausal period and the least in childhood. The cause of bleeding in in these two periods is mostly organic - in the reproductive period also dysfunctional and pregnancy-related. Possible emergencies are also genital injuries such as ruptures, bleedings and hematomas, which occur as the result of a fall or a blow with a solid object, sexual violence (rape), car accidents, and even sexual intercourse. In the first half of the pregnancy bleeding, abortion as well as sickness and vomiting may occur unexpectedly. Emergencies in the second part of the pregnancy include preeclampsia and other hypertensive disorders, eclampsia, HELLS syndrome, injuries and bleedings. The most common reasons for bleeding in the second half of the pregnancy are premature separation of properly lying placenta, low-lying placenta, uterine rupture, and low-lying arteries. Deliveries in the field are not common. When providing firts aid in a sudden delivery, one should follow the rule that the first assistant should do as little as possible, the approach should be calm and only the most urgent procedures should be performed. After the birth, the umbilical cord needs to be ligated and cut and the newborn protected against hypothermia. Most emergencies in gynecology and obstetrics can be ultimately dealt with at specialized institutions.
Izvleček		Nujna stanja v ginekologiji obsegajo nenaden pojav bolečine, krvavitve iz rodil ter poškodbe. Ginekološki vzroki za akutno bolečino v medenici so ciste jajčnikov, zavitje (torzija) adneksov, ovulatorna bolečina, endometrioza, leiomiomi, dismenoreja, pelvično vnetje, izvenmaternična nosečnost in hiperstimulacija jajčnikov. Krvavitve iz rodil so ena izmed najpogostejših ginekoloških težav pri ženskah v reproduktivnem obdobju, redkeje se pojavijo v pomenopavznem obdobju, najredkeje v otroštvu. Vzroki za krvavitve v zadnjih dveh obdobjih so pretežno organski, v reproduktivnem obdobju pa tudi disfunkcionalni in povezani z nosečnostjo. Srečamo se lahko tudi s poškodbami spolovil, kot so raztrganine, krvavitve in hematomi. Nastanejo kot posledica padca ali udarca s trdim predmetom, spolnega nasilja (posilstvo), prometne nesreče in celo spolnega odnosa. V prvi polovici nosečnosti nas lahko presenetijo krvavitve, splav ter slabosti in bruhanje nosečnic. Urgentna stanja, ki nastopajo v drugi polovici nosečnosti, obsegajo predeklampsijo in druge hipertenzivne motnje, eklampsijo, HELLP sindrom, poškodbe in krvavitve. Najpogostejši vzrok krvavitev v drugi polovici nosečnosti so prezgodnje ločevanje pravilno ležeče posteljice, nizkoležeča posteljica, raytrganje maternice in nizko ležeče žile. Porodi na terenu niso pogosti. V prvi pomoči pri nenadnem pravilu se ravnamo po pravilu, naj prvi pomagalec čim manj ukrepa, pristop naj bo umirjen in naj ukrene le najnujnejše. Po rojstvu otroka je potrebno podvezati in prerezati popkovnico, novorojenca pa zaščititipred podhladitvijo. Večino nujnih stanj v ginekologiji in porodništvu lahko dokončno oskrbimo šele v specializiranih ustanovah.
Deskriptorji		GYNECOLOGY EMERGENCIES OBSTETRICS