A.A. KHASANOV¹, A.R. GALYAVEEVA¹

¹Kazan State Medical University of the Ministry of Health of the Russian Federation, Kazan

²Republican Clinical Hospital of the Ministry of Healthcare of the Republic of Tatarstan, Kazan

 Khasanov A.A. — MD., Professor of the Department of Obstetrics and Gynecology named after V.S. Gruzdev, Perinatal Center Physician

Address: 49 Butlerova St., Kazan, Russian Federation, 420012, tel.: +7 (843) 236-08-73, e-mail: albirkhasanov@mail.ru

  The article provides a brief review of the literature and the results of our own development of a new etiopathogenetic model for the treatment of obstetric bleeding.

Material and methods. Modern organ-preserving operations and their etiopathogenetic component were studied. 40 cesarean sections were performed in patients with a high risk of postpartum uterine bleeding with introduction of half-thawed plasma into the uterine cavity with subsequent bandaging.

Results. In case of uterine hypotension, the use of uterotonics or the application of compression sutures is recommended, placenta ingrowth — all types of uterine devascularization, in case of birth trauma — uterine artery embolization (UAE), in order to stop coagulopathic bleeding — introducing procoagulants into the uterine cavity with its subsequent bandaging.

Conclusion. Obstetrician-gynecologists are recommended to get acquainted with the developed model and put it into practice in view of ease of use, high efficiency and cost-effectiveness.

Key words: postpartum haemorrhage, hypotonic bleeding, placenta ingrowth, coagulopathy, new ethiopathogenetic model, semi-frozen plasma.

(For citation: Khasanov А.А., Galyaveeva А.R. A new etiopathogenetic model for the treatment of obstetric bleedings. Practical Medicine. 2019. Vol. 17, № 6 (part 2), P. 32-34)

REFERENCES

1. Aylamazyan E.K., Repina M.A., Kuz’minykh T.U. Another look at the problem of obstetric bleeding. Zhurnal akusherstva i zhenskikh bolezney, 2008, no. 3, pp. 3–11 (in Russ.).
2. Aylamazyan E.K., Kulakov V.I., Radzinskiy V.E. et al. Akusherstvo: natsional’noe rukovodstvo [Obstetrics: A National Guide]. Moscow: GEOTAR-Media, 2014. 1218 p.
3. Milovanov A.P., Bushtyreva I.O., Belyakov L.V., Dobryakov A.V., Nozdryakov K.V., Mikhonoshina N.A., Starchenko A.A. Prichiny i rezervy snizheniya materinskoy smertnosti na sovremennom etape: rukovodstvo dlya vrachey [Causes and reserves of reducing maternal mortality at the present stage: a guide for doctors]. Moscow, Rostov on Don, 2014. Pp. 100–101.
4. Kurtser M.A. Sovremennye podkhody k lecheniyu i profilaktike akusherskikh krovotecheniy. Materaly. 6-go Vseros. nauch. foruma “Mat’ i ditya” [Modern approaches to the treatment and prevention of obstetric bleeding. Materials. 6th All-Russian. scientific Forum «Mother and Child»]. Moscow, 2004. Pp. 112–113.
5. Kurtser M.A., Breslav I.Yu., Lukashina M.V. True growth of the placenta (placentaaccreta). Conservative therapy. Akusherstvo i ginekologiya, 2011, no. 4, pp. 118–122 (in Russ.).
6. Bushtyrev A.V. Predikatsiya i profilaktika akusherskikh krovotecheniy pri anomaliyakh platsentatsii: avtoref. dis. … kand. med. nauk [Prediction and prevention of obstetric hemorrhage with placental abnormalities. Synopsis of dis. PhD med. sciences]. Saint Petersburg, 2017. 26 p.
7. Anderson J.M., Etches D. Prevention and management of postpartum hemorrhage. Am Fam Physician, 2007, Mar 15, vol. 75 (6), pp. 875–882.
8. Gottlieb A.G., Pandipati S., Davis K.M. et al. Uterine necrosis: a complication of uterine compression sutures. Obstet Gynecol, 2008, vol. 112, pp. 429–431.
9. Abou E.l., Senoun G., Singh M., Mousa H.A., Alfrevic Z. Update on the new modalities on the prevention and management of postpartum haemorrhage. Fetal and Maternal Medicine Review, 2011, vol. 22, pp. 247–264.
10. Schjoldager B., Mikkelsen E., Lykke M.R. et al. Topical application of recombinant activated factor VII during cesarean delivery for placenta previa. Am J Obstet Gynecol, 2017, vol. 216, pp. 608.e1–608.e5.