R.I. SHARIPOVA¹, A.L. MIROLUBOV¹, L.M. MIROLUBOV², M.E. ZHELEZOVA¹, L.I. MALTSEVA³

 ¹Kazan (Volga Region) Federal University, Kazan

²Kazan State Medical University, Kazan

³Kazan State Medical Academy — branch campus of the FSBEI FPE RMACPE MOH Russia, Kazan

 Contact details:

Sharipova R.I. — PhD (Medicine), Associate Professor of the Department of Obstetrics and Gynecology

Address: 74 Karl Marks St., 420012 Kazan, Russian Federation, tel.: +7 (843) 236-34-51, e-mail: rezedusha@mail.ru

 The purpose — to assess the effectiveness of temporary occlusion of the uterine arteries with atraumatic vascular clamps to reduce intraoperative blood loss and improve cesarean section outcomes in pregnant women with a burdened obstetric history.

Material and methods. We assessed the experience of applying atraumatic vascular clamps on the uterine arteries in the Obstetric Department of the medical unit of Kazan Federal University in 2025. The aim was to reduce blood loss during caesarean section in 30 pregnant women with one or two previous caesarean sections, moderate and severe preeclampsia, II grade anemia, and a combination of these conditions.

Results. With the application of atraumatic vascular clamps to the uterine arteries during the repeated caesarean section in 30 pregnant women, the average blood loss decreased to 252.2 ml (50), while the average operation time remained the same — 31.6 minutes (1.33). In 70% of cases (21 women), the post-operation hemoglobin level remained within the reference values.

Key words: pregnancy, childbirth, caesarean section, haemorrahage

REFERENCES

1. Rossiyskoye obshchestvo akusherov-ginekologov. Klinicheskiye rekomendatsii. Rody odnoplodnyye, rodorazresheniye putem kesareva secheniya [Russian Society of Obstetricians and Gynecologists. Clinical guidelines. Singleton deliveries, delivery by cesarean section]. Moscow, 2024.
2. Rossiyskoye obshchestvo akusherov-ginekologov. Assotsiatsiya anesteziologov-reantimatologov. Assotsiatsiya akusherskikh anesteziologov-reantimatologov. Natsional′naya assotsiatsiya spetsialistov menedzhmenta krovi patsiyenta. Klinicheskiye rekomendatsii. Poslerodovoye krovotecheniye [Russian Society of Obstetricians and Gynecologists. Association of Anesthesiologists and Intensive Care Specialists. Association of Obstetric Anesthesiologists and Intensive Care Specialists. National Association of Patient Blood Management Specialists. Clinical guidelines. Postpartum hemorrhage]. Moscow, 2025.
3. Betran A.P., Ye J., Moller A.B., Souza J.P., Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health, 2021, vol. 6 (6), p. e005671.
4. Boerma T., Ronsmans C., Melesse D.Y. et al. Global epidemiology of use of and disparities in caesarean sections. Lancet, 2018, vol. 392 (10155), pp. 1341–1348.
5. Pavord S., Daru J., Prasannan N. et al. UK guidelines on the management of iron deficiency in pregnancy. Br. J. Haematol, 2020, vol. 188 (6), pp. 819–830.
6. Brown M.A., Magee L.A., Kenny L.C. et al. Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension, 2018, vol. 72 (1), pp. 24–43.
7. Wu C., Ling Z., Wang Y., Lv Y., Miao Z., Liu L., Ji X. Clinical analysis of risk factors and perinatal outcomes in recurrent pre-eclampsia with severe features. Reprod. Sci, 2024, vol. 31 (9), pp. 2763–2770. DOI: 10.1007/s43032-024-01529-4
8. Dai Y.M., Wei J., Wang Z.Q., Zhang X.B., Cheng L., Gu N., Hu Y.L. Intrauterine balloon tamponade combined with temporary abdominal aortic balloon occlusion in the management of women with placenta accreta spectrum:a randomized controlled trial. Zhonghua Fu Chan Ke Za Zhi, 2020, vol. 55 (7), pp. 450–456. DOI: 10.3760/cma.j.cn112141-20200225-00135
9. Bouchghoul H., Madar H., Resch B., Pineles B.L., Mattuizzi A., Froeliger A., Sentilhes L. Uterine-sparing surgical procedures to control postpartum hemorrhage. Am. J. Obstet. Gynecol, 2024, vol. 230 (3S), pp. S1066–S1075.e4. DOI: 10.1016/j.ajog.2022.06.018
10. Belou R., Beyti R. Atlas sosudistoy khirurgii [Atlas of vascular surgery]. Moscow: Meditsina, 1990. 216 p.