[Prevention of hypotonic hemorrhage in high risk group of maternity patients during perioperative and postsurgical periods].

OBJECTIVE: Introduction: Maternal mortality has always been the main problem in obstetrics worldwide. According to WHO, obstetric hemorrhage is one of the three major causes leading to mortality in 27% of all maternal losses. In Russia, hypotonic hemorrage is the leading cause of maternal mortality, whereas in the developing countries it is usually connected with traumas. However, today modern medicine rejects these ways as ineffective and time-wasting. Instead, doctors use other methods, such as compression hemostatic sutures, controlled balloon tamponade and modern uterotonic drugs. The aim of research is to improve the effect of caesarean section used for pregnant patients already having a uterine scar and low insertion of placenta.

PATIENTS AND METHODS: Materials and methods: The research included 63 pregnant patients who had experienced the caesarean section before and who had had a low placenta in the lower uterine segment. These patients were put into three groups based on prophylaxis method for preventing hypotonic hemorrhage. The research was based on employing common clinical and special examination techniques, namely: ultra sound tests for those with full-term pregnancy, including post-surgical period, Doppler tests for examination of uterine vessels during the postsurgical period.

RESULTS: Results: After a caesarean section, all the patients in the research group had compression hemostaic sutures put (the Radzinsky modification) in the area of the low utera segment, which reduced their recovery in the postsurgical period as well as their hospital stay.

CONCLUSION: Conclusions: Preventive use of the uterine scar improves not only the clinical, but also economic effect, such as the reduction of patients' stay period in hospitals, the reduction of the amount of infusion media, medicines used, etc.