APPLICATION OF VASOPRESSIN ANALOGUE IN CAESAREAN SECTION IN WOMEN AT HIGH RISK OF BLEEDING
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Abstract
Aim – the aim of the study is to carry out a comparative assessment of clinical and anamnestic indicators and features of caesarean section surgery in patients with a high risk of developing intraoperative bleeding, delivered with and without the use of the vasopressor drug Terlipressin.
Materials and methods. A retrospective case-control study of 92 women, with a high risk of developing intraoperative bleeding, delivered at the Belyaev Kuzbass Regional Clinical Hospital for 2020-2021 was conducted. The main group was 12 women who were injected intraoperatively into the thickness of myometry with the drug Terlipressin immediately after crossing the umbilical cord. The control group included 80 women operated without terlipressin. Statistical data processing was carried out using the computer program Microsoft Excel 2007. To compare the frequencies of qualitative features, the criterion χ2 was used. The level of statistical significance when testing the null hypothesis was taken as corresponding p < 0.05.
Results. Patients who were administered terlipressin at caesarean section had a higher incidence of placental presentation and placenta accreta, i.e., initially belonged to the group of extremely high risk of obstetric bleeding. During caesarean section surgery, these patients were naturally statistically significantly more likely to undergo dressing of the descending branch of the uterine artery, application of compression sutures, additional administration of uterotonic preparations, tranexamic acid, colloidal solutions. The average blood loss in patients who received terlipressin was slightly higher than in the control group, however, no differences were found in the severity of blood loss, the frequency of massive blood loss was recorded in only one woman (8.3 %) who needed Cell Saver and hemotrasfusion.
Conclusions. The analogue of vasopressin «Terlipressin» during caesarean section surgery is significantly more often used in patients of extremely high obstetric risk. Use of this preparation in combination with compression sutures and ligation of the descending branch of the uterine artery allows preventing massive blood loss. Further in-depth research is needed in this direction.
Keywords
Author Biographies
Яна Андреевна Парфенова,
clinical resident, G.A. Ushakova department of obstetrics and gynecologyНаталья Владимировна Артымук,
Artymuk Natalia Vladimirovna
MD, PhD, professor, deputy editor of the journal Mother and Baby in Kuzbass.
She is the Head of the Department of Obstetrics and Gynaecology №2, the Deputy Editor-in-Chief. She is also the President of the Kemerovo regional public organization “Association of obstetricians and gynecologists”, the chief obstetrician-gynecologist of the Siberian Federal district; the member of the Board of the Russian Society of Obstetricians and Gynaecologists, the member of the European Society of Contraception and Reproductive Health, the European Society of Gynaecological Oncology and the International Society of Gynecological Endocrinology.
She has graduated from Kemerovo State Medical institute with honors. She studied in clinical residency in obstetrics and gynecology at School of Arenberg (Salzburg, Austria) and School of Bloomberg (Johns Hopkins University, Baltimore, USA). One is a specialist in ultrasound diagnostics in obstetrics and gynecology, endocrinology and endoscopic surgery. In 1996 in Barnaul she defended her PhD thesis and her doctoral thesis in 2003 in Moscow.
Her priorities are: endocrine gynecology, infertility, cervix uteri pathology, menopausal disorders, disorder of menstrual function, endoscopic and abdominal gynecological surgery.
She deals with reproductive health problems, non-surgical and surgical treatment of benign neoplasms of genital organs. She is an author of more than 450 scientific works, including 3 monographs and study manuals for doctors. She has her highest medical qualification category in “Obstetrics and gynecology”.
Оксана Николаевна Новикова,
doctor of medical sciences, professor of the G.A. Ushakova department of obstetrics and gynecologyНонна Марковна Шибельгут,
candidate of medical sciences, deputy chief physician for obstetric and gynecological careНаталья Анатольевна Батина,
obstetrician-gynecologist, head of the maternity departmentМихаил Сергеевич Просветов,
obstetrician-gynecologist, maternity departmentВасилий Николаевич Паличев,
physician anaesthesiologist, head of the department of anaesthesiology and resuscitationArticle Details
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