Controlled balloon tamponade in the combined treatment of postpartum hemorrhage after cesarean section


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Abstract

Objective. To improve the results of treatment in patients with postpartum hemorrhage, by applying the combined tactics with an instrumental assessment of the coagulation profile (thromboelastography) of surgical hemostasis (ligation of the descending branch of the uterine artery and placement of a hemostatic external uterine supraplacental assembly suture) and with mechanical intrauterine exposure (balloon tamponade). Subjects and methods. A study group consisted of 65 women who underwent combined tactics; a comparison group included 29 women who did tradition obstetric tactics. Resu1ts. Lower uterine segmental bleeding (60.64%) due to the abnormal position of the placenta (placenta previa) and its abnormal attachment (placental rotation) was predominant among the obstetric hemorrhages. Conclusion. A combined therapeutic and diagnostic set for obstetric hemorrhage, which encompasses surgical hemostasis, thromboelastography, and intrauterine balloon tamponade, can reduce the volume of blood loss by 1.5 times, the number of hysterectomies by 5 times, and the use of fresh frozen plasma by 2 times.

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About the authors

Sergey Vladimirovich Barinov

Omsk State Medical Academy, Ministry of Health of Russia

Email: barinov_omsk@mail.ru
MD, Professor

Yakov Grigoryevich Zhukovsky

Gynamed Ltd. Russia

Email: innova2l@yandex.ru
PhD, Honored doctor RF, Director

Vladimir Terentyevich Dolgikh

Omsk State Medical Academy, Ministry of Health of Russia

Email: prof_dolgih@mail.ru
MD, Professor, Honored Worker of Science

Irina Vladimirovna Medyannikova

Omsk State Medical Academy, Ministry of Health of Russia

Email: mediren@gmail.com
PhD, assistant professor of obstetrics and gynecology № 2

Elena Vladimirovna Rogova

Omsk State Medical Academy, Ministry of Health of Russia

Email: rogova@mail.ru
PhD, assistant professor of obstetrics and gynecology № 2

Irina Nicholayevna Razdobedina

Regional Clinical Hospital

Email: razdobedina@mail.ru
head of department of obstetrics, observational maternity hospital Omsk

Olga Albertovna Grebenyuk

Regional Clinical Hospital

Email: grebenuk@mail.ru
PhD, Head of the department of obstetrics, observational maternity hospital Omsk

Eugene Sergeyevna Makkoveeva

Regional Clinical Hospital

Email: makkoveeva@mail.ru
physician, obstetric department, observational maternity hospital Omsk

References

  1. Баринов С.В., Долгих В.Т., Медянникова И.В. Гемокоагуляционные нарушения у беременных с гестозом. Журнал акушерства и женских болезней. 2013; 62(6): 5-12. [Barinov S.V., Dolgikh V.T. , Medyannikova I.V. Hemocoagulation disorders in pregnant women with preeclampsia. Zhurnal akusherstva i zhenskih bolezney. 2013; 62 (6): 5-12. (in Russian)]
  2. Баев О.Р., Жуковский Я.Г. Обязательное звено: баллонная тампонада матки стала обязательным звеном в протоколе лечения послеродового кровотечения. Медицинский вестник. 2013; 3(616): 14-5. [Baev O.R., Zhukovsky Y.G. Obligatory link: uterine balloon tamponade became mandatory step in the protocol treatment of postpartum hemorrhage. Meditsinskiy vestnik. 2013; 3 (616): 1-5. (in Russian)]
  3. Медянникова И.В., Баринов С.В., Долгих Т.И., Полежаев К.Л., Ралко В.В. Нарушения системы гемостаза в акушерской практике: руководство для врачей. М.: Литтерра; 2014. 128 с. [Medyannikova I.V., Barinov S.V., Dolgikh T.I., Polezhaev K.L., Ralko V.V. Disorders of hemostasis in obstetric practice: a guide for physicians. M.: Litterra; 2014: 128. (in Russian)]
  4. Butwick A., Ting V., Rails L.A., Harter S., Riley E. The association between thromboelastographic parameters and total estimated blood loss in patients undergoing elective cesarean delivery. Anesth. Analg. 2011; 112(5): 1041-7.
  5. Devine P.C. Obstetric hemorrhage. Semin. Perinatol. 2009; 33: 76-81.
  6. Kozek-Langenecker S.A. Perioperative coagulation monitoring. Best Pract. Res. Clin. Anaesthesiol. 2010; 24: 27-40.
  7. Mc Lintock C., James A.H. Obstetric hemorrhage. J. Thromb. Haemost. 2011; 9: 1441-51.
  8. Rajpal G., Pomerantz J.M., Ragni M.V., Waters J.H., Vallejo M.C. The use of thromboelastography for the peripartum management of a patient with platelet storage pool disorder. Int. J. Obstet. Anesth. 2011; 20: 173-7.
  9. Roeloffzen W.W., Kluin-Nelemans H.C., Mulder A.B., de Wolf J.T. Thrombocytopenia affects plasmatic coagulation as measured by thrombelastography. Blood Coagul. Fibrinolysis. 2010; 21: 389-97.
  10. White H., Zollinger C., Jones M., Bird R. Can Thromboelastography performed on kaolin-activated citrated samples from critically ill patients provide stable and consistent parameters? Int. J. Lab. Hematol. 2010; 32(2): 167-73.
  11. Soon R., Aeby T., Kaneshiro B. Cesarean scar dehiscence associated with intrauterine balloon tamponade placement after a second trimester dilation and evacuation. Hawaii Med. J. 2011; 70(7): 137-8.

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