Evaluation of the efficiency of uterine artery embolization in reducing intraoperative blood loss in pregnant women with complete placental presentation


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Abstract

Subject and methods. A comparative study of the results of operative delivery of 78 pregnant women with placental presentation, which were divided into 2 groups. The first group included 64 patients, in whom surgical delivery was carried out without performing UAE. The second group - 14 patients to whom selective embolization was performed in the course of surgical delivery. In most cases, a median laparotomy and bottom cesarean section were performed. In cases of localization of the placenta on the rear wall and in its absence the lower segment is capable of performing laparotomy by Pfannenstiel "high " cross-section in the uterus. UAE and caesarean section were performed under angiographic operating. Results. The value of the average blood loss in the group of patients who underwent UAE amounted to 2428,5 ± 869,4 ml, in the control group - 1725,7 ± 486,9 ml. In the group of patients who underwent EMA physiological postoperative blood loss in volume to 1000 ml (50 and 12.5%, respectively) significantly more often were observed, meanwhile significantly less blood loss (in the amount of 1000 to 1500 ml - 14.3 and 46.8%, respectively). We have not found signif icant differences in the frequency of massive blood loss from 1500 to 3000 ml, and the massive "critical" blood loss over 3000 ml in patients in the two comparison groups. Significant frequency of hysterectomies reduction in the group of patients who had performed EMA, compared with the control group (7.1 and 6.2% respectively), was not assigned. A case of a patient with a hysterectomy performed UAE, accompanied by blood loss of 12 000 ml, is described Conclusion. We have not received significant evidence to support the effectiveness of intraoperative UAE during delivery patients with placenta previa.

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About the authors

Vitaly B. Tskhai

V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: tchai@yandex.ru
MD., professor, Head of the Department of Perinatology, Obstetrics and Gynecology, Medical Faculty

Andrey V. Pavlov

Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: kdb@kdb.krasmed.ru
chief physician

Julia G. Garber

Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: kdb@kdb.krasmed.ru
Deputy Chief of Obstetrics and Gynecology

Sergey M. Bryukhovets

Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: kkb@medgorod.ru
physician of X-ray angiography department

Pavel K. Yametov

V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: mail.rurwap@mail.ru
assistant of Perinatology, Obstetrics and Gynecology Department, Medical Faculty

Juriy S. Raspopin

Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: oar24@mail.ru
Head of ICU

Julia N. Glyzina

V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: glizinajulia@mail.ru
assistant of Perinatology, Obstetrics and Gynecology Department, Medical Faculty

Natalia V. Brezhneva

V.F. Voino-Yasenetsky Krasnoyarsk State Medical University

Email: nata1686@bk.ru
assistant of Perinatology, Obstetrics and Gynecology Deaprtment, Medical Faculty

Ekaterina A. Levanova

Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: ekkovaleva@rambler.ru
physician Department of the pathology of pregnancy The Center of Maternal and child health.

Anna Y. Dudina

V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; Krasnoyarsk Territorial Clinical Center for Maternal and Child Care

Email: anybar@mail.ru
assistant of Perinatology, Obstetrics and Gynecology Department, Medical Faculty

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