Modern aspects of uterine bleeding treatment with placenta previa

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Abstract

Uterine bleeding caused by placenta previa is one of the main causes of massive blood loss and death in obstetric practice.

Objectives. To analyze the efficacy and safety of various therapeutic strategies to stop uterine bleeding in women in labor and puerperants on the basis of research results.

Materials and Methods. Available researches on the diagnosis and treatment of uterine bleeding with placenta previa between 2000 and 2015 were included in the study. The search was carried out in medical databases PubMed and Cochrane Library with free access to the publication.

Results. 61 publications were included in the analysis. The basic principles of diagnosis and intensive therapy of uterine bleeding with placenta previa are presented from the position of obstetrician and anaesthesiologist-resuscitator. Particular attention is paid to the analysis of studies evaluating the efficacy and safety of infusion-transfusion therapy in this category of patients. Main indications and contraindications to blood clotting factors and antifibrinolytic agents are shown.

Conclusion. The combined use of all available modern methods of stopping uterine bleeding can significantly reduce blood loss and help to improve disease outcomes. The most promising therapy is a targeted assignment of clotting factors concentrates under the control of thromboelastography which indicates the need for further research.

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About the authors

Oksana V Ryazanova

St Petersburg State Pediatric Medical University

Author for correspondence.
Email: oksanaryazanova@mail.ru
MD, Ph.D., Associate Professor. Department of Anesthesiology and Intensive Care and Emergency Pediatrics Russian Federation

Yuri S Alexandrovich

St Petersburg State Pediatric Medical University

Email: Jalex1963@mail.ru
MD, PhD, Dr Med Sci, Professor, Head. Department of Anesthesiology and Intensive Care and Emergency Pediatrics Faculty of Postgraduate Education Russian Federation

Efim M Shifman

Moscow Regional Research Clinical Institute of M.F. Vladimirsky

Email: eshifman@mail.ru
MD, PhD, Dr Med Sci, Professor Russian Federation

Konstantin V Pshenisnov

St Petersburg State Pediatric Medical University

Email: Psh_K@mail.ru
Ph.D., assistant professor. Department of Anesthesiology and Intensive Care and Emergency Pediatrics Faculty of Postgraduate Education Russian Federation

Vitaliy A Reznik

St Petersburg State Pediatric Medical University

Email: vitaliy-reznik@mail.ru
Ph.D., Assistant Professor. Department of Obstetrics and Gynecology Russian Federation

Aleksander V Kulikov

Ural State Medical University

Email: kulikov1905@yandex.ru
MD, PhD, Dr Med Sci, Professor. Department of Anesthesiology Russian Federation

Alla N Drobinskaya

Novosibirsk State University

Email: drobinskaya@rambler.ru
MD, Associate Professor. Department of Obstetrics and Gynecology Russian Federation

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Copyright (c) 2016 Ryazanova O.V., Alexandrovich Y.S., Shifman E.M., Pshenisnov K.V., Reznik V.A., Kulikov A.V., Drobinskaya A.N.

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