Late postpartum hemorrhage

• Rodchenkova Alexandra A.
• Polina S. Melnik
• Aryutin Dmitriy G.

Abstract

Aim. To develop an algorithm of management and to improve treatment outcomes for patients with a diagnosis of "late postpartum hemorrhage".

Material and methods. In the course of this study a retro- and prospective analysis of the treatment of 103 patients with bleeding of the late postpartum period was performed. Taking into account the severity of the conditions and the results of the examination conservative or surgical treatment was carried out.

Results. Comprehensive conservative pathogenetic therapy, taking into account the severity of the patient's condition and the volume of blood loss, and also its adequate replenishment, allows in many cases to avoid surgical intervention. Repeated surgical treatment is impractical in case of the ineffectiveness of the instrumental emptying of the uterine cavity. So the endovascular occlusion of the uterine vessels

and/or internal iliac vessels should be the method of choice, since it combines not only high efficiency and safety, but also reduces the risk of adverse bleeding outcomes.

Conclusions. Despite a large amount of scientific research, the problem of late postpartum complications currently is extremely urgent. The development of modern treatment algorithms involving the use of pharmacological and surgical technologies and the analysis of adverse treatment outcomes, - that's what is the most promising direction in resolving the issue of such a complication of the postpartum period as uterine bleeding.

Keywords:maternal mortality, postpartum complications, late postpartum hemorrhage, late postpartum bleeding, hematometer, coagulopathy, uterine artery, uterine vessels, uterine artery embolization

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