СOMPARATIVE ANALYSIS OF COMPLICATIONS OF THE POSTOPERATIVE PERIOD IN CAESAREAN SECTION ACCORDING TO M. STARK AND MODIFIED METHODOLOGY
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11840Keywords:
Cesarean section, technique, modification, postoperative complications, preventionAbstract
The aim of the study – to conduct a comparative analysis of the features of the postoperative period and the frequency of complications during Caesarean section according to M. Stark and the use of a modified method.
Materials and Methods. The course of the postoperative period was analyzed among 205 cases of – by the method of M. Stark. The proposed technique of Cesarean section (CS) is based on the rational teamwork of the surgeon and assistant. The main differences in the technique of abdominal delivery are the use of an improved method of entry into the abdominal cavity and the simultaneous suturing of the wound on the uterus by two operators, starting from the corners of the wound edges with a continuous single-row vicryl suture with fixing blind at each end of the two threads. By the above analogy, suturing of the aponeurosis and skin is performed.
Results and Discussion. Given the lack of statistical dependence between the studied preoperative predictors among patients of both study groups (p> 0.05), it can be assumed that the decrease in the number of some postoperative complications is associated with the use of a modified technique of abdominal delivery. When using the advanced method of CS there is a decrease in the overall frequency of postoperative complications more than 2 times – 14.8 % compared with the technique of abdominal delivery by M. Stark – 35.1 %. Due to the rapid elimination of the main source of bleeding – suturing of the uterus, the volume of intraoperative blood loss is reduced by almost 200 ml (p <0.05), which significantly increases the effectiveness of prevention of certain complications (anemic condition, blood transfusions, hysterectomy) in the postoperative period (p <0.05). Improving the technical aspects of CS allows to reduce the frequency of diagnosis of uterine subinvolution (p = 0.032) and the use of uterotonic, antibacterial drugs.
Conclusion. The data obtained by us confirm the effectiveness of the application of the improved technique of abdominal delivery to reduce the number of some postoperative complications.
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