COMPARATIVE ANALYSIS OF INTRAOPERATIVE BLOOD LOSS IN PREMATURE CHILDBIRTH CESARANEAN SECTION BY CLASSICAL METHOD AND MODIFIED METHODOLOGY
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i1.11733Keywords:
cesarean section, premature birth, blood loss, modificationAbstract
The aim – to carry out a comparative analysis of the volume of intraoperative blood loss during cesarean section (CS) according to the classical method and when using a modified technique in conditions of preterm labor (PL).
Material and Methods. A comparative analysis of 59 cases of preterm birth, the delivery of which was by the abdominal route, was carried out. The main group (clinical I) consisted of 29 patients in whom the caesarean section was performed according to the proposed modified technique. Comparative group (II clinical) - 30 patients who were operated on by the classical CS method. For a more reliable analysis, each clinical group was divided into two subgroups depending on the gestational age (29-33 weeks 6 days and 34-36 weeks and 6 days, respectively). The main differences of the proposed method of abdominal delivery are the use of an improved method of entering the abdominal cavity and simultaneous suturing of the wound on the uterus by two operators, starting from the corners of the wound with a continuous single-row vicryl suture with a fixing loop at each of the ends of two threads. In cases of the birth of children in the early stages of up to 30 weeks of gestation, a corporal incision in the uterus and their birth in the whole fetal bladder.
Results. We found that the use of a modified technique of abdominal delivery helps to reduce the amount of intraoperative blood loss in PL by almost 300 ml (p<0.001), minimizes the development of massive obstetric bleeding (MAC), virtually eliminates the need for intraoperative blood transfusion and hysterectomy (p<0.05).
Conclusions. The data confirm the effectiveness of using the improved technique of abdominal delivery to reduce the volume of intraoperative blood loss in PR.
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