FEATURES OF INTENSIVE ORGAN-SPARING THERAPY FOR MASSIVE POSTPARTUM HEMORRHAGE

Bleeding in pregnancy, childbirth and the postpartum period is one of the leading causes of maternal morbidity and mortality worldwide. There is no doubt that obstetric bleeding demands the development of improved methods for its diagnostics and treatment. We assessed the effectiveness of the treatment strategy for massive postpartum hemorrhage (PPH) with preservation of reproductive function, applied in the Perinatal Center of Irkutsk. We performed a retrospective analysis of 24 delivery cases, complicated by massive bleeding and successfully treated with preservation of reproductive organs. The massive nature of bleeding (≥ 30 % of blood volume) was registered in 15 (62.5 %) cases, mild (≥ 20 % but ≤ 30 % of blood volume) – in 9 (37.5 %). Emergency operative delivery (cesarean section) was performed in 40 % of massive PPH cases and in 66.7 % of mild PPH cases. Uterotonic drugs were used in all PPH cases. When analyzing complex mechanical methods of PPH arrest, we noticed that in 20 % of cases balloon tamponade was used. In 33.3 % of mild PPH cases, balloon tamponade with great vessels ligation was performed. Thus, the most effective method was balloon tamponade coupled with Baksheev forceps and early surgical hemostasis. All in all, prevention of hemorrhage in risk groups and early fluid and surgical therapy, and also administration of uterotonic drugs in PPH treatment not only provide a hemostatic effect but also preserve reproductive function.

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Diagnosis of neoplastic diseases of reproductive system in context of healthcare system modernization: need for integrated approach

Medical alphabet ◽

10.33667/2078-5631-2021-19-23-29 ◽

2021 ◽

pp. 23-29

Author(s):

I. P. Aminodova ◽

T. P. Vasilieva ◽

E. V. Perminova ◽

E. S. Kastor

Keyword(s):

Reproductive System ◽

Data Exchange ◽

Screening Program ◽

Reproductive Function ◽

Integrated Approach ◽

Risk Groups ◽

Disease Diagnosis ◽

Reproductive Organs ◽

Start Time ◽

Tumor Diseases

The relevance of the problem of screening of tumor diseases of reproductive organs is caused by high rates of incidence of tendencies to rejuvenation, unsatisfactory results of therapy. In Russia, indicators of active detection of acute respiratory disease, diagnosis in the preinvasive and early stages remain low, adversely affecting the quality and life expectancy of the patient and her reproductive function. The purpose of the study: on the basis of the analysis of literature sources to establish the reasons for the ineffectiveness of screening of tumorous diseases of the reproductive organs. The results of the bibliographic analysis of modern screening principles and methods have shown that the main reasons for unsatisfactory screening and early diagnosis of tumor diseases of reproductive organs should be considered low scoring coverage rates, inconsistency of the legislative base, inconsistency of the start time, end of examination and screening interval, lack of a single information base with the possibility of fiing and archiving results of the survey, violation of the logistics of data exchange conducted research, expressed the dissonance of diagnostic capabilities in different regions, lack of an integrated approach and a single screening program nationwide. One of the possible solutions to decide this problem should be a solution to the implementation of a comprehensive diagnostic survey with a simultaneous assessment of the condition of all organs of the reproductive system, including the mammary glands, in order to timely identify the tumor diseases of reproductive organs with the formation of risk groups for tumor pathology and to correct tactic of reference.

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Bakri balloon tamponade is an effective and safe treatment for life-threatening postpartum hemorrhage (PPH)

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0028-1089093 ◽

2008 ◽

Vol 68 (S 01) ◽

Author(s):

AMA Diemert ◽

G Ortmeyer ◽

T Somville ◽

M Lotz ◽

K Hecher

Keyword(s):

Postpartum Hemorrhage ◽

Safe Treatment ◽

Balloon Tamponade ◽

Life Threatening ◽

Bakri Balloon

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Morphological features of endo- and myometrium in patients with uterine leiomyoma and infertility

HEALTH OF WOMAN ◽

10.15574/hw.2020.151-152.33 ◽

2020 ◽

pp. 33-37

Author(s):

M.A. Flaksenberg ◽

◽

Keyword(s):

Uterine Leiomyoma ◽

Negative Impact ◽

Reproductive Function ◽

Cell Types ◽

Underlying Disease ◽

Reproductive Organs ◽

Pathological Process ◽

Simple Type ◽

Morphological Examination ◽

Blastocyst Implantation

The objective: determination of morphofunctional features of leiomatous nodes and endometrium in women with uterine leiomyoma and infertility to restore reproductive function and prevent recurrence of the underlying disease. Materials and methods. In order to restore reproductive function and prevent recurrence of the underlying disease, morphofunctional features of leiomatous nodes and endometrium in women with uterine leiomyoma and infertility were determined. Thirty samples of leiomyomatous nodes and endometrium were examined, among which 15 were obtained from women with multiple uterine leiomyoma and infertility and 15 samples from women with uterine leiomyoma with isolated uterine leiomyoma. During the study, a general-histological method was used for staining with hematoxylin-eosin and picrofuxin by van Gizon, as well as immunohistochemical methods. Histological examination of the endometrium was performed according to conventional protocol, taking into account the day of the menstrual cycle and R.W. Noyes criteria. Results. In the morphological examination of leiomyomatous nodes in the vast majority of cases the presence of uterine leiomyomas of simple and cell types or their combination was established. In women with multiple uterine leiomyoma, simple-type leiomyoma (53.3%) was predominant, and in patients with isolated leiomyoma the signs of cellular uterine leiomyoma (66.7%) were more frequently found. In 80.0% of women with uterine leiomyoma revealed pathology of the endometrium, such as glandular and glandular-fibrous polyps, simple and complex atypical endometrial hyperplasia, which confirms the theory about the only pathogenetic mechanisms of the emergence of hyperplastic processes of female organs. In 66.7% of women with multiple leiomyomas, signs of chronic endometritis have been found, which exacerbates the pathological process and can have a negative impact on the reproductive function, such as secretory endometrial transformation and impaired blastocyst implantation, and explains a much higher percentage of infertility in the group. Conclusion. In women with impaired reproductive function, patients with uterine leiomyoma, it is necessary to conduct a study of the receptivity of the reproductive organs, namely - the endometrium and leiomatous nodes. This will make it possible to use one or another method of treatment in order to restore reproductive function and prevent recurrence of the underlying disease. Keywords: infertility, uterine leiomyoma, endometrium, receptive apparatus.

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Effect of Exposure to Mixture of Heavy Metals Arsenic, Cadmium and Lead on Reproductive Function and Oxidative Stress in Female Rats

INTERNATIONAL JOURNAL OF TOXICOLOGICAL AND PHARMACOLOGICAL RESEARCH ◽

10.25258/ijtpr.v9i03.9075 ◽

2017 ◽

Vol 9 (03) ◽

Author(s):

Choudhuri D. ◽

Bhattacharjee T.

Keyword(s):

Oxidative Stress ◽

Heavy Metals ◽

Ascorbic Acid ◽

Reproductive Function ◽

Reproductive Organs ◽

Female Rats ◽

Corpora Lutea ◽

Oestrus Cycle ◽

Implantation Sites ◽

Live Fetus

Background : Toxicological consequences arising from exposure to mixtures of heavy metals especially at low, chronic and environmentally relevant doses are poorly recognised. In the present study, we evaluated effects of chronic exposure to combinations of three metals arsenic (As), cadmium (Cd) and lead (Pb) present frequently in drinking water on reproductive function and oxidative damage caused to reproductive organs of female rats. Method : Female rats were exposed to mixture of metals (As, Cdand Pb) for 90 consecutive days. The gain in body weight and weight of reproductive organs were recorded following autopsy on 91 stday. The oestrus cycle were monitored during entire treatment period. Numbers of corpora lutea, implantation sites, live fetus and survival of the fetus were evaluated in rats mated successfully with untreated male after completion of their respective treatment. Ovarian cholesterol, protein, ascorbic acid and enzyme Δ 5 -3β HSD levels were estimated. Serum levels of steroid hormones oestrogen and progesterone were estimated. Histopathological picture of both ovary and uterus were assessed. Levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidise (GPX) activity, amount of reduced glutathione (GSH) and malondyaldehyde (MDA) in blood, ovary and uterus were measured as biomarkers of oxidative stress. Results : The treated rats showed reduced body weight gain and reduction in the weight of ovary and uterus. Oestrus cycle was disrupted with continuous diestrous in treated animals. Number of corpora lutea, implantation sites and live fetus and the survival of fetus evaluate were reduced significantly in treated groups. The levels of ovarian cholesterol and ascorbic acid increased in treated rats with decrease Δ5 -3β HSD level. There was reduction in serum level of both the ovarian steroid hormones oestrogen and progesterone. The protein levels did not differ between the groups. There was a significant increase in levels of MDA and decrease in levels of all the antioxidant enzymes in treated group. Conclusion : The results revealed there was disruption to reproductive functions with decrease in stereoidogenic activity and associated oxidative stress in female rats treated with combination of mixture of metals (Cd, As and Pb) at low dose for 90 consecutive days.

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TO EVALUATE THE EFFECTIVENESS OF CONDOM BALLOON CATHETER IN TREATING INTRACTABLE POSTPARTUM HEMORRHAGE AT KONTUM PROVINCIAL HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2018.6.24 ◽

2018 ◽

Vol 8 (6) ◽

pp. 178-183

Author(s):

Dinh Nguyen Gia ◽

Thanh Cao Ngoc

Keyword(s):

Maternal Death ◽

Postpartum Hemorrhage ◽

Medical Management ◽

Balloon Catheter ◽

Uterine Atony ◽

Cross Sectional ◽

Common Cause ◽

Provincial Hospital ◽

Balloon Tamponade ◽

Condom Catheter

Background: Postpartum hemorrhage (PPH) remains a significant contributor to maternal morbility and mortality and accounts for 31% of maternal death in Vietnam. The most common cause of PPH is uterine atony. Recently, uterine tamponade using intrauterine condom appears to be an effective tool in the management of intractable PPH. Objectives: To evaluate the success of condom as a tamponade to arrest intractable PPH due to uterine atony in patients not responding to medical management. Materials and Methods: The study was designed as a cross-sectional and descriptive, included 32 patients who underwent condom balloon tamponade at Kontum Provincial Hospital from 1/2012 to 8/2016. Results: 32 women (mean age 25.71 ± 6.45 years range, 16 - 39) underwent condom balloon tamponade for PPH controls. 29 patients (90.62%) successfully responded the tamponade therapy by the use of condom catheter. Three patients (9.37%) required hysterectomy. Conclusions: Condom catheter balloon effectively controls the intractable PPH due to uterine atony. Key words: PPH (Pospartum hemorrhage), Tamponade, Condom catheter balloon, Uterine atony

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