scholarly journals Multidisciplinary approach in the treatment of cervical-cervical and cervical pregnancies with the use of modern low-invasive x-ray endovascular technology

2018 ◽  
pp. 185-191
Author(s):  
A. E. Mitichkin ◽  
Yu. E. Dobrokhotova ◽  
S. V. Apresyan ◽  
D. G. Gromov ◽  
V. I. Dimitrova ◽  
...  

Multidisciplinary approach in the treatment cervical ectopic pregnancy has been developed, it includes the systemic use of methotrexate, the embolization of uterine arteries and follow-up fetal egg remove. The new method of combination treatment of cervical pregnancy of one-stage use of embolization uterine artery and temporary balloon occlusion of the internal iliac arteries was applied for the first time in Russia. This algorithm helps to preserve the reproductive function of women.

2021 ◽  
pp. 51-66
Author(s):  
A. E. Markarov ◽  
S. V. Apresyan ◽  
V. I. Dimitrova ◽  
S. A. Papoyan ◽  
D. G. Gromov ◽  
...  

Introduction. In the cohort prospective comparative study, the investigators examined the effectiveness of intraoperative administration of Antiadgesin and adjuvant therapy with Gynestril after laparoscopic-assisted myomectomy combined with temporary balloon occlusion of the internal iliac arteries and embolization of uterine arteries in the treatment of uterine fibroids.Objective. To achieve stable remission of the disease, improve reproductive outcomes after myomectomy.Materials and methods. 100 women who underwent organ-preserving treatment of uterine fibroids from January 1, 2015 to December 31, 2020 were enrolled in the study. The eligibility criteria were as follows: the age of 28–45 years (the mean age was 34 ± 4.5 years), organ-preserving treatment of uterine fibroids. The exclusion criteria from the study were as follows: the age of over 45 years; allergic reactions to mifepristone, Antiadgesin and contrast media; patients with contraindications for use of drugs, with aggravated medical history, with liver diseases, with endometrial hyperplastic processes (adenomyosis, endometrial hyperplasia).Conclusions. It has been shown that the continuous use of Gynestril at a dose of 50 mg/day for 3 months after surgical treatment due to proliferating uterine fibroids led to the absence of disease-recurrences within two years after discontinuation of the drug, and the occurrence of a relapse in one patient three years after treatment. The use of Gynestril after embolization of the uterine arteries made it possible to statistically reduce the size of the node by 25% within 12 months, 50% after 24 months and 70% – after 36 months. (p <0.05). Intraoperative use of Antiadgesin made it possible to prevent adhesion and development of tubalperitoneal infertility.Conclusion. The combination treatment of uterine fibroids, including myomectomy and drug therapy with Antiadgesin and Gynestril, made it possible to implement reproductive function in 73.3% of patients, moreover, 40% of patients had undergone a natural delivery


Author(s):  
Anna Rosner-Tenerowicz ◽  
Michał Pomorski ◽  
Tomasz Fuchs ◽  
Jakub Śliwa ◽  
Katarzyna Pilecka ◽  
...  

2020 ◽  
Vol 37 (3) ◽  
pp. 84-96
Author(s):  
O. B. Kalinkina ◽  
M. V. Nechaeva ◽  
Yu. V. Tezikov ◽  
I. S. Lipatov ◽  
O. R. Aravina ◽  
...  

In modern obstetrics, an abnormal placental invasion is a serious problem associated with the following high perinatal losses: massive obstetric bleeding that leads to the death of both the mother and the fetus. Objective. The purpose of the study was to analyze the methods of delivery in patients with placenta accreta. Materials and methods. The study group consisted of 31 patients aged 25 to 42 years with placenta ingrowth, who underwent metroplasty in the Perinatal Center of V. D. Seredavin Samara Regional Clinical Hospital in the period from May 2018 to December 2019. Most often, placental ingrowth was detected in the second trimester of pregnancy (41.94 %). In 5 cases, placental ingrowth was diagnosed in the operating room (16.3 %). On average, the time of detection of ingrowth is 24.96 weeks of gestation. Results. Out of 31 patients we observed, 27 underwent metroplasty using complex compression hemostasis, and 1 patient underwent temporary balloon occlusion of the internal iliac arteries. The total volume of blood loss was 1625 485 ml, and the median was 1455 ml. Only 5 (17.24 %) patients had a blood loss of more than 2000 ml, and there was no blood loss of more than 3000 ml. Conclusions. Introduction of organ-preserving operations allows maintaining a woman's reproductive health, avoiding massive blood loss, and improving perinatal outcomes. Patients with a scar on the uterus after cesarean section, with placentation on the anterior wall and in the area of the scar on the uterus should be immediately sent to the third level of rendering specialized medical care.


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