scholarly journals THE COMPARISON OF OUTCOMES AFTER LAPAROSCOPIC MYOMECTOMY WITH THE USE OF DIFFERENT UTERINE SUTURE TECHNIQUES

2020 ◽  
Vol 1 (1) ◽  
pp. 58-69
Author(s):  
B. Habrat ◽  
O. Lytvak ◽  
B. Lysenko ◽  
A. Habrat
Keyword(s):  
Blood Loss ◽  
Reproductive Function ◽  
Tissue Perfusion ◽  
Laparoscopic Myomectomy ◽  
Control Group ◽  
Cell Mediated Immunity ◽  
Aseptic Inflammation ◽  
Group I ◽  
Suture Tension ◽  
Suturing Technique

Purpose: to improve the outcomes and speed up the recovery after laparoscopic myomectomy in females with uterine leiomyoma, based on the comprehensive study and comparison of different uterine suturing techniques. Material and methods. The study enrolled 130 patients, including 100 females underwent laparoscopic myomectomy. Based on the simple randomization, the sample of 100 surgically treated females was subdivided into two subsamples depending on the applied uterine suturing technique:         group I – extracorporeal knotting (n=50); and group II – intracorporeal continuous suturing (n=50). The control group included 30 apparently healthy females (group III). The clinical examination was performed before surgery in the outpatient setting, and in the hospital – after procedure and at the discharge (day 2). We assessed the parameters of myometrium tissue perfusion and the severity of inflammation in the surgical alteration area 1 month before and 1 month following the procedure. The ultrasound signs of myometrium regeneration completeness in the uterine scar area were determine 3 months after surgery. The late outcomes after myomectomy and catamnesis of reproductive function were evaluated at 6-month and 1-year follow-up. Results and discussion. We established that the use of intracorporeal continuous suturing technique in patients underwent laparoscopic myomectomy was favorable for preservation of microcirculatory bed in myometrium, related to a more uniform distribution of suture tension in the tissue and a more even distribution of pressure exerted on the wound edges, as compared to extracorporeal knotting technique. These advantages of intracorporeal continuous suturing technique over the extracorporeal knotting one are useful for the significant reduce of tissue hypoxia and myometrium ischemia in the alteration area. Additionally, this technique is in favor of the physiological programmed suture absorption and the cell-mediated immunity, and associated with the lower risk of necrotic areas formation. In contrast to the intracorporeal continuous suturing technique, the tight and non-uniform extracorporeal knotting is associated with the suppression of staged elimination of blood microclots and other factors of aseptic inflammation in the surgical alteration area. Conclusions. The use of extracorporeal knotting technique had no advantages over the intracorporeal continuous suturing, and, in the majority of cases, was associated with longer duration of procedure, inappropriate blood loss, as well as excessive consumption of suture material. The intracorporeal continuous suturing is the most optimal technique for uterine wound edges approximation, and associated with the positive outcomes regarding the reproductive function (the reproductive function could be realized in 3 months after the use of intracorporeal continuous suturing technique, in contrast to 6 months – after the extracorporeal knotting one), the minimal frequency of complications and favorable economic profile. The laparoscopic myomectomy in case of myoma sized 10 cm and more is associated with the risk of significant uterine wall defect and excessive blood loss, indicating the need for the intracorporeal continuous suturing technique for closing tissue defects in the area of surgical alteration of myometrium.

scholarly journals The influence of dietary supplementation with the leucine metabolite β-hydroxy-β-methylbutyrate (HMB) on chemotaxis, phagocytosis and respiratory burst of peripheral blood granulocytes and monocytes in calves

2020 ◽  
Author(s):  
Roman Wójcik ◽  
Joanna Małaczewska ◽  
Grzegorz Zwierzchowski ◽  
Jan Miciński ◽  
Edyta Kaczorek-Łukowska
Keyword(s):  
Oxidative Metabolism ◽  
Respiratory Burst ◽  
Peripheral Blood ◽  
Phagocytic Activity ◽  
Chemotactic Activity ◽  
Control Group ◽  
Cell Mediated Immunity ◽  
Specific Cell ◽  
Group I ◽  
Experimental Group

Abstract Background The objective of this study was to evaluate the effect of HMB on the chemotactic activity, phagocytic activity and respiratory burst of peripheral blood granulocytes and monocytes in calves. Method The experiment was performed on 14 calves aged 30±2 days, divided into two equal groups of control (group I) and experimental (group II) animals. The feed administered to experimental group calves was supplemented with HMB (Metabolic Technologies Inc. Ames, IA, USA) at 40 mg/kg BW, whereas control calves were administered standard farm-made feed without supplementation. Blood was sampled from the jugular vein immediately before the experiment (day 0) and on experimental days 15, 30 and 60 to determine: chemotactic activity (MIGRATEST® kit), phagocytic activity (PHAGOTEST® kit) and respiratory burst (BURSTTEST® kit) of peripheral blood granulocytes and monocytes by flow cytometry. Results An analysis of granulocyte and monocyte chemotactic activity and phagocytic activity revealed significantly higher levels of phagocytic activity in calves administered HMB than in the control group, expressed in terms of the percentage of phagocytising cells and mean fluorescence intensity (MFI). HMB also had a positive effect on the oxidative metabolism of both granulocytes and monocytes after stimulation with Escherichia coli bacteria and with PMA (4-phorbol-12-β-myristate-13-acetate), expressed in terms of the percentage of oxidative metabolism and MFI. Conclusion HMB stimulates non-specific cell-mediated immunity, which is a very important consideration in newborn calves that are exposed to adverse environmental factors in the first weeks of their life. The supplementation of animal diets with HMB for both preventive and therapeutic purposes can also reduce the use of antibiotics in animal production.

Operative vaginal delivery: outcomes for mothers and newborns

2020 ◽  
Vol 69 (2) ◽  
pp. 33-42
Author(s):  
Margarita D. Leonova ◽  
Natalia V. Aganezova ◽  
Sergey S. Aganezov ◽  
Elena V. Frederiks ◽  
Yulia R. Dymarskaya
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Good Condition ◽  
Injury Rate ◽  
Control Group ◽  
Vacuum Extraction ◽  
Group Iii ◽  
Operative Vaginal Delivery ◽  
Group I ◽  
Abdominal Delivery

Hypothesis/aims of study. The frequency of surgical abdominal delivery in Russia, as in the world, continues to grow, reaching 29.3% in 2017. Operative vaginal delivery is an alternative to abdominal delivery in the second stage of labor. This study was aimed at analyzing the outcome of labor for mothers and newborns using different operative vaginal delivery methods. Study design, materials and methods. We studied 293 cases of childbirth in the period from 2015 to 2018. Three groups were distinguished: (I) the main group consisting of 172 women delivered by the operation of applying obstetric forceps (OF); (II) the comparison group including 85 patients delivered by the operation of vacuum extraction (VE) with the fetal head being near the pelvic floor; and (III) the control group comprising 34 cases of vaginal birth without use of instrumental delivery. In group I, 114 patients were delivered by the low forceps operation (subgroup IA), and 60 individuals by the mid forceps operation (subgroup IB). Results. Vaginal lacerations were found in 21.3% of cases in group I, less often less often in groups II (10.6%, p 0.05) and III (2.9%, p 0.05). Vaginal hematoma occurred in one patient of group III (2.9%) and three women of group I (1.7%, p 0.05). There were no cases of damage to the anal sphincter. The greatest blood loss was recorded in subgroup IB (554 44.9 ml), when compared to subgroup IA (473 20.7 ml; p 0.05), group II (418 24.9 ml; p 0.05), and group III (347 33.4 ml; p 0.05). There were no differences in blood loss between the outlet OF and VE groups (p 0.05). Most newborns were born in good condition (84.5%, 77.6%, and 88.2% of cases in groups I, II, and III, respectively). Cephalohematoma in newborns was more common after VE (32.9%) than after OF (9.2%, p 0.01) and in control (5.9%, p 0.01). No retinal hemorrhage was recorded in newborns. There were no significant differences in the frequency of children being transferred to the childrens hospital (7.5%, 9.4%, and 8.8% of cases in groups I, II, and III, respectively; p 0.05). Conclusion. The use of OF is an effective and safe method of vaginal operative delivery. It does not increase the fetal injury rate, the frequency of newborn cephalohematoma being 3.5 times less than with VE. Complications of OF and VE (except for a greater number of vaginal lacerations in cases of OF), blood loss, and the course and duration of the postpartum stay in the maternity ward are comparable.

scholarly journals Features of reproductive function in infertile women with hyperthyroidism

2021 ◽  
Vol 38 (1) ◽  
pp. 64-71
Author(s):  
L. M. Rzakulieva ◽  
A. E. Hajizade
Keyword(s):  
Thyroid Gland ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Early Menopause ◽  
Ovarian Volume ◽  
Infertile Women ◽  
Group I ◽  
Toxic Goiter

Objective. The aim was to study the characteristics of reproductive function in women of fertile age with infertility and hyperfunction of the thyroid gland. Materials and methods. The object of the study was 148 women of fertile age. To compare the indicators obtained by special methods, the control group included the indicators of laboratory and instrumental examination of 30 non-pregnant women of reproductive age. Reproductive function was evaluated in 118 women with hyperthyroidism: 58 retrospectively (group I) and 60 prospectively (group II); the control group consisted of 30 healthy women of reproductive age. Hormonal studies were performed by radioimmune and enzyme immunoassay methods using the automatic analyzer "Cobb" ("Hoffmann La Roche", Switzerland), as well as DPS test systems the analyzer Immulite (USA). Ultrasound of the thyroid gland was performed by a linear sensor with a frequency of 7.5 MHz. The volume of the thyroid gland was calculated according to the Bruno formula. Results. For women of fertile age with hyperthyroidism, a decrease in ovarian reserve is characteristic that is manifested by a significant increase in FSH level (14.1 3.1 IU / L, p 0.05), and a decrease in inhibin B level (35.9 12,7 pg / ml, p 0.05). In 47.7 % of women of fertile age with hyperthyroidism, there is a decrease in ovarian volume and a significant reduction in the average number of antral follicles of normal size (4.34 1.56, p 0.05). Conclusions. Based on the results obtained, it can be assumed that in diffuse toxic goiter there are not only functional disorders (metabolism of hormones of the reproductive system), but also deep organic changes in the structure of the ovaries that leads to a rapid suppression of their functions. In cases of thyroid diseases, the clinical manifestation of these changes is premature and early menopause.

scholarly journals ВПЛИВ МІКРОЕЛЕМЕНТІВ ТА ГУМІЛІДУ НА ВІДТВОРНУ ФУНКЦІЮ ТЕЛИЦЬ УКРАЇНСЬКОЇ М’ЯСНОЇ ПОРОДИ

2016 ◽  
Vol 18 (2(66)) ◽  
pp. 44-48
Author(s):  
V. Gryban ◽  
D. Mylostiva ◽  
E. Pecheniy
Keyword(s):  
Trace Elements ◽  
Physiological State ◽  
Reproductive Function ◽  
Protein Composition ◽  
Biologically Active ◽  
Control Group ◽  
Group I ◽  
Group Ii ◽  
The Impact ◽  
Experimental Group

The article presents research data on the impact of deficient dietary microelements (cobalt and selenium) and biologically active supplement Humilid  on the indicators of the reproductive function of heifers after the first calving. We have found out that Humilid and trace elements influence on the physiological state of reproductive organs and stimulate the sexual heat of animals. Regarding the duration of the period from calving to fertilized insemination, the difference between the control and experimental groups is more visible. Thus, the service period in the experimental group I (under the influence of Humilid) was 293.2 days, which is 2.6 days less than in the control group. In the experimental group II (under the influence of cobalt and selenium), it was, respectively, by 3.9 days less than in the control one. This may indicate that the minerals and dietary supplements contribute to more rapid recovery of the ovarian cycle. Protein composition of blood serum was investigated in the study of the biochemical spectrum of blood. Balancing the nutrition of animals with deficient dietary microelements and adding Humilid increase the concentration of protein molecules, which is visible from the indicator of crude protein and its components - albumen and globulin.In comparison with animals in the control group, a total protein level of heifers in the experimental group I was higher by 8.8% (P <0.05), and in the experimental group II - by 8.6% (P <0.05). This may indicate the increased intensity of synthetic and redox processes in heifers’ bodies in preovulatory period which serve best for the insemination.The level of albumen was also higher by 8.0 and 7.3% respectively under the influence of Humilid and trace elements in relation to the control group, indicating the improvement of transport of substances, in our case estradiol.As far as globulin is concerned, the growth of this class of proteins was marked by 9.4 and 9.6%, indicating the improvement of the level of resistance of the organism. Thus, the increase in blood biochemical parameters creates certain conditions in heifers’ body to improve their insemination.

scholarly journals A STUDY TO ASSESS THE EFFECTIVENASS OF IMMEDIATE BREAST FEEDING ON DURATION OF THIRD STAGE OF LABOUR AND BLOOD LOSS DURING THE SAME IN SELECTED HOSPITALS

2020 ◽  
Vol 8 (11) ◽  
pp. 1048-1068
Author(s):  
Ujwala Rajendra Parker ◽  
Keyword(s):  
Data Collection ◽  
Blood Loss ◽  
Breast Feeding ◽  
Sampling Technique ◽  
General System ◽  
Control Group ◽  
Check List ◽  
Third Stage Of Labor ◽  
Group I ◽  
Third Stage

An experimental study was conducted to assess the effectiveness of immediate breast feeding on duration of third stage of labour and blood loss during the same in selected hospitals of Pune city. The conceptual framework adopted for the study was General System Model. The sample size was 60 full term mothers in active labour, divided into two groups. Purposive sampling technique was used for selection of sample. Where, Group I is experimental group and Group II is an control group. Each consisted of 30 samples. Data collection was accomplished by using observation check list as a tool. It consists of three sections. First section dealt with demographic profile of the samples. Second section dealt with observation check list to assess duration of labour.Third section dealt with amount of blood loss.Pilot study was conducted to assess the feasibility of the study. It was conducted on 14 mothers.Final data collection was done. Data gathered was analysed by using descriptive and inferential statistics. Based on the analysis interpretations were made.The study analysis shows that immediate breast feeding statistically reduces the duration of third stage of labor and the amount of blood loss.

Uterine fibroids, laparoscopic surgery and morcellation: comparative analysis of the results of organ-preserving operations

GYNECOLOGY ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. 73-77
Author(s):  
Alexander A. Seregin ◽  
Anastasiia B. Nadezhdenskaia ◽  
Anna S. Makarova ◽  
Polina L. Sheshko ◽  
Anna V. Tregubova ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Blood Loss ◽  
Abdominal Cavity ◽  
Uterine Fibroids ◽  
Operation Time ◽  
Main Group ◽  
Laparoscopic Myomectomy ◽  
Control Group ◽  
Tumor Spread ◽  
Plastic Containers

Aim. To conduct a comparative analysis of the results of organ-preserving laparoscopic operations performed for uterine fibroids with the use of plastic containers for morcellation and without it. Materials and methods. We examined 57 patients with a diagnosis of uterine fibroids who were admitted to the Department of Innovative Oncology and Gynecology of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology for organ-preserving surgical treatment. To achieve the goal of the study, the patients were divided into the following groups: the main group 29 patients who underwent laparoscopic myomectomy and morcellation of removed nodes using plastic containers. The control group consisted of 28 patients who underwent morcellation during laparoscopic myomectomy without the use of plastic containers. Results. The duration of laparoscopic operations performed using plastic containers main group was 85.6925.87 minutes. Laparoscopic conservative myomectomies, performed without the use of limiting systems, took a slightly longer amount of time control group 88.7530.36 minutes. There were no statistically significant differences, but in the second group, more prolonged sanitation of the abdominal cavity and removal of small fragments of myomatous nodes after morcellation outside the sacs were required. Autoinfusion was used in 6 (20.69%) patients in the main group, in 7 (25%) patients in the control group. Blood transfusion was not used in any case. Average blood loss was 120.6967.50 ml in the main group, 125.0099.54 ml in the control. The duration of hospitalization in the main group was 4.661.76 days, in the control group 5.793.62 days. In the main group, histological examination revealed leiomyoma in all cases, leiomyoma was detected in 96.4% (27 patients) of cases in the control group, and leiomyosarcoma in 1 patient (3.6%). Conclusion. In all groups of patients, there was a favorable course of the postoperative period, early activation of patients. In the group of laparoscopic operations, one patient (3.6%) after morcellation of the myomatous node without the use of a plastic container was found to have leiomyosarcoma. The use of plastic containers in our study did not increase the duration of operations and did not affect the volume of blood loss, the frequency of intra- and postoperative complications. In contrast, the operation time was slightly higher among patients who were operated without the use of containers. In all likelihood, this was due to the fact that the morcellation stage itself took longer, since it was required to extract small fragments of myomatous nodes, as well as thorough and prolonged sanitation of the abdominal cavity. It should be noted that the use of plastic containers, of course, requires the development of certain skills from the surgeon, taking less and less time in parallel with the learning curve. Of course, further studies are required to assess the risk of tumor spread in patients undergoing surgery using plastic containers, but preliminary data indicate that ablastic morcellation can and should be used in organ-preserving surgery for uterine myoma.

scholarly journals Disorders of the hemostasis system while doing coronary shunting on a working heart

2019 ◽  
Vol 86 (7) ◽  
pp. 23-26
Author(s):  
A. P. Mazur ◽  
P. V. Gurin ◽  
M. M. Babich
Keyword(s):  
Blood Loss ◽  
Colloidal Solution ◽  
Infusion Therapy ◽  
Control Group ◽  
Colloidal Solutions ◽  
Hemostasis System ◽  
Therapy Program ◽  
Group I ◽  
Working Heart ◽  
Blood Loss Volume

Objective. To investigate the connection between application of solutions for infusion and parameters of the hemostasis system while the elective operations performance of coronary shunting on the working heart. Materials and methods. The results of examination and surgical treatment were analyzed in 80 patients, in whom coronary shunting on the working heart was conducted. The patients were divided into three groups: the Investigation Group I (IG I) – 20 patients, in whom colloidal solution of hydroxyethyl starch (HES) 130/0.4 was applied intraoperatively, the Investigation Group II (IG II) - 20 patients, in whom colloidal 4% solution of gelatin was used intraoperatively, and a Control Group, consisted of 40 patients, in whom only crystalloidal solutions were included in the infusion therapy program. The coagulation hemostasis indices, the blood loss volume and the need for hemotransfusion were compared. Results. In the IG I patients the volume of perioperative blood loss was more than in the IG II patients – (615 ± 191) and (438 ± 62) ml, accordingly (p=0.0003), and the coagulation hemostasis indices were trustworthily lower at the operation ending, demanding the erythrocytic mass transfusion doing in 3 (15%) patients. The IG II patients, comparing with the Control Group, suffered more volume of the blood loss - (560 ± 164) and (438 ± 62) ml, accordingly (p=0,02), and the changes in the coagulation indices, similar to changes in patients of the IG I, comparing with the Control Group patients. Any patient from the IG II needed hemotransfusion perioperatively. Conclusion. Application of colloidal solutions while doing elective operations of CSH on the  working heart leads to disorder of coagulation hemostasis, the intraoperative blood loss and the need for hemotransfusion enhancement.

scholarly journals A comparative study between the efficacy of local intra-myometrial injection of vasopressin and octreotide acetate, in reducing blood loss during myomectomy

2017 ◽  
Vol 6 (10) ◽  
pp. 4230
Author(s):  
Amira Mohammed Badawy
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Operative Time ◽  
Pressure Effects ◽  
Control Group ◽  
Group Iii ◽  
Abdominal Myomectomy ◽  
Octreotide Acetate ◽  
Group I ◽  
Group Ii

Background: Symptomatic Uterine leiomyomata may lead to many symptoms including abnormal uterine bleeding, mass pressure effects and infertility. Myomectomy is an option for conservative management, however, it is associated with some disadvantages, mainly increased intra-operative blood loss. Intra-myometrial vasopressin injection during myomectomy is an effective method to decrease the intraoperative bleeding due to its vasoconstrictor effect. Octreotide Acetate (OA) is another vasoconstrictor agent that have not been tested for gynaecologic indications. The current study was conducted to assess the efficacy of local injection of OA in reducing blood loss during conventional abdominal myomectomy, and to compare it with local instillation of vasopressin.Methods: 60 cases with symptomatic leiomyomata were recruited and planned for abdominal myomectomy, they were divided randomly into 3 groups, 20 cases in each. Group I, where local vasopressin was used, group II, where OA was used, and group III (the control group), where no specific medication was used and only free Saline was injected locally.Results: The overall results showed that OA group had significantly less operative time and less blood loss compared to control group. However, when compared to cases in group I, operative time and blood loss were significantly higher. Postoperative haemoglobin levels were significantly lower in group III compared to groups I (P = 0.039) and II (P = 0.044). Blood transfusion was indicated in 9 cases among group III, while only one case needed blood transfusion in group II, and no cases in group I.Conclusions: The use of local intra-myometrial OA is an option for reducing blood loss during myomectomy, but still efficacy is less than local vasopressin. This may be attributed to the low concentrations used, and to the less potency of OA as a vasoconstrictor agent.

Liver Hemostasis by Using Cold Plasma

2017 ◽  
Vol 24 (3) ◽  
pp. 253-258 ◽  
Author(s):  
Alexander Aleinik ◽  
Alexander Baikov ◽  
Georgiy Dambaev ◽  
Evgeniy Semichev ◽  
Pavel Bushlanov
Keyword(s):  
Blood Loss ◽  
Plasma Treatment ◽  
Bacterial Infections ◽  
Cold Plasma ◽  
High Efficiency ◽  
Nonequilibrium Plasma ◽  
Control Group ◽  
Surgical Interventions ◽  
Blood Indices ◽  
Group I

Surgical resection is associated with blood loss and bacterial infections. The aim of this study was to evaluate the effectiveness of cold plasma treatment during liver resection. Thirty adult male Wistar rats were divided randomly into 2 groups. Group I was the control group—intact animals (5 in total). The second group (25 in total)—experimental animals—had atypical resection of the left lobe of the liver with subsequent coagulation by “nonequilibrium” plasma. Histological tissue samples, biochemical blood indices, and hemocoagulation parameters were investigated on 3, 5, 7, 14, and 30 days after plasma treatment. The sterilization test was made to investigate the plasma bactericidal effects. Cessation of bleeding took less than 1 minute. Blood loss was negligible. Morphometric analysis of the liver revealed increased number of hepatocytes with signs of dystrophy after surgical intervention, which returned to the baseline values after 30 days. Biochemical blood parameters revealed significant differences in the groups only in terms of glucose ( P < .05); other parameters remained unchanged. High sterilization efficiency of cold plasma is confirmed. These results demonstrate the high efficiency of cold plasma treatment during surgical interventions.

Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I

2021 ◽  
Vol 20 (1) ◽  
pp. 11-20
Author(s):  
Yu.S. Raspopin ◽  
◽  
E.M. Shifman ◽  
A.A. Belinina ◽  
A.V. Rostovtsev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
High Risk ◽  
Caesarean Section ◽  
Blood Loss ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Control Group ◽  
Study Group ◽  
Group I

Prevention of postpartum haemorrhage is one of the important tasks of modern obstetrics, anesthesiology and intensive care. Objective. To assess the efficacy and safety of terlipressin usage as a means of postpartum haemorrhage development prevention during caesarean section in high-risk pregnant women. Patients and methods. From February to December 2020, a multicenter comprehensive cohort study, in which 5 medical centers participated, was conducted. The study included 454 pregnant women who underwent caesarean section and who were divided into two groups: control group I (n = 351) and study group II (n = 103), with the use of terlipressin injected into myometrium. Evaluation of the preventive effect of the drug was carried out in several main directions: the volume of blood loss, the need for additional methods of surgical hemostasis, the safety of intraoperative use. Results. Considerable differences were found in the assessment of significant risk factors for the development of postpartum haemorrhage, associated pathologies and comorbidity between the groups. The study group turned out to be more threatened by the postpartum haemorrhage development. In the control group, additional measures of surgical hemostasis were more often used, including hysterectomy (2.6% versus 1.9%) and relaparotomy (1.9% versus 1%). The median blood loss was statistically lower in the study group (700 ml versus 800 ml). Nevertheless, the considerable spread of data on the volume of blood loss should be noted, with a maximum blood loss of 10,000 ml in the control group and 4,500 ml in the study group. There were no serious complications in both groups. Conclusion. The study showed that the use of terlipressin can reduce the volume of blood loss in women with high risk factors for postpartum haemorrhage, as well as reduce the number of hysterectomies and relaparotomies. It is necessary to continue the prospective part of the study with an increase in the randomized sample of patients. Key words: obstetric haemorrhage, caesarean section, terlipressin

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