The paper deals with the problem of recovery of fertility with young women with hysteromyoma. For choosing the method of conservative myomectomy, it is justified the reasonability of division of patients into groups, according to the degree of surgical complexity for carrying out an operation and the possibility of subsequent pregnancy: low, medium and high. The prospective research was done with 83 patients of high complexity with sterility and noncarrying of pregnancy caused with semeiotic hysteromyoma, who had conservative myomectomy done in the traditional open way. As a result of the carried out operation, the fertility has been recovered with 35 (42.2%) females out of 83, by now. At that, 25 pregnant females were able to bear at full term. 4 females aborted at terms of gestation of 8-26 weeks, while the rest of 6 fell out of monitoring. Recurrent tumor has been noted in 2 (2.4%) cases, among those in 1 case (1.2%) it was established the rapid growth of multiple myomatous nodes.
It has been done a research with 28 pregnant females in various terms, with hysteromyoma, who had conservative myomectomy done. The indications for the operation were: incurable threat of abortion, rapid growth, trophopathy, necrosis of myoma, desired pregnancy. This kind of intervention is characterized as the last reserve for maintenance of pregnancy. The pregnancy was terminated at various terms with 4 (14.3%) patients while the rest were able to bear at full term and the delivery was done through Caesarian section. There was no forced hysterectomy in either case and there was not uncontrolled bleeding, intraoperatively.
AIM OF STUDY The study of the results of delivery of pregnant women with placenta ingrowth in the uterine scar depending on the clinical status and the methods of blood saving.MATERIAL AND METHODS The design of a selective retrospective study included 54 pregnant women with central placenta previa and uterine scar after caesarean section (CS), with histologically confirmed results of placenta accreta. Among blood-saving methods we used: ligation of three pairs of main vessels of the uterus, ligation of the internal iliac arteries, complex compression hemostasis according to R.G. Shmakov, temporary clamping of the common iliac arteries.RESULTS CS with fundal incision was performed in 47 women (87.0%) out of 54. Hysterectomy was performed in 17 women (31.5%) out of 54. In the remaining 37 cases (68.5%), metroplasty and organ preservation were performed. There was no relaparotomy; there was no maternal mortality; perinatal mortality was 4 (7.4%); forced opening, bladder resection were performed in 7 (13.0%) cases; opening of the bladder without wall resection — in 2 (3.7%); 2 near miss cases; there were no complications associated with temporary clamping of the common iliac arteries; endometritis (recovery after conservative treatment) was revealed in 2 women (3.7%). Histologic examination results: 15 (27.8%) of placenta accreta, 30 (55.6%) of placenta increta, 8 (14.8%) of placenta percreta. In 8 cases, there was a combination of placenta increta into the uterine scar region of different depths, and in 2 (3.7%) cases, a combined deeply invasive lesion of the posterior wall of the lower segment and the body of the uterus.CONCLUSION Complex compression hemostasis according to R.G. Shmakov is the most rational and promising method of blood saving, acceptable among the majority of patients with placenta accreta spectrum. Temporary clamping of the common iliac arteries is advisable in case of damage to the posterior wall of the bladder. Preservation of the uterus: in case of a deeply invasive lesion, including cases of combined damage to the posterior wall of the lower segment of the uterus or the body of the uterus, significant blood loss before the woman enters the hospital, it is not an imperative of surgical tactics.
We investigated the bacterial contamination of the milk of women in the iris group in parallel with the determination of lysozyme activity in it. The risk group included birthing women with a history of mastitis, foci of chronic infection; acute respiratory infections during pregnancy, childbirth, postpartum period, other febrile conditions; lactostasis; prolonged labor; severe forms of toxemia of the second half of pregnancy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.