Obstetric Hemorrhages on the Background of Gestosis: a Modern Therapeutic Management (Review of Literature)

Abstract

Obstetric hemorrhages are a topical problem of modern health care. They are remains one of the principal causes of maternal death. A series of therapeutic measures for stopping obstetric hemorrhage worked for decades. Recently, however, a number of pharmacological and surgical methods that ensure a more effective management of postpartum hemorrhages have been introduced, which in its turn results in preservation of the reproductive function in young women. This article presents the world literature data on the theories of gestosis, its frequencies, pathogenesis and the role of gestosis in the development of obstetric hemorrhage. It is shown that the hyper-coagulable syndrome and hypovolemia, specific to gestosis, are directly related to the decrease of tolerance of the female body during obstetric hemorrhage, as well as they lead to the disruption of compensatory reactions with the development of multiple organ dysfunction syndrome, even at a small loss of blood. The article describes the modern conserving approach for the management of obstetric hemorrhage and the role of integrated infusion- transfusion therapy with early addition of donor fresh frozen plasma in the treatment of bleeding in the early postpartum period to preserve the reproductive function of women.