METHOD OF OPERATIVE DELIVERY OF PATIENTS WITH INGROWTH OF PLACENTA INTO TRIPE ON UTERUS WITH TOURNIQUET HEMOSTASIS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, particularly to obstetrics and gynecology. If the operative delivery of the patients with ingrowth of the placenta into the scar on the uterus is performed by the Cesarean section, the fetus is removed through a uterine incision. Then, the umbilical residue going to the placenta is ligated and immersed into the uterus. Uterine incision is not closed without placenta extraction. Inconsistent uterine wall is incised, including a uterine aneurism with a portion of ingrown placenta within the healthy tissues, manual removal of the rest placenta tissue is performed, and the obtained defect is closed with the tourniquet hemostasis. Tourniquet hemostasis is performed as follows. Ascending branches of uterine arteries and ovarian arteries are clamped by placing the first tourniquet at the level of the upper end of the uterine aneurysm around the uterus body, grasping the broad ligaments of the uterus with uterine tubes from both sides in a single block. After the uterus is separated from the bladder to the lower end of the uterine aneurysm, the uterine arteries are clamped by placing a second turnabout around the uterus at the level of the lower end of the uterine aneurysm. After excising an inconsistent uterine wall, including a uterine aneurism with a segment of ingrown placenta, closure of the obtained defect of the uterine wall, the tourniquets are removed.;EFFECT: medico-technical effect consists in simultaneous provision of simple execution of hemostasis, a cost-saving intervention by improving hemostasis reliability.;5 cl, 1 ex