Lakatosh V. P., Bondarenko N. P.

EXPERIENCE IN THE APPLICATION OF ORGAN-PRESERVING TACTICS OF SURGICAL TREATMENT OF OBSTETRIC PERITONITIS AFTER CESAREAN SECTION (CLINICAL CASES)

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About the author:

Lakatosh V. P., Bondarenko N. P.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Obstetric peritonitis, which develops against the background of uterine sutures failure after cesarean section, continues to be very important topic of complications of abdominal accouchement and will never lose its relevance, as the frequency of cesarean section as a method of accouchement is increasing in the world. At the same time, this trend leads to increase in the incidence of complications due to surgical intervention and purulent-septic diseases, such as obstetric peritonitis. The need to perform a relaparotomy in the postpartum period is considered an “emergency” because it creates significant risks associated with unexpected cessation of fertility for a patient of reproductive age. Due to the development of modern technologies, the prospects for the use of organ-preserving operations in obstetrics dictate necessity to develop new surgical approaches in the treatment of obstetric peritonitis, which will allow to preserve the uterus in women of childbearing age. The article describes the cases of treatment of obstetric peritonitis due to uterine sutures failure using metroplasty. The selection of patients for this approach to the treatment of obstetric peritonitis after cesarean section was carried out strictly individually, taking into account the general condition of the patient at the time of surgery, the condition of the uterine tissue and the prevalence of necrotic changes in the uterine wall. In all cases, the patients were under round-the-clock supervision of doctors who were ready to perform an extended operation on an emergency basis at any time if necessary. Clinical and laboratory analysis of cases of obstetric peritonitis allowed us to identify risk factors that increase the likelihood of suture failure. Successful results of treatment of such patients are obtained on condition of: early diagnosis of postoperative complication, with an objective assessment of the prevalence of obstetric peritonitis and the condition of the uterus before the possibility of organ-preserving surgery, perioperative administration of ultra broad-spectrum antibiotics in combination with early intensive care in the intensive care unit.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 4, 175, 398-409 pages, index UDC 618.36-07:613.1

DOI:

10.29254/2077-4214-2024-4-175-398-409