METHOD OF HYSTEROTOMY IN REPEATED CESAREAN SECTION IN PATIENTS WITH PLACENTATION IN UTERINE CICATRIX Russian patent published in 2020 - IPC A61B17/42 A61M25/04 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to obstetrics and gynecology. Performing transverse incision of myometrium with length of 1.5–2 cm, blunt dilution of placental tissue without detachment of placenta from uterine wall, opening of amniotic membrane and removal of amniotic fluid without expansion of incision, blunt one-stage dilution of myometrium, placenta, amniotic cover in capito-caudal direction, closure of wound on uterus with two-row continuous suture after fetus, placenta and metroplasty. After laparotomy, a posterior wall of the urinary bladder and a lower uterine segment are mobilized with thorough hemostasis in the aberrant vessels. Intraoperative incision is made on an upper edge of a modified wall of a lower uterine segment. Uterine exteriorisation is performed after the fetus is removed and the umbilical cord is crossed without attempts to remove the placenta. Performing the complex surgical haemostasis using the turnstile harnesses from the elastic rubber tubes on the inner throat and the funnel-pelvic ligaments with subsequent removal of the placenta, excising placental growth areas and altered uterine wall with formation of one suture on uterus.

EFFECT: method enables reducing surgical injury, reducing intraoperative blood loss, reducing the risk of placentation within the scar and rupture of the uterus with the possibility of realizing the reproductive function in the future.

1 cl, 5 ex