METHOD OF PREVENTING MASSIVE BLOOD LOSS DURING DELIVERY IN PATIENTS WITH PLACENTA PRESENTING IGGRIGUS Russian patent published in 2023 - IPC A61B17/42 A61B17/12 

FIELD: medicine; obstetrics.

SUBSTANCE: for surgical delivery of a patient with placenta accreta, after opening the abdominal cavity, first dissection of the vesicouterine fold of the peritoneum and dissection of the posterior wall of the bladder are performed. Then the fetus is removed through an incision in the uterus in the area of its fundus. The umbilical cord leading to the placenta is tied and immersed in the uterus. The uterine incision in the area of its fundus is sutured without removing the placenta. Next, blood flow through the uterine arteries is limited. It is performed by applying a ligature of absorbable thread around the uterus at the level of the internal os and tying its ends in front and below the hernial protrusion of the uterine wall containing the placenta, pinching the uterine arteries and blocking the lumen of the cervical canal. Then the incompetent uterine wall with the area of placenta accreta is excised, the remaining placental tissue is manually removed and the resulting uterine defect is sutured. Collection of oozing blood and autohemotransfusion are carried out. The applied ligature is preserved after completion of the surgical intervention.

EFFECT: method allows to reduce intraoperative blood loss by reducing the time between possible detachment of a part of the normally attached placenta after fetal extraction and a technique that limits blood flow through the uterine arteries; helps to prevent recurrent bleeding due to “delayed” restoration of blood flow through the uterine arteries; reduces operation time by eliminating surgical techniques aimed at removing temporary tourniquets, as well as techniques that include interventions on the great vessels.

1 cl, 1 ex