Massive obstetric bleeding: optimization of total hysterectomy surgery technique and conservative treatment

Abstract

Objective. Reducing maternal mortality during massive obstetric bleeding (MOB) through optimizing total hysterectomy technique and improving the quality of infusion therapy. Materials and methods. The analysis and evaluation of the results of MOB treatment in a comparative aspect were carried out in retrospective and prospective groups from 2014 to 2019 in Urgench perinatal center and three maternity complexes of Khorezm region, Uzbekistan. The retrospective group included 72 pregnant women with an average blood loss of 2450.0±80.0 ml, while the prospective group included 78 pregnant women with an average blood loss of 2530.0±70.0 ml. Results and discussion. 1,419 (6.2 %) cases out of 22,896 deliveries in the retrospective group were accompanied by abnormal blood loss, and the MOB frequency of more than 1500.0 ml was determined in 0.3 % of all deliveries. 5 (62.5 %) of 8 cases of maternal mortality were directly related to MOB. In the retrospective group, a total hysterectomy was performed using traditional method for MOB, with an interoperable blood loss of 860.0±110.0 (p