Anesthetic management for Placenta Accreta

Authors

  • Kim En-Din State Institution Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent, Uzbekistan
  • N S Nadyrkhanova P.L.Shupyk National University of Health Care, Kiev, Ukraine
  • R A Tkachenko P.L.Shupyk National University of Health Care, Kiev, Ukraine
  • Yu V Kulichkin St. Petersburg State Pediatric Medical University, Russia
  • F P Nishanova State Institution Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent, Uzbekistan
  • K D Mikirtichev State Institution Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent, Uzbekistan
  • I I Dzhatdaev State Institution Republican Specialized Scientific and Practical Medical Center of Obstetrics and Gynecology, Tashkent, Uzbekistan

DOI:

https://doi.org/10.31636/pmjua.v6i2.3

Keywords:

placenta accreta, cesarean section, anesthesia, rheosorbilact

Abstract

Дослідження виконані у 82 вагітних і породіль при кесаревому розтині з приводу передлежання плаценти з вростанням на 37–38 тижні. Органозберігаюча операція була виконана за такою методикою: лапаротомія за Джоель Кохен, донний кесарів розтин з залишенням плаценти, перев’язка трьох пар магістральних маткових судин і внутрішніх клубових артерій з обох сторін (поетапна деваскуляризація матки) з подальшим видаленням стінки матки (метропластика) при вростанні плаценти. Операції виконані в умовах спінальної анестезії (Сан) 0,5 % гіпербаричним розчином бупівакаїну. Інфузійна програма будувалася відповідно до рекомендацій з обмежувальної інфузії. Преінфузію проводили збалансованим кристалоїдом Реосорбілакт (10–15 мл/кг) з подальшим введенням на етапах операції збалансованого кристалоїду і компонентів крові за необхідності. Оцінювали гемодинаміку, КОР та електроліти крові. Оцінку крововтрати проводили гравіметричним способом.

Дослідження показали, що Сан і Реосорбілакт у програмі малооб’ємної інфузійної терапії зберігають доставку кисню на фізіологічному рівні, стабілізують гемодинамічний профіль і КОР. При вростанні плаценти використання сучасних технологій в анестезіології реаніматології та акушерстві, з мультидисциплінарним підходом, дозволяють реалізувати органозберігаючу тактику у цієї категорії жінок

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Анестезиологический менеджмент при Placenta Accreta

Published

2021-08-28

How to Cite

1.
En-Din K, Nadyrkhanova NS, Tkachenko RA, Kulichkin YV, Nishanova FP, Mikirtichev KD, Dzhatdaev II. Anesthetic management for Placenta Accreta. PMJUA [Internet]. 2021 Aug. 28 [cited 2021 Dec. 9];6(2):29-36. Available from: https://painmedicine.org.ua/index.php/pnmdcn/article/view/256

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