Несмотря на достижения в профилактике и лечении послеродовые кровотечения остаются важной проблемой в акушерстве. Послеродовые кровотечения являются одной из основных причин материнской смертности.
Obstetric hemorrhages, despite the global measures introduced to prevent them, still represent a real threat to the maternal health and life, and require a search for more effective measures for their prevention and treatment. The list of references which formed the basis for the present review will allow the reader to determine the vector of searching for modern information on obstetric hemorrhages, to compare the outcomes of labor with postpartum hemorrhage in different countries, and to understand the prognostically significant risk factors.
The problem of the development of polyhydramnios is relevant in connection with the complications of pregnancy and childbirth, both for the mother and for the fetus. One of the most dangerous complications is hypotonic bleeding in the postpartum period, which leads to an increase in maternal morbidity and mortality. Among the causes of bleeding, polyhydramnios, the frequency of which reaches 1–8% of the total pool of pregnant women, occupies one of the leading positions. The aim of the study was to study the features of the clinic and the morphological structure of the uterine wall in polyhydramnios of varying severity. All this dictates the need to improve ways to prevent hypotonic postpartum bleeding in women with polyhydramnios.
The aim of the study is to improve the results of diagnosis and surgical treatment of victims with closed abdominal injury by developing a new approach to ultrasound assessment of the amount of hemoperitoneum, expanding and specifying indications for laparoscopy, taking into account the volume of free fluid in the abdominal cavity.
The object of the study were 160 patients with closed abdominal injury with stable hemodynamics, was hospitalized in the surgical Department of the Republican specialized scientific and practical center for emergency medicine of the Samarkand branch (clinical departments of surgical diseases № 2 and surgery postgraduate faculty of Samarkand state Medical Institute) for the period from 2010 to 2019.
The scientific novelty of the study is as follows: a fundamentally new approach to ultrasound evaluation of discrete volumes of free fluid in the abdominal cavity is proposed, based on taking into account the thickness of the fluid layer and its prevalence in the abdominal cavity zones; The expediency of using the ultrasound indicator "free fluid in the abdominal cavity < or >500 ml" in choosing the tactics of surgical treatment of patients with closed abdominal injury is substantiated; an algorithm for choosing surgical tactics for the treatment of patients with closed abdominal trauma was developed based on an ultrasound assessment of the volume of free fluid in the abdominal cavity.
Implementation of research results. Based on the results of a scientific study to improve the diagnosis and surgical treatment of patients with closed abdominal trauma:methodological recommendations "The choice of tactics for surgical treatment of closed abdominal trauma based on ultrasound assessment of the nature and severity of the injury" have been developed (certificate of the Ministry of Health No. 8n-z/1282 dated November 15, 2022). The proposed recommendations made it possible to increase the effectiveness of the diagnosis of intra-abdominal injuries in patients with abdominal trauma;
The results of scientific research on improving the diagnosis and surgical treatment of patients with closed abdominal injury have been introduced into medical practice, including the clinical practice of the Republican Scientific Center for Emergency Medical Care and its Samarkand, Surkhandarya and Navoi branches (conclusion of the Ministry of Health No. 8 n-z/699 dated December 21, 2022). The introduction of the obtained results into clinical practice allowed to improve the quality of high-tech surgical care provided to patients with isolated and combined abdominal injuries, to reduce the frequency of postoperative complications from 11.9 to 3.1% (p=0.144).
The structure and volume of the dissertation. The dissertation consists of an introduction, 4 chapters, conclusions and a list of cited literature. The volume of the text material is 107 pages.
Согласно данных ряда эпидемиологических исследований, с годами растет число женщин репродуктивного периода, страдающих дисфункциональными маточными кровотечениями (ДМК). Репродуктивная система женщин высокочувствительная к воздейтсвию неблагоприятных факторов, среди которых важная роль отводится хронической анемии (ХА). Выявлена зависимость характера нарушения менструальной функции от степени ХА, провоцирующего фактора в формировании нарушений менструального цикла. Одной из наиболее частых форм этих нарушений являются дисфункциональные маточные кровотечения^ 1,2)