Glushko O. Prognosis, preclinical diagnostics and optimization of conservative treatment of obstetrical hemorrhage.

Hemorrhage remains a major problem in obstetrical practice, being the first of the top five causes of maternal death around the world. This research work presents the results of a comprehensive evaluation of the peculiarities of extragenital and gynecological pathologies, as well as the course of pregnancy and labor in women with hypotonic postpartum hemorrhage. The results received allowed the authors to define the main risk factors for hypotonic hemorrhage and to suggest preventive use of repository uterotonic drug carbetocin in women from groups where vaginal delivery poses high and extremely high risk. The research has proved the benefits of combined use of uterotonic and vasoconstrictive drugs for hypotonic obstetrical hemorrhage as compared to the conventional techniques. The work sets forth the role of factors contributing to the formation of postpartum hemostasis, studies the leading causes for uterine contractility disorders in the postnatal period, and the connection between polymorphous variants of FV (G1691A) and FBG (C148T) genes and uterine hypotonia during the postnatal period. The research conducted allows to increase the efficiency of prognosis, prevention and treatment of postpartum hypotonic hemorrhage, thus reducing maternal disease rate and preventing maternal death.