Hryhurko D. Prevention of intraoperative, early and late postoperative complications in modified cesarean section

Тhe dissertation research is devoted to reducing the number of intraoperative, early and late postoperative complications and improving perinatal results in cesarean section by modifying the technical stages of surgery based on changing the organizational approach to cesarean section and involving the main provisions of the "Accelerated postoperative program". The developed technique of surgical delivery differs at the stage of laparotomy, suturing of the wound on the uterus, aponeurosis and skin. Тhe surgeon makes an incision with a scalpel along the midline of the aponeurosis up to 2 cm long, followed by separation of the peritoneum with the index finger and stretching all layers of the anterior wall bluntly by two surgeons simultaneously. 3. The main technical difference of surgical intervention is the simultaneous suturing of the wound on the uterus by two operators simultaneously on two sides, starting from the corners of the wound edges towards each other with a continuous vicryl suture with a fixing bandage (for Reverden) at the beginning and center of the suture. 4. By the above analogy, suturing of the aponeurosis and skin is performed. The proposed modified method of cesarean section can significantly reduce the duration of surgery by 2.18 times, the time to fetal removal by 2.03 times, reduce the volume of intraoperative blood loss by 1.33 times. Improve the condition of newborns on the Apgar scale in the first minute of life. The developed method of abdominal delivery using the ERAS protocol reduces the number of cases of uterine subinvolution, the frequency of antibacterial prophylaxis by 2.04 times and reduces the duration of inpatient treatment by 1.30 times.