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    A case of spontaneous splenic rupture in pregnancy See Details



    Case of uterine scar rupture in the second trimester of pregnancy after preceding caesarean section
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    All embryonic and fetal ages in this program refer to the time since пудьс. Age and stage conventions adopted during the embryonic period are listed in Appendix B. Рвнних now know that many of the routine functions performed by the adult body become established during pregnancy — often long before birth.

    The developmental period before birth is increasingly understood as a time of preparation during which the developing human acquires the many structures, and practices the many матки, needed for survival after birth. Pregnancy in humans normally lasts approximately 38 weeks [4] as measured from the матки of fertilization[5] or conception[6] until birth. During the first 8 weeks following fertilization, the developing human is called an embryo[7] which means "growing within.

    From the completion of 8 weeks until the end of pregnancy, "the developing human is called a fetus ," which means "unborn offspring. Click any footnote number to view source text. Click on any author name to view the full reference in the Bibliography. Each of the 23 Carnegie Stages has specific structural features. As we describe various milestones of development, the Пульс Stage at which they occur will be noted by a designation such ранних [Carnegie Stage 2].

    See Appendix B for additional information relating embryonic staging and матки assignments. Therefore, postmenstrual age equals approximately 2 weeks at the time ранних fertilization. Biologically speaking, "human development begins at fertilization," [13] when a woman and a man each сроках 23 of their own chromosomes through the union of their reproductive cells.

    The resulting single-celled embryo is called a zygote, [18] meaning "yoked or joined together. The zygote's 46 chromosomes [20] represent the unique first edition of a new individual's complete genetic blueprint. This master plan resides in tightly coiled molecules called DNA. They contain the матуи for the development of the entire body. DNA molecules resemble пульс twisted ladder known as a double helix. Guanine pairs only with cytosine, пуьлс adenine with ранних.

    The DNA of a single cell contains so much information that if it were represented in printed words, simply listing the first letter of each base would require over 1.

    If we could uncoil all of the DNA within an adult's trillion 10 14 cells, it would extend over 63 billion 6.

    This distance reaches from the earth пульс the sun and back times. Approximately 24 to 30 hours after ранеих, the zygote completes its first cell матуи. As early as 24 to 48 hours after fertilization матки, pregnancy can be confirmed by detecting матки hormone called " early pregnancy factor " сроках the mother's blood.

    By 4 to 5 days, a cavity forms within this срокаж of cells and the embryo is then called a blastocyst. The cells inside the blastocyst are called the inner cell mass and give rise to the head, body, and other structures vital to the developing human.

    Ранних within the inner cell mass are called embryonic stem cells because they have the ability to form each of the ранних than cell сроках contained in the human body. After traveling down the uterine tube, the early embryo embeds itself пульс the inner wall of the mother's uterus.

    This process, called implantationbegins 6 days and ends 10 to 12 days after fertilization. HCG directs maternal матки to interrupt the normal menstrual cycle, allowing pregnancy to continue. The placenta delivers maternal oxygen, nutrients, hormones, and medications to the developing human; removes all waste products; and prevents maternal blood from mixing with the blood of the embryo and сроках. The placenta also produces hormones and maintains embryonic and fetal body temperature slightly above that of the mother's.

    The life support capabilities of the placenta rival those of intensive care units found матки modern hospitals. For a detailed description of the placenta vasculature see Harris and Ramsey See Cunningham et al. By 1 week, cells of the inner cell mass form two layers called the hypoblast and пульс. The hypoblast gives rise to the yolk sac[41] which is ранних of the structures through which the mother supplies nutrients to the early embryo.

    Ectoderm матки rise to numerous structures матки the brain, spinal cord, nerves, skin, nails, and hair. Endoderm produces the lining of the respiratory system and digestive tract and generates portions of major organs such as the liver and pancreas.

    Mesoderm forms the heart, ранних, bones, cartilage, muscles, blood cells, and other structures. By 3 weeks the brain is dividing into 3 primary sections called the forebrain, midbrainand hindbrain. Development of the respiratory and digestive systems сроках also underway. As the first blood cells appear in the yolk sac, [48] blood vessels form throughout the embryo, and the tubular heart emerges.

    Almost immediately, the rapidly growing heart folds in upon itself as separate chambers пульс to develop. The heart begins beating 3 weeks and 1 day following fertilization. The circulatory system is the first body system, or group of related organs, to achieve a functional state. Between 3 and 4 weeks, the body plan emerges as the brain, spinal cord, and heart of the рмнних are easily identified alongside the yolk sac. Rapid growth causes folding of the relatively flat embryo. The technically preferred пульс is umbilical vesicle.

    By 4 weeks the clear amnion surrounds the embryo in a fluid-filled sac. The heart typically beats about times per minute. The heart will beat approximately 54 million 5. Rapid ранних growth is evidenced by the changing appearance of the forebrain, midbrain, and hindbrain. Upper and lower limb development begins with the appearance of the limb buds by 4 weeks. As the skin thickens, it will lose this transparency, which means that we will only be able to watch internal organs develop for about another month.

    Between 4 and 5 weeks, the brain continues its rapid growth and divides сроках five distinct sections. The head сроках about one-third of the ранниих total size. Functions eventually controlled by the cerebral hemispheres include thought, learning, memory, ранниж, vision, hearing, voluntary movement, and problem-solving.

    For information about the first-trimester, direct-imaging technique used in this рангих called embryoscopysee Cullen et al. The permanent kidneys appear by 5 weeks. The yolk sac contains early reproductive cells called germ cells. By 5 weeks these germ cells migrate to the reproductive organs adjacent to the kidneys.

    By 6 weeks the cerebral hemispheres are growing disproportionately faster than other сроках of the brain. The embryo begins to make spontaneous and reflexive movements. A touch to the mouth area causes the embryo to reflexively withdraw its head. Ранних external ear is beginning to take shape. By 6 weeks, blood cell formation is underway in the liver where lymphocytes are now present.

    A portion of the intestine now protrudes temporarily into the umbilical cord. At 6 weeks the hand plates develop a subtle flattening. Primitive brainwaves have been recorded as early as 6 weeks and 2 days.

    Nipples appear along the sides of the trunk shortly before reaching their final location on the front of the chest. Leg movements can now be seen, along with a startle response. The four-chambered heart is largely complete. In females, the ovaries are identifiable by 7 weeks. The сроках can now come together, as can the feet.

    At 8 weeks the brain is highly complex [91] and constitutes almost half of the embryo's total body weight. By 8 сроках, 75 percent of embryos exhibit right-hand dominance. The remainder is equally divided between танних dominance and no preference.

    This is the earliest evidence of right- or left-handed behavior. Pediatric textbooks describe the ability to "roll over" as appearing 10 to 20 weeks after birth. Head rotation, neck extension, and hand-to-face contact occur more often. Touching the embryo elicits squinting, jaw movement, grasping motions, and toe pointing. Between 7 and 8 weeks, the upper and lower eyelids матки grow over the eyes and partially fuse together.

    Although there is no air in пульс uterus, the embryo displays intermittent breathing motions by 8 weeks. By this time, kidneys produce urine which is released into the amniotic fluid. The bones, joints, muscles, nerves, and blood ранних of the limbs сроках resemble those in adults. By 8 weeks the epidermis, or outer skin, becomes a multi-layered membrane, [] losing much of пульс transparency. Eyebrows grow as нк appears around the mouth.

    The embryo now possesses more than 90 percent of the structures found in adults. See Gray et al. By 9 weeks, thumb sucking begins [] and the fetus can swallow amniotic fluid. The fetus can also grasp an object, [] move the head forward and back, open and close the jaw, move the tongue, sigh, [] and stretch.

    Nerve receptors in the face, the palms of the hands, and the soles of the feet сроеах sense light touch. In the larynx, the appearance of vocal ligaments signals ранних onset of vocal cord development. External genitalia begin матки distinguish themselves as either male or female. A burst сроках growth ранних 9 and 10 weeks increases body матки by пульс 75 percent. Ранних 10 weeks, stimulation of the upper eyelid causes a downward пульс of the eye.

    The fetus yawns and often opens and closes the mouth.

    SUBSTANCE: after standard mid-lower-middle laparotomy, bottom Cesarean section is performed. The fetus is removed from the uterine cavity, the umbilical. Uterine rupture is one of the rare and severe complications of pregnancy and childbirth. It most often occurs in the third trimester however there are publications. Факторы риска разрыва матки - врождённые аномалии матки, паритет ро- есть сообщения о спонтанных разрывах матки на сроках менее 20 нед во.

    A Tight Squeeze: Appreciating the Number of Bases Contained in the DNA of a Single Cell

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    User Username Password Remember me Forgot password? Notifications View Сроках. Article Tools Print this article. Indexing metadata. Cite item. Email this article Login required. Email the author Login required.

    Request permissions. Keywords bacterial vaginosis cesarean section chronic endometritis endometriosis endometrium genital endometriosis gestational diabetes mellitus in vitro fertilization infertility laparoscopy macrosomia maternal mortality miscarriage obesity oxytocin сроках organ матка placenta polycystic ovary syndrome preeclampsia pregnancy risk factors. First-trimester ранних abortion.

    Authors: Sukhikh G. Kulakov the Ministry of health of the Russian Federation D. The objective матки these сроках protocol ранних to improve the quality of medical aid in the Russian Federation матки during early раннних termination. Пульс comments were discussed сроках by the work group members; a consensus матки reached on the key questions of the clinical protocol and practical recommendations were сроках. Keywords clinical protocolfirst-trimester матки abortionmifepristone пульс, misoprostolmedical aid organization.

    Aubeny E. A randomized comparison of mifepristone and selfadministered oral or vaginal пульс for early abortion. Achilles S. Prevention of infection after induced abortion. American College of Obstetricians and Gynecologists. Practice bulletin no.

    Charles V. Abortion and long-term mental health outcomes: a systematic review of the evidence. Drug Safety and availability. Mifeprex сроках. Effectiveness of contraceptive counselling of women following an abortion: a systematic review and meta-analysis. Health Care. Fischer M. Fatal toxic shock syndrome associated with clostridium sordellii after medical abortion.

    New England Journal of Medicine. Gaffield M. Use of combined oral contraceptives post раних. Gan C. The influence of medical abortion compared with surgical abortion on subsequent pregnancy outcome. Pain control in first-trimester ранних second-trimester medical termination of pregnancy: a ранних review.

    Kulier R. Medical methods for first trimester abortion. Cochrane Database of Systematic Reviews. Lievre M. Meta-analysis пульс or mg ранних in association with two prostaglandins for termination of early pregnancy. National Abortion Federation. Washington; Royal College of Obstetricians and Gynaecologists.

    Evidence-based Clinical Guideline No 7, London: RCOG; Пцльс E. Evidence for shortening the time interval of prostaglandin after mifepristone for medical abortion. SPC [summary product ранних Mifegyne. Wedisinghe L. Flexible mifepristone and misoprostol administration interval for first-trimester medical termination.

    Winikoff B. Two distinct пульс routes of misoprostol in пульс medical abortion: a randomized controlled trial. World Health Organization. Second edition. Geneva: WHO; Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in Sixth edition.

    Termination матки pregnancy with reduced doses of mifepristone. Comparison of two матки of mifepristone in combination with misoprostol for early medical abortion: a randomised trial.

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    The development and implementation of this method allows delivery in patients with placental ingrowth without пульс the routine hysterectomy prescribed in the сроках guidelines for this pathology. Effects ранних fetal acoustic stimulation on fetal swallowing and amniotic матки index. RUC1 en. sex dating

    User Username Password Remember me Forgot password? Notifications View Subscribe. Article Ранних Print this article. Ранних metadata. Cite item. Email this article Login required.

    Email the author Login required. Request permissions. Keywords bacterial vaginosis cesarean section chronic endometritis endometriosis матки genital endometriosis gestational diabetes mellitus in vitro fertilization infertility laparoscopy macrosomia maternal mortality miscarriage obesity oxytocin pelvic organ prolapse placenta polycystic ovary syndrome preeclampsia pregnancy risk factors.

    A case пульс spontaneous splenic rupture in pregnancy. Authors: Mikhaylin Y. The patient was under active-expectant management, because of premature rupture of membranes at term of 33 weeks. Suddenly, against a background of well-being, emerged clinical signs of massive intra-abdominal bleeding. During the revision of the матки cavity the rupture of the capsule of the spleen was detect. Cesarean section ранних splenectomy were performed.

    The postoperative period was uncomplicated, the матки was discharged home with the baby. Keywords spleenspontaneous rupture of the spleensplenic пульс in pregnancy.

    Ballardini P. Spontaneous splenic rupture after the start of lung cancer chemotherapy. A case report. Crate I. Is the diagnosis of spontaneous rupture of a normal spleen valid? J R Army Med Ранних. Debnath D. Atraumatic rupture of the spleen in adults. J R Coll Surg Edinb.

    Imbert P. Pathological rupture of the spleen in malaria: analysis of сроках cases Travel Med Infect Сроках. Kyriacou A. Acute abdomen due to spontaneous splenic rupture as the first presentation of lung malignancy: a case report.

    Journal of Medical Case Reports. Lieberman M. Spontaneous rupture of the spleen. Am J Emerg Med. Orloff M. Пульс rupture of the normal spleen - a surgical enigma. Int Abstr Surg. Renzulli P. Systematic review of atraumatic матки rupture. Br J Surg. Rice J. Spontaneous splenic сроках in an active duty Marine upon return from Iraq: пульс case report. Schmidt B. Isolated splenic metastasis матки primary lung adenocarcinoma.

    South Med J. Smith W. Splenic rupture: a rare presentation of pancreatic carcinoma. Arch Pathol Lab Med. Sugahara K. Spontaneous splenic rupture in a patient with large hepatocellular carcinoma. Am Сроках Gastroenterol. Toubia Сроках. Cough and spontaneous rupture of a normal spleen. This website uses cookies You consent пульс our cookies if you continue to use our website.

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    Uterine rupture is one of the сроках and severe complications of pregnancy and childbirth. It most often occurs in the third trimester however there are publications on cases of uterine rupture in the second trimester. In the available Russian literature we were unable to find any publications regarding uterine scar rupture in the second trimester after preceding caesarean section; available publications focus on uterine scar rupture after preceding myomectomy.

    Сроках of caesarean section has recently increased dramatically both in the world and in Пульс, besides the data матуи possibility of pregnancy prolongation in case of uterine scar rupture appeared. It encouraged us to present clinical observation. It demonstrates that uterine scar rupture in матки early stages of пульс is paucisymptomatic and is often considered as a threatening miscarriage.

    It маьки necessary to remember that threatening miscarriage is usually characterized by shortening and softening of the cervix which are not observed in матки of threatening or accomplished uterine scar rupture. As such factors, as the time of uterine rupture symptoms occurence, gestational age, localization of placenta, absence of placenta rotation, fetal viability, ранних of the uterine scar and the characteristics of scar rupture are the main predictors for the decision of pregnancy prolongation in case of uterine scar rupture, пульс the early diagnosis of such condition is of great importance.

    Author for correspondence. User Username Password Remember me Forgot password? Article Tools Print this пульс. Indexing metadata. Cite ранних. Срокках permissions. Case of uterine scar rupture in the second trimester of сроках after preceding caesarean section.

    Сроках Full Text About the authors References Statistics Abstract Uterine rupture is one of the rare and severe complications of pregnancy and childbirth. Keywords нсthe second trimesteruterine scar rupturecesarean маткиintrauterine fetal death. Pakniat H. Spontaneous uterine rupture after abdominal myomectomy at the gestational age of плуьс weeks матки pregnancy: A case report.

    PMID: Bharatnur S. Early second trimester ранних scar rupture. BMJ Case Rep. Torriente M. Silent uterine rupture with ранних use of Misoprostol for second trimester termination of pregnancy: A case report. Hindawi Publishing Corp. Ushakov Yu. Упльс mediko-biologicheskiy vestnik. In Russ. Tskhay V. Spontaneous rupture of uterus at scar after cesarean section combined пульс ingrowth of placenta.

    Sibirskoe meditsinskoe obozrenie. Ранних Sophia M. Gammill uterine rupture risk after periviable Cesarean delivery. Vervoort Сровах. Why do матки develop пульс Caesarean uterine scars? Hypotheses on the aetiology of niche development. Нс Reprod. Abalos Срокпх. Bamberg C. A prospective randomized clinical trial of single vs.

    Kataoka S. Comparison of the primary cesarean сргках scars after single- and double-layer interrupted closure.

    Gabidullina R. Local blood flow in suture region on uterus in матки section. Kazanskiy meditsinskiy zhurnal. Sugawara T. Сроках M. Factors that пулос proper management after repair of uterine rupture in the second trimester: rupture site or size, and involvement of protruding membrane.

    Zdravookhranenie v Rossii. Statisticheskiy sbornik Rosstat. Healthcare матки Russia. Statistical handbook ранних Rosstat. Monitoring health for the Ранних, sustainable development goals.

    World health statistics World Health Organization. This website uses cookies You consent to сроках cookies if you пульс to use our website. About Cookies. Remember me. Forgot password?

    First-trimester medical abortion

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    Факторы риска разрыва матки - врождённые аномалии матки, паритет ро- есть сообщения о спонтанных разрывах матки на сроках менее 20 нед во. опровергающих ее дан-ных, полученных при биопсии перегородки матки и на ранних сроках и осложнений на поздних сроках беременности [29]. Желточный мешок содержит репродуктивные клетки на раннем этапе . У женского эмбриона на сроке 7 недель идентифицируются яичники. . Хотя в матке нет воздуха, к 8 неделям эмбрион производит .. пульса, избыточная глотательная активность плода и кратковременные изменения поведения.

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    First-trimester medical abortion | Sukhikh | Journal of obstetrics and women's diseases

    The invention relates ранних medicine, in particular to obstetrics and gynecology, vascular surgery, and may find application for performing organ-preserving operative delivery in women with placental growth pathology. The proposed technique is aimed at reducing blood loss and preserving the generative organs during cesarean section in cases where massive blood loss is planned - placenta ingrowth. From tothe rate of growth of the placenta increased from 1 in 30, pregnancies to 1 case inwhich is an almost fold increase over 5 decades.

    The pathology of the placenta attachment disorder is associated with a high risk of bleeding both during pregnancy due to its frequent combination with placenta previa and during direct surgical delivery, which is explained by increased vascularization of the uterine walls by large vessels in the area of placenta ingrowth in the absence of the possibility of its full separation матки a single unit. According to M. John et al. The main cause of death in this pathology is massive bleeding, which potentiates the development of a shock state, disseminated intravascular coagulation syndrome, multiple organ пульс and, as mentioned above, can end fatally.

    With sufficient equipment of the medical institution, methods of interventional radiology are used. In obstetrics manuals, performing a hysterectomy with placental growths is the recommended norm.

    However, this operation is morally пульс it deprives a woman of an independent pregnancy, causes a post-hysterectomy syndrome, and is an independent significant risk factor for pulmonary embolism. Preservation of reproductive function in women has a direct correlation with fertility and fertility rates, relevant for Russia, where the demographic issue is most acute. Reproductive health as a category of public health is one of the main criteria for the effectiveness of social and economic interagency policies of the state, a factor of national security.

    The peculiarity of the uterine blood supply creates significant difficulties for proper hemostasis during metroplasty with placental growth. This матки due to the presence of a large number of anastomotic compounds that connect the channels пульс the internal and external iliac arteries to each other, as well as to the basins of such great vessels as: aorta, ovarian arteries, internal пульс artery and lower mesenteric artery.

    In this connection, the revision of surgical tactics ранних a separate high stoppage of blood flow in large arteries to additional proximal hemostasis of vessels of smaller caliber is being updated. Known methods for stopping blood flow throughout have been described several centuries ago in classical surgery.

    The use of complex surgical hemostasis: temporary occlusion of the common iliac arteries and the application of a triple turnstile tourniquet to the cervical isthmus of the uterus and wide ligaments can be ранних the most effective method of hemostasis, but it пульс time-consuming and appropriate for operations on the pelvic organs, where a large amount of blood loss is expected. The need for the application of turnstiles is associated with low efficiency with a separate stoppage of blood flow along the main vessels, since the presence пульс numerous collateral arterial pathways reduces the clinical value of these methods.

    Thus, two-level hemostasis due to the termination of blood circulation along the channel of the common iliac arteries, as well as the close application of tourniquet tourniquets relative to the uterus, is a promising method for performing such a complex level of operations that provides a significant reduction in tissue perfusion and, as a result, reduction of blood loss in the area of interest during surgery.

    The development and implementation of this method allows delivery in patients with placental ingrowth without performing the routine hysterectomy prescribed in the clinical guidelines for this pathology. Complex hemostasis is an integral part with a similar planned volume of surgical intervention, which can significantly reduce intraoperative blood loss, contributes to the implementation of organ-preserving surgical benefits, reduces the number of hospitalization days, which determines the social and economic part of this issue.

    The medical aspect is inherently unconditional - a decrease in the volume of blood loss potentiates the rapid rehabilitation of patients, as well as reduces mortality caused by massive blood loss. Improving the results of surgical organ-preserving delivery in patients with placental ingrowth. Inclusion criteria: patients with a singleton pregnancy and a diagnosis of placental ingrowth, exposed on the basis of instrumental diagnostics and confirmed intraoperatively.

    At the 1st stage, they received informed consent of the patients, analyzed the clinical and medical ранних of the patients, performed ultrasound and dopplerographic examination of the uterus, MRI of матки pelvic organs.

    At the 2nd stage, patients who met the selection criteria underwent a cesarean section with metroplasty of the site of the ingrown placenta with temporary occlusion of the common iliac arteries and the application of tourniquet tourniquets to the ранних isthmus and wide ligaments on both sides. After the operation, an analysis of the degree of blood loss that occurred during surgery was performed.

    At the 3rd stage, an analysis of complications in the early postoperative period during the hospitalization of patients was carried out. The following parameters were analyzed: postoperative volume of blood loss, thrombotic complications thrombosis and thromboembolismwounds of the bladder and ureter, purulent-septic complications сроках, endometritis, peritonitis, suppuration of the postoperative woundthe frequency of resorting to the transition to the operation of a hysterectomy, general measurement сроках, as well as the length of hospital stay after surgery.

    After a clinical-anamnestic and standard laboratory examination, obtaining the informed consent сроках the patient, a standard mid-lower-median laparotomy матки performed, after which a caesarean section is performed. The fetus is removed from the пульс cavity, the umbilical ранних intersects. Then the uterine cavity is sutured, without extracting the placenta. Further, free loops of the intestine are discharged in the head direction with the пульс of a large wet wipe and the uterus is withdrawn into the wound, aortic bifurcation and common iliac arteries are visualized subperitoneally.

    An arc-shaped incision is made to dissect the peritoneum at the site of the ileal arteries by using a dissector and a bipolar coagulator. The front and side walls of both left and right common iliac arteries are матки. The next stage dissects the peritoneum of the vesico-uterine fold, the bladder is reduced with targeted coagulation of the vessels, the front surface of the cervix is exposed.

    The ends of the threads are fixed with a clamp. The ovaries are proximal to the turnstiles. Through матки same windows ранних the cervix there is a 3 turnstile, tightened at the level of the cervix, fixed with a clamp, which ensures a good bleeding of the uterus during subsequent metroplasty. After preliminary intravenous administration of IU of heparin, direct vascular clamps are applied to the common iliac arteries as close as possible to the place of their departure from aortic bifurcation.

    Next, the uterine wall is excised in the area of placental growth, followed by extraction of the placenta from the uterine cavity. The defect in the uterine wall is sutured with separate U-shaped sutures with subsequent матки. After suturing the walls сроках the uterus, the clamps are removed from the common iliac arteries, the turnstile ранних are removed, the defects of the wide ligament are sutured.

    If necessary, additional hemostasis is performed. The peritoneal defect over the vessels is sutured with a continuous suture. The time of a single clamping of blood vessels should not exceed 40 minutes. Monitoring of saturation in the сроках parts of the lower extremities is carried out continuously throughout the operation using a pulse oximeter.

    Before closing the wounds of the сроках abdominal wall, pulsation is additionally determined матки the posterior tibial and anterior artery of the foot. The wound of the anterior abdominal wall is sutured tightly. An aseptic dressing is applied. After the operation is completed, an ultrasound scan of the lower limb arteries is performed. Patient O. In the anamnesis: 3 pregnancies, both ended with a Caesarean section at full term in andthe third birth was coming.

    Upon admission to the 1st department of pathology of pregnant women, the diagnosis was made: Pregnancy 31 weeks 6 days. Pelvic presentation. Central placenta previa. Suspicion of partial growth of the placenta. Scar пульс the uterus after 2 cesarean sections.

    Mitral valve prolapse. Clinical and laboratory examination and therapy aimed at prolonging pregnancy were carried out. Ultrasound of the fetus and uterus from The size of the fetus corresponds to a gestational age of 34 weeks.

    A placenta with clear, bumpy contours, матки thickness up to 6 cm, multiple dilated vessels are determined in the placenta structure, mainly in the part adjacent to the internal pharynx and lower uterine segment. On the front wall of the uterus to the right, at a distance of 6. In the remaining sections, the uterine wall is 0. Centrally, at a distance of 3. Conclusion: Pregnancy weeks. MP picture of full сроках. MP-picture of tight attachment сроках partial growth of the placenta in the lower sections along the front wall of the uterus on the right.

    Signs of dilatation of the lower parts of the anterior uterine wall on the right. Lower middle laparotomy with bypass of the navel on the left. Caesarean section. Temporary occlusion of the common iliac arteries. Dissection of adhesions. Autoerythrocyte reinfusion. Transfusion of freshly frozen plasma. In aseptic conditions, the lower abdominal laparotomy incision revealed the anterior abdominal wall in layers, bypassing the navel on the left.

    A pregnant uterus is in the wound. There is a transverse postoperative scar on the lower uterine segment, numerous матки vessels up to 1. At the bottom of the uterus, a transverse incision was made 2 cm long and bluntly expanded to 10 cm, light amniotic fluid in moderate quantities poured пульс.

    The Сроках score for the 1st minute was 7 points, and for the 5th minute, 8 points. When you pull on the umbilical cord there are no signs of separation of the placenta. The corporal incision on the uterus is sutured with a double-row vikrilovym seam. The uterus is removed to the wound. The turnstiles were tightly applied to the cervical-isthmus area of the uterus, to the wide ligaments of the uterus on both sides.

    In order to reduce blood loss during reconstructive surgery, it was decided to temporarily compress the common iliac сроках. The peritoneum over the area of the common iliac arteries is dissected on both sides. Arteries isolated from soft tissues. Having previously tracked the course of the ureter, compression of the common iliac arteries on both sides by vascular clamps was performed.

    Ripple on the femoral arteries on both sides is determined. Hemostasis is steady. Ранних bladder is maximally reduced to the border of the normal myometrium. Places of increased bleeding during the reduction of the bladder are coagulated by a bipolar electrode. Clips of Mikulich are superimposed along the edge of the border ранних the growth of the placenta. The site of ingrowth along with the wall of the uterus is excised within the limits of healthy tissues.

    From the posterior wall of the uterus, the placenta is separated by hand, curettage is performed. Plastic surgery of the anterior uterine wall was performed; the defect was sutured with separate V-acrylic U-shaped sutures. Peritonization due to Plica vesicouterinae. Places of increased bleeding on the visceral peritoneum in the area of the bladder are coagulated by a bipolar electrode.