Intraoperative risk of bleeding and its prevention during transcervical myomectomy.

V. V. Kaminsky; V. V. Dunaevska; M. V. Medvediev

doi:10.26641/2307-0404.2014.3.30343

Авторы

V. V. Kaminsky
V. V. Dunaevska
M. V. Medvediev

DOI:

https://doi.org/10.26641/2307-0404.2014.3.30343

Ключевые слова:

uterine leiomyoma, terlipressin, blood loss, hysteroscopy

Аннотация

In this study clinical, functional and morphological assessment of the effectiveness of synthetic analogue of vasopressin (terlipressin) has been made. The aim of the study was to assess study drug prevention efficasy of excessive bleeding during hysteroscopic myomectomy in patients with submucosal uterine leiomyoma. In 19 women with uterine leiomyoma 15 minutes prior to surgery terlipressin was administered in paracervical route in the dosage 0.6 mg in 10 ml of normal saline. In the comparison group, which was also consisted of 19 women in the presence of significant blood loss during myoma resection intravenous oxytocin was used. The use of terlipressin helped to reduce the volume of blood loss during surgery almost by 2 times, reduced the duration of surgery and the risk of postoperative complications. On the basis of the ultrasonic doppler blood flow studies in uterine vessels, morphological and immunohistochemical studies of hemocapillars density in removed myoma nodules it was found that terlipressin contributes significantly to reduction of the number of functioning blood vessels and also to reduction of blood flow in all parts of the vascular system both in uterus and in leiomyoma, whereas oxytocin was not observed to decrease myometrium perfusion. It conclusion the study results showed that terlipressin use is the most effective method of prevention of excessive blood loss during hysteroscopic myoma resection.

Биографии авторов

V. V. Kaminsky

Shupyk National medical academy of postgraduate education
Department of Obstetrics, Gynecology and Reproduction
Dorohozhyts’ka str., 9, Kyiv, 04112, Ukraine

V. V. Dunaevska

Shupyk National medical academy of postgraduate education
Department of Obstetrics, Gynecology and Reproduction
Dorohozhyts’ka str., 9, Kyiv, 04112, Ukraine

M. V. Medvediev

SE "Dnipropetrovsk medical academy of Health Ministry of Ukraine"
Department of Obstetrics and Gynecology
Dzerzhinsky str., 9, Dnepropetrovsk, 49044, Ukraine

Библиографические ссылки

Краснопольский В.И. Репродуктивные пробле¬мы оперированной матки / В.И. Краснопольский, Л.С. Логутова, С.Н. Буянова. – М.: Изд-во «Миклош», 2008. – 160 с.

Миома матки и миомэктомия / В.А. Линде, М.С. Добровольский, Н.Н. Волков, А.В. Иванов. – М.: Изд-во «SweeGroup», 2010. – 94 с.

Современные аспекты органосохраняющей те¬ра¬пии лейомиомы матки / Т.Ф. Татарчук, Н.В. Косей, Д.М. Мо¬гилевский, Е.И. Сухоребрая [и др.] // Репро¬дук¬тив¬ное здоровье женщины. – 2006. - № 1(25).–С.123-129.

Тихомиров А.Л. Миома матки / А.Л. Тихо¬миров, Д.М. Лубнин. – М.: ООО «Мед. информ. аген¬ство», 2006. – 176 с.

Divakar H. Asymptomatic utЕРine fibroids / H. Di¬vakar // Best. Pract. Res. Clin. Obstet. Gynaecol. – 2008. – Vol. 22, N 4. – P. 643-654.

Kongnyuy E.J. A systematic review of rando¬mized controlled trials to reduce hemorrhage during myo¬mectomy for utЕРine fibroids / E. J. Kongnyuy, van den N. Broek C. S.Wiysonge // Int. J. Gynaecol. Obstet. – 2008. – Vol. 100, N 1. – P. 4-9.

Oxytocin during myomectomy: a randomized stu¬dy / A. Agostini, I. Ronda, F. Franchi, F. Bretelle [et al.] // Eur. J. Obstet. Gynecol. Reprod. Biol. – 2005. – Vol. 118, N 2. – P. 235-238.

Ultrasonographic prediction of the efficacy of GnRH agonist thЕРapy before laparoscopic myomectomy / F. Zullo, M. Pellicano, C. Di Carlo, R. De Stefano [et al.] // J. Am. Assoc. Gynecol. Laparosc. – 1998. – Vol. 5, N 4. – P. 361-366.

UtЕРine leiomyoma and menstrual cycle cha¬ract¬ЕРistics in a population-based cohort study / J. L. Marino, B. Eskenazi, M. WarnЕР, S. Samuels [et al.] // Hum. Re¬p¬rod. – 2004. – Vol. 19, N 10. – P. 2350-2355.

WamstekЕР K. TranscЕРvical hystЕРoscopic re¬sec¬tion of submucous fibroids for abnormal utЕРine blee¬ding: results regarding the degree of intramural extension / K. WamstekЕР, M.H. Emanuel, J.H. de Kruif // Ob¬stet. Gynecol. – 1993. –Vol. 82, N 5. – P. 736-740.

Krasnopol'skiy VI, Logutova LS, Buyanova SN. [Reproductive problems operated uterus]. М.: Izdatel'stvo « Miklosh », 2008;160. Russian.

Linde VA, Dobrovol'skiy MS, Volkov NN, Iva¬nov AV. [Uterine fibroids and myomectomy]. М.: Iz¬datel'stvo «SweeGroup», 2010;94. Russian.

Tatarchuk TF, Kosey NV, Mogilevskiy DM, Su¬kho¬rebraya EI, Shakalo IN. [Modern aspects of conser¬ving therapy of uterine leiomyoma]. Reproduktivnoe zdorov'e zhenshchiny. 2006;1(25):123-9. Russian.

Tikhomirov AL, Lubnin DM. [Uterine fibroids]. М.: ООО «Meditsinskoe informatsionnoe agenstvo», 2006;176. Russian.

Divakar H. Asymptomatic utЕРine fibroids. Best. Pract. Res. Clin. Obstet. Gynaecol. 2008;22(4):643-54.

Kongnyuy EJ, van den N. Broek, Wiysonge CS. A systematic review of randomized controlled trials to reduce hemorrhage during myomectomy for utЕРine fibroids. Int. J. Gynaecol. Obstet. 2008;100(1):4-9.

Agostini A, Ronda I, Franchi F, Bretelle F. Oxy¬tocin during myomectomy: a randomized. Eur. J. Obstet. Gynecol. Reprod. Biol. 2005;118(2):235-8.

Zullo F, Pellicano M, Di Carlo C, De Stefano R. Ultrasonographic prediction of the efficacy of GnRH ago¬nist thЕРapy before laparoscopic myomectomy. J. Am. Assoc. Gynecol. Laparosc. 1998;5(4):361-6.

Marino JL, Eskenazi B, WarnЕР M, Samuels S. [et al.] UtЕРine leiomyoma and menstrual cycle cha¬ractЕРistics in a population-based cohort study. Hum. Reprod. 2004;19(10):2350-5.

WamstekЕР K, Emanuel MH, de Kruif JH. Tra¬nsc¬ЕРvical hystЕРoscopic resection of submucous fib¬roids for abnormal utЕРine bleeding: results regarding the degree of intramural extension. Obstet. Gynecol. 1993;82(5):736-40.