Current approaches to correcting blood loss in obstetric care

• Published in: Anesteziologiia i reanimatologiia no. 6; p. 51
• Main Author: Tumanian, S V
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01-11-2007
• Subjects: Adult; Blood Loss, Surgical - prevention & control; Blood Volume; Cesarean Section; Erythrocyte Transfusion; Female; Hemodynamics - physiology; Humans; Isotonic Solutions - administration & dosage; Isotonic Solutions - therapeutic use; Pre-Eclampsia - blood; Pre-Eclampsia - physiopathology; Pre-Eclampsia - surgery; Pregnancy; Severity of Illness Index
• ISSN: 0201-7563

The paper considers current approaches to the strategy and tactics of infusion-transfusion therapy (ITT) in the development of obstetric bleedings. The results of treatment were analyzed in 124 patients in whom pregnancy or labor had been complicated by hemorrhage. Various ITT options are presented depending on the volume of blood loss and physiological background. The ITT programs applied are based on the combined used of colloid and crystalloid solutions and hypertonic sodium chloride solution. With increased blood loss volume, artificial colloids are gradually excluded from an ITT program in the following order: dextrans, hydroxyethyl starch, and gelatin derivatives. Subsequently, priority is given to natural colloids. Blood components were transfused if strictly indicated. The studies have indicated that the baseline blood circulation of patients with physiological and severe gestosis-complicated pregnancy should be taken into account during ITT for acute obstetric blood loss. The differential approach to ITT and its pattern and type depend on the quantity of lost blood, that should be calculated as percentage with reference to the volume of circulating blood of a pregnant woman rather than relied on its total volume. The pathophysiologically substantiated approach to ITT for acute obstetric blood loss with the physiological background being kept in mind makes it possible to stabilize the parameters of blood circulation, volemic and colloid-osmotic homeostasis, thereby reducing the incidence of postoperative complications.