A differential approach to surgical hemostasis in obstetric hemorrhage

Bleeding control remains a priority in obstetrics. The purpose of the study: to search for methods to reduce blood loss during surgical hemostasis. The article describes a new approach to the anatomical classification of bleeding, which contributes to the differential tactics in surgical delivery for bleeding. Depending on the clinical and anatomical picture, bleeding is divided into 3 levels. In order to assess the effectiveness of the technique, a prospective case-control cohort study of 40 cases of obstetric bleeding was conducted, and an analysis of management tactics and surgical interventions was carried out. According to the results obtained, depending on the level of bleeding, it was revealed - at the 1st level of bleeding: effective devascularization of the uterus by ligation of the main vessels of the uterus. At level 2 bleeding, it is advisable to use compression sutures in combination with ligation of the main vessels of the uterus. For level 3 bleeding, the use of ligation of the internal iliac artery should be a priority in the provision of surgical care.