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ANALYSIS OF THE FEATURES OF THE COURSE OF PREGNANCY AND LABOR IN PUERPERAS WITH DEVELOPED POSTPARTUM HEMORRHAGE
Negmatshayeva Habiba Nabievna, candidate of medical sciences, associate professor, Head of the Department of Obstetrics and Gynecology-2 Yuldasheva Azadaxon Sabirovna, candidate of medical sciences, associate professor, Department of Obstetrics and Gynecology-2 Shokirova Sadokatxon Muxammatsolievna, assistant of the Department Obstetrics and Gynecology-2 Gafurova Shaxnoza Mavlanovna, assistant of the Department Obstetrics and Gynecology-2 Mamajonova Saida Otaxanovna, assistant of the Department Obstetrics and Gynecology-2 Andijan State Medical Institute Uzbekistan. Oty of Andijan E-mail: isaidbek@bk.ru
ANALYSIS OF THE FEATURES OF THE COURSE OF PREGNANCY AND LABOR IN PUERPERAS WITH DEVELOPED POSTPARTUM HEMORRHAGE
Abstract: In this paper, an analysis of the features of the course of pregnancy and childbirth in puerperas with developed postpartum hemorrhage is discussed. The work was carried out at the Department of Obstetrics and Gynecology of the II Perinatal Center at the AGMI from 2017 to 2018. Under our supervision there were 64 women in gestational age of 37-40 weeks. When examining pregnant and parturient women, the obstetric and gynecological history was carefully studied, with emphasis on the morphofunctional features of the reproductive systems. To obtain the most complete information on the obstetric-gynecological history, the course of this pregnancy, childbirth, the early puerperal period, the history of labor was used additionally (U. S. No. 096/y).
Keywords: Bleeding, childbirth, pregnancy, mother.
Relevance of the topic. The most important problems in providing high-quality care to pregnant women, mothers and puerperas include obstetric hemorrhages. Around the world, obstetric bleeding remains one of the most important causes of maternal mortality. In the 21st century, more than 529.000 women die each year from complications associated with pregnancy and childbirth. At least in every fourth observation, the cause of the fatal outcome is bleeding. Postpartum hemorrhage (PPH) is an obstetric complication that transforms the normal physiological process of childbirth into a life-threatening state. In the structure of maternal mortality in Russia, massive obstetric hemorrhages continue to occupy one of the leading places, being in 20-25% of cases the only cause of deaths. Most obstetric hemorrhages occur in the postpartum period. The frequency of obstetric hemorrhages ranges from 2.7 to 8% of the total number of births.
Purpose of the study. To analyze the features of the course of pregnancy and childbirth in puerperas with developed postpartum hemorrhage.
Material and research methods: The work was carried out at the Department of Obstetrics and Gynecology of the II Perinatal Center at the State Medical Institute from 2017 to 2018. Under our supervision there were 64 women in the gestational age of 37-40 weeks.
During the examination of pregnant women and women in labor, the obstetric and gynecological anamnesis was carefully studied with an emphasis on the morphofunctional features of the reproductive system, the course and outcomes of previous pregnancies complicated by bleeding in the patient, as well as in her mother and other relatives.
To obtain the most complete information on the obstetric and gynecological history, the course of this pregnancy, childbirth, and the early puerpera period, we also used the history of childbirth (account No. 096/y).
Результаты. Gynecological diseases before this pregnancy were observed in 42(65.6%) women. The most commonly diagnosed inflammatory diseases were: chronic adnexitis was detected in 16(25%) women, chlamydia in 5(7.8%), ureaplasmosis in 5(7.8%), trichomoniasis in
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11(17.1%), cervical erosion - in 15(23.4%), yeast colpitis -in 12(18.7%).
Menstrual dysfunction among 64 pregnant women was observed in 12(18.7%) cases, more often in the form of hy-perpolymenorrhea, algomenorrhea.
The vast majority of women had their first pregnancy, on average, 1-2 years after the onset of sexual activity.
Among 64 patients, 23(35.9%) were primiparous women, 22(34.3%) were repetitive, 19 of them were multipath, (29.6%). The frequency of spontaneous abortion was established in the history of18 women, which amounted to 28.1%.
Of these, 11(17.2%) had spontaneous miscarriages, 7(10.9%) had premature births.
According to the anamnesis, the threat of termination of this pregnancy in the early and (or) later periods was observed in 13 (20%) women. This pregnancy was complicated by early toxicosis in 25 women, which amounted to 39.1%.
Conclusions. The results of the study showed that all 65.6% of women had gynecological diseases before the present pregnancy. At the same time, the high frequency of spontaneous miscarriages 1(17.2%) and 7(10.9%) - premature labor draws attention.
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