Интраоперационные осложнения множественных кесаревых сечений (обзор литературы).
DOI:
https://doi.org/10.52692/1857-0011.2022.3-74.09Ключевые слова:
кесарево сечение, множественные кесарева сечения, интраоперационные осложнения, интраоперационные затрудненияАннотация
Множественные операции кесарева сечения повышают риск интраоперационных осложнений: спаек, по- вреждений органов малого таза (мочевого пузыря, мочеточников, кишечника), кровотечений с необходимостью гемотрансфузии, аномальной плацентации, гистерэктомии при кесаревом сечении, несостоятельности рубца на матке, разрыва матки. Частота этих осложнений увеличивается пропорционально количеству предшествующих кесаревых сечений. Хотя причинно-следственную связь часто трудно установить, некоторые из этих осложнений, вероятно, связаны с хирургически индуцированными спайками.
Повторные операции кесарева сечения связаны с более сложными хирургическими вмешательствами: труд- ности вскрытия брюшной полости, затрудненное отделение матки, мочевого пузыря и мочеточников от спаек, необходимость гемотрансфузии и хирургической коррекции повреждений соседних органов (мочевой пузырь, мочеточники, кишечник), необходимость дополнительного хирургического вмешательства как гистерэктомия.
Сокращение количества неоправданных первичных кесаревых сечений и частоты повторных кесаревых се- чений, проведение вагинальных родов после кесарева сечения и тщательная хирургическая техника могут значи- тельно снизить интраоперационные хирургические осложнения.
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