A-11

Intrauterine balloon tamponade in the management of postpartum hemorrhage

Saikal Osmonova,  Saltanat Nazaralieva

Objective: According to WHO, the maternal mortality ratio in Kyrgyz Republic is 76 cases per 100.000 live births and is the highest among the Central Asian and Eastern European countries. It is necessary to study and implement minimally invasive postpartum hemorrhage treatment methods to prevent massive obstetric hemorrhage.

Methods: A prospective study of 35 cases of the use of intrauterine balloon tamponade (UBT) for the treatment of hypotonic postpartum hemorrhage was conducted. The indicators were assessed to evaluate the effectiveness of UBT.

Results: Hemostatic effect after UBT was achieved in 30 cases (85.7%), the average total blood loss was 664.57

(117.83) ml; reduced need for blood products, high doses of prostaglandins, large volume of fluid maintenance was observed. Breastfeeding started within the first 30 – 60 minutes after birth in 88.6% of cases.

Conclusion: UBT fully complies with the strategy for preservation of the reproductive potential in women, allows to improve medical and economic indicators.

Key words: Uterine balloon tamponade, hypotonic postpartum hemorrhage 

A-12

Possibilities of endobiliary stenting with complex choledocholithiasis

V.V. Yurchenko, O.J. Uzakov

Objective:  To increase the effectiveness and safety of endosurgical treatment of choledocholithiasis.

Methods:  The set goal is achieved by studying the causes of unsatisfactory results of lithoextractions, improving its tactics and technology. Patients with known predictors of the futility of lithoextraction were excluded from the study. Based on the study of other causes of inefficiency namely strangulation of calculi with a basket, progression of obstructive jaundice, the addition of purulent cholangitis or postpapillotomy bleeding some new tactical rules and endosurgical techniques were formulated. Their effectiveness was tested in group of patients.

Results: When comparing the research and control groups, a decrease in the frequency of endosurgical treatment of choledocholithiasis was revealed.

Conclusion: The effectiveness of the proposed tactical principles and technological techniques has been proved.

Key words: endoscopic papillosphinctertomy, endoscopic lithoextraction, obstructive jaundice, purulent cholangitis, postpapillotomy bleeding.