SOME PATHOMORPHOLOGICAL PECULIARITIES OF UTERUSES REMOVED FOR MASSIVE OBSTETRIC HEMORRHAGES

Aim. To detect the most significant factors for development of obstetric hemorrhages taking into account morphological changes in reproductive organs of patients of this group. Materials and methods. Retrospective analysis of 108 histories of deliveries complicated by massive hemorrhages as well as protocols of histological studies of surgical material according to the data of medical institutions of Udmurt Republic for 2010-2012 is presented in the paper. Group I involved 48 delivery histories with placental presentation and chorion villi ingrowth (44,5%), group II - 60 histories of deliveries complicated by uterine hypotonia (55,5%). Results. Women’s anamnesis in both groups had indications to high delivery parity (the current pregnancy is the third and more in 80% of women in both groups), intrauterine interventions (curettage of uterine cavity for spontaneous, artificial abortions) - 61,3% of women in group I and 57,4% in group II, presence of small pelvic inflammatory diseases, disturbed menstrual function by algodismenorrhea and menorrhagia types. The results of histological study showed presence of morphological signs of chronic inflammatory processes in the uterus and appendages. Conclusions. Endometrial alteration (consequences of multiple intrauterine interventions) associated with subacute inflammatory processes in small pelviс organs as well as dysharmonal disturbances and adenomyosis can be considered as the possible risk factors for chorion villi ingrowth and development of obstetric hemorrhages during placental and puerperal periods.

Obstetric hemorrhage, puerperal hemorrhage, placental ingrowth, morphological uterine changes, adenomyosis, maternal mortality