The use of inhibitors of fibrinolysis in the treatment of obstetric hemorrhage due to placenta detachment

Abstract

Purpose. Comparative evaluation of efficacy of aprotinin and tranexamic acid for the influence on the system of hemostasis, fibrinolysis, and the blood loss degree. Results. There were studied the results of fibrinolysis inhibitor therapy in women undergoing cesarean section for premature detachment of the placenta. The condition of hemostasis was controlled by low-frequency piezoelectric thromboelastography. There were obtained data on a more pronounced antifibrinolytic and blood preserving effect of the tranexamic acid, which was reflected in the reduction of the intraoperative, general and postoperative blood loss in group of tranexamic acid by 19.8%, 13.4% and 47.6%. The need for transfusion was also the lowest in the group with the tranexamic acid, which showed its greatest "blood preserving" effect. Conclusions. Early use of inhibitors of fibrinolysis in premature detachment of the placenta is pathogenetically justified and necessary, allowing to reduce the perioperative blood loss. Using low-frequency piezoelectric thromboelastography in obstetric bleeding makes it possible to detect quickly and reliably disorders in various levels of hemostasis, allowing to carry out their correction timely and fully.