Comparative analysis of intraoperative blood loss during thе classical cesarean section de scribed by m. stark and the modified cesarean section

Abstract

Introduction: According to the WHO, obstetric bleeding keeps a leading position among the top three causes of maternal mortality. The incidence of abnormal blood loss (BL) varies widely from 1.5% to 22%, and the incidence of acute blood loss reaches up to 1,7%, with the variation from 0% to 4%. Every year, this complication causes death in 128 women that amounts to 1.7% per 1,000 deliveries The aim of this study is a comparative analysis of intraoperative blood loss during the classical cesarean section described by M. Stark and modified cesarean section was performed. Materials and metods: The study has been conducted on the basis of the Obstetrics department of the Kherson regional clinical hospital. Patients were selected according to the type of surgery (the classical technique described by M. Stark or the modified method) for the period from 2015 to 2018. The formation of the clinical groups was performed in accordance with the retrospective data retrieved from the labor and delivery records of 205 patients, who delivered via cesarean section. The comparative estimation of intraoperative blood loss volumes was carried out using a direct (gravimetric) method. Results: The proposed modification of abdominal delivery is based on the rational teamwork of a surgeon and an assistant, with the modernization of the surgical stages allowed halving the surgery duration as compared to the classical cesarean section technique introduced by M. Stark. Аnd the improved surgical technique of abdominal delivery contributes to the reduction in the volume of intraoperative blood loss by 200 ml (p < 0,001). Conclusions: Modified cesarean section allows avoiding massive obstetric hemorrhage, thereby creating an additional reserve for improving the safety of the operative delivery in general.