BACHADON ATONIYASI TUFAYLI MASSIV AKUSHERLIK QON KETISHIDA XIRURGIK GEMOSTAZNI TAKOMILLASHTIRISH

Abstract

Annotatsiya. Gemorrogik shok, disseminirlangan tomir ichi qon ivishi va poliorgan yetishmovchiligi bilan kechadigan massiv akusherlik qon ketishi dunyoda onalar o’limi va kasallanishiga sabab bo’luvchi asosiy omildir. Dunyo bo’ylab tug’ilishlarning aksariyati(65%0 tabiiy tug’ruq yo’llari orqali 500 ml dan 1000 ml gacha fiziologik qon yo’qotish bilan sodir bo’lib, ayollar va chaqaloqlar uchun asoratsiz kechadi. Ammo 3-8 % holatlarda qon yo’qotish hajmi 1500 ml dan yoki ayol tana vaznining 2,0% dan ko’p qismiga tog’ri keladiki, bu massiv akusherlik qon ketishi(MAQ) hisoblanadi. MAQ dan onalar o’limi mamlakatimizda 2013 yildan 2022 yilgacha bo’lgan davrda 22,8% dan  34,6% gacha oshgan. 2022 yilning o’zida bu ko’rsatkich 39,6 % holatni tashkil qiladi. Yiliga 2,5-3ming nafar ayolda gisterektomiya amaliyoti bajariladi. Bu esa kuniga 7-8 nafar ayolga to’g’ri keladi(Доклад Зам.Министра Здравоохранений 2022г). “Massiv akusherlik qon ketishi(MAQ) infuzion-transfuzion terapiya va jarroxlik aralashuvi bilan shoshilinch intensiv terapiya talab qiluvchi va ko’pincha (1:30) onalar o’limi bilan tugovchi o’ta og’ir holatlardir”( Tug’ruqdan keyingi qon ketishning oldini olish bo’yicha JSST tavsiyalari-Jeneva; JSST). O’z vaqtida qon ketishini aniqlash, akusherlik-ginekologlar, reanimatsiya va jarroxlik guruhlarining bir tartibdagi ishi tufayli kompleks intensiv davolash va to’g’ri ishlab chiqilgan akusherlik taktikasi massiv akusherlik qon ketishidan onalar o’limini kamaytirishga yordam beradi.

Annotation: Hemorrhagic shock, disseminated intravascular coagulation, and organ failure are the primary causes of maternal mortality and morbidity associated with massive obstetric hemorrhage (MOH) worldwide. Globally, the majority of births (65%) occur via vaginal delivery with physiological blood loss ranging from 500 to 1000 ml, which generally proceeds without complications for both mother and newborn. However, in 3–8% of cases, blood loss exceeds 1500 ml or corresponds to more than 2.0% of the maternal body weight, constituting massive obstetric hemorrhage (MOH). Maternal mortality due to MOH in our country increased from 22.8% in 2013 to 34.6% in 2022. In 2022 alone, this rate reached 39.6%. Annually, 2,500–3,000 women undergo hysterectomy, which corresponds to 7–8 women per day (Доклад Зам.Министра Здравоохранений 2022г). “Massive obstetric hemorrhage (MOH) represents critical conditions requiring urgent intensive therapy with infusion-transfusion treatment and surgical intervention and often (1:30) results in maternal death” (WHO Recommendations for the Prevention of Postpartum Hemorrhage, Geneva; WHO). Timely recognition of hemorrhage and coordinated work of obstetric-gynecological, intensive care, and surgical teams allow for comprehensive intensive management and properly developed obstetric strategies, significantly reducing maternal mortality from massive obstetric hemorrhage.