Aim. To analyze the maternal and perinatal outcomes in repeated caesarean section. The first group included 50 laboring women who received combined endotracheal anesthesia for a repeat cesarean section. The second group included 50 laboring women who received spinal anesthesia during the operative delivery. The condition of 100 newborns born by repeated cesarean section was studied.Results. In postpartum period in the women of first group very often, develop endometritis (24%), in second group – 36%, hematometra in first group we see in 12%, in second – 26%. Tracheobronhitis occur in first group among 30%. Research of the condition and course of early neonatal period in newborns showed, that combined anesthesia initiates pathological course of this period. The main complications were asphyxia (28%), and neurological disorders (22%).Conclusions. Different types of analgesia initiate different types of complications in the postoperative period, but better neonatal outcomes with the use of regional anesthesia techniques qualify them as the anesthesia method of choice for repeat cesarean section.
Aim. To study the causes of maternal mortality in fatal SARS-COV-2-associated pneumonia during gestation in order to optimize medical care for this category of pregnant women. Material and methods. 70 pregnant women with moderate, severe and critical course of SARS-CoV-2 were examined. The extent of study corresponded to the standard of examination of pregnant women with SARS-CoV-2 coronavirus infection. Out of all cases 7 (1 %) were lethal. Results and discussion. Analysis of organizational aspects of management revealed defects in the organization of medical care for pregnant women with SARS-CoV-2 coronavirus infection at the outpatient and inpatient levels. The reasons for late hospitalization were: self-treatment of pregnant women at home within 3 days, outpatient treatment within 7-10 days, primary hospitalization carried out in non-specialized hospitals. Routing breaches in pregnant women occurred in 2 (28.6 %) cases. Underestimation of the condition in the hospital contributed to delayed delivery in 5 (71.4 %) cases. Conclusion. Breaches in the organizational aspects of medical management of lethal SARS-CoV-2-associated pneumonia correspond with late hospitalization, late diagnosis and underestimation of the condition contributed to the delaying of delivery.
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