Our early reports have shown that the prophylactic use of terlipressin reduces blood loss during caesarean section. Considering that the drug is a powerful vasopressor, the question of the safety of its topical use in women with hypertensive disorders during pregnancy remains open.
PURPOSE OF THE STUDY
To assess the safety of topical application of terlipressin in pregnant women with hypertensive disorders for the prevention of postpartum hemorrhage during caesarean section.
PATIENTS AND METHODS
110 pregnant women with hypertensive disorders during pregnancy and high risk factors for bleeding were examined. The control group (n=49) used standard therapy according to clinical guidelines. In the study group (n=61), standard prophylaxis was supplemented by the introduction of terlipressin into the myometrium. The assessment of systemic hemodynamics, the volume of blood loss, the need for the introduction of second-line uterotonics and additional methods of surgical hemostasis was carried out. Complications, allergic and side effects associated with the use of terlipressin have also been studied.
RESULTS
Comparison of non-invasive hemodynamic parameters in absolute numbers did not show a statistically significant difference in the studied groups at the stages of the operation and the postoperative period. When evaluating the deltas of hemodynamic parameters, there was a decrease in mean BP at the stage of postoperative observation both in the study and in the control group — by 12% and 18%, respectively (p<0.05). A statistically significant difference in the mean values of heart rate (p=0.009) and mean blood pressure (p=0.054) was noted only in the early postoperative period. The mean values of the shock index in the groups did not differ statistically. Changes in the shock index were shown only in the subgroup with blood loss1000 ml from the study group: the increase was more than 60%, while in the control group it was no more than 40%. The frequency of hysterectomies in the control group is 4.3 times more frequent than in the study group.
CONCLUSION
The use of terlipressin into the myometrium does not cause changes in systemic hemodynamics in patients with hypertensive disorders during pregnancy. Against the background of the use of the drug, no side and undesirable reactions were noted.
