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Возможности использования терлипрессина в акушерско-гинекологической практике: на примере случая неразвивающейся беременности позднего срока, осложненной кровотечением
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
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Tskhay VB, Yametov PK, Raspopin YuS, Yametova NM, Polstyanaya GN, Ryabinin DA. Terlipressin in obstetric and gynecological practice: a case of a missed miscarriage in late pregnancy complicated by bleeding. Case report. Gynecology. 2023;25(1):116–120. DOI: 10.26442/20795696.2023.1.202116
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Ключевые слова: кровотечение, поздний аборт, медикаментозный гемостаз, вазопрессин, терлипрессин
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A few randomized multicenter studies indicate that prophylactic vasopressin in obstetric and gynecological surgeries is mainly safe and associated with a significant reduction in intraoperative blood loss. This article reviews recent scientific papers describing the use of vasopressin in obstetric and gynecological practice with an assessment of its effectiveness depending on the dose and route of administration. We present a clinical case demonstrating that drugs with a vasopressor effect, in particular terlipressin, in a patient with uterine bleeding after a late induced miscarriage allowed to obtain an excellent hemostatic effect and avoid the need for additional methods of surgical hemostasis.
Keywords: bleeding, late abortion, drug hemostasis, vasopressin, terlipressin
2. García-Enguídanos A, Calle ME, Valero J, et al. Risk factors in miscarriage: a review. Eur J Obstet Gynecol Reprod Biol. 2002;102(2):111-9. DOI:10.1016/s0301-2115(01)00613-3
3. Linnakaari R, Helle N, Mentula M, et al. Trends in the incidence, rate and treatment of miscarriage-nationwide register-study in Finland, 1998–2016. Hum Reprod. 2019;34(11):2120-8. DOI:10.1093/humrep/dez211
4. Nelson DB, Bellamy S, Nachamkin I, et al. First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women. Fertil Steril. 2007;88(5):1396-403. DOI:10.1016/j.fertnstert.2007.01.035
5. Sneider K, Christiansen OB, Sundtoft IB, Langhoff-Roos J. Recurrence of second trimester miscarriage and extreme preterm delivery at 16–27 weeks of gestation with a focus on cervical insufficiency and prophylactic cerclage. Acta Obstet Gynecol Scand. 2016;95(12):1383-90. DOI:10.1111/aogs.13027
6. McNamee KM, Dawood F, Farquharson RG. Mid-trimester pregnancy loss. Obstet Gynecol Clin North Am. 2014;41(1):87-102. DOI:10.1016/j.ogc.2013.10.007
7. Garofalo G, Garofalo A, Sochirca O, et al. Maternal outcomes in first and second trimester termination of pregnancy: which are the risk factors? J Perinat Med. 2018;46(4):373-8. DOI:10.1515/jpm-2017-0106
8. Jacques L, Heinlein M, Ralph J, et al. Complication rates of dilation and evacuation and labor induction in second-trimester abortion for fetal indications: A retrospective cohort study. Contraception. 2020;102(2):83-6. DOI:10.1016/j.contraception.2020.04.018
9. Grossman D, Blanchard K, Blumenthal P. Complications after second trimester surgical and medical abortion. Reprod Health Matters. 2008;16(31 Suppl.):173-82.
DOI:10.1016/S0968-8080(08)31379-2
10. Dahlke JD, Mendez-Figueroa H, Maggio L, et al. Prevention and management of postpartum hemorrhage: a comparison of 4 national guidelines. Am J Obstet Gynecol. 2015;213(1):76.e1-10. DOI:10.1016/j.ajog.2015.02.023
11. Zhou X, Tripathi D, Song T, et al. Terlipressin for the treatment of acute variceal bleeding: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97(48):e13437. DOI:10.1097/MD.0000000000013437
12. Abbas MS, Mohamed KS, Ibraheim OA, et al. Effects of terlipressin infusion on blood loss and transfusion needs during liver resection: A randomised trial. Acta Anaesthesiol Scand. 2019;63(1):34-9. DOI:10.1111/aas.13226
13. Rouholamin S, Hashemi M, Haghshenas S. The Effect of Vasopressin during Hysteroscopic Myomectomy in Patients with Submucosal Myoma: A Randomized Controlled Trial. Adv Biomed Res. 2021;10:22. DOI:10.4103/abr.abr_70_20
14. Song T, Kim MK, Kim M-L, et al. Use of vasopressin vs epinephrine to reduce haemorrhage during myomectomy: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2015;195:177-81. DOI:10.1016/j.ejogrb.2015.10.003
15. Lee EJ, Park SJ, Kim Y, et al. Effect and safety of diluted vasopressin injection on bleeding during robot-assisted laparoscopic myomectomy: a protocol for a randomised controlled pilot trial. BMJ Open. 2022;12(9):e056145. DOI:10.1136/bmjopen-2021-056145
16. Wong ASW, Cheung CW, Yeung SW, et al. Transcervical intralesional vasopressin injection compared with placebo in hysteroscopic myomectomy: a randomized controlled trial. Obstet Gynecol. 2014;124(5):897-903. DOI:10.1097/AOG.0000000000000515
17. Ascher-Walsh CJ, Capes T, Smith J, Michels A. Cervical vasopressin compared with no premedication and blood loss during vaginal hysterectomy: a randomized controlled trial. Obstet Gynecol. 2009;113(2 Pt 1):313-8. DOI:10.1097/AOG.0b013e3181954c44
18. Ghomi A, Makhlouf F, Kasturi S, Einarsson JI. Intramyometrial injection of vasopressin in laparoscopic supracervical hysterectomy. J Minim Invasive Gynecol. 2008;15(2):197-201. DOI:10.1016/j.jmig.2007.12.002
19. Hafidh B, Latifah HM, Gari A, et al. Vasopressin to Control Blood Loss during Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Minim Invasive Gynecol. 2022;29(3):355-64.e2. DOI:10.1016/j.jmig.2021.10.003
20. Александрович Ю.С., Ростовцев А.В., Кононова Е.С., и др. Эффективность низких доз терлипрессина для профилактики интраоперационной кровопотери в акушерстве. Вестник анестезиологии и реаниматологии. 2020;17(4):78-84 [Aleksandrovich YuS, Rostovtsev AV, Kononova ES, et al. Efficacy of low doses of terlipressin to prevent intra-operative blood loss in obstetrics. Messenger of Anesthesiology and Resuscitation. 2020;17(4):78-84 (in Russian)]. DOI:10.21292/2078-5658-2020-17-4-78-84
21. Распопин Ю.С., Шифман Е.М., Белинина А.А., и др. Эффективность и безопасность применения терлипрессина при кесаревом сечении у беременных с высоким риском кровотечения: многоцентровое всенаправленное когортное исследование Terli-Bleed. Часть I. Вопросы гинекологии, акушерства и перинатологии. 2021;20(1):11-20 [Raspopin YuS, Shifman EM, Belinina AA, et al. Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2021;20(1):11-20 (in Russian)].
DOI:10.20953/1726-1678-2021-1-11-20
22. Распопин Ю.С., Шифман Е.М., Белинина А.А., и др. Эффективность и безопасность применения терлипрессина при кесаревом сечении у беременных с высоким риском кровотечения: многоцентровое всенаправленное когортное исследование Terli-Bleed. Часть II. Вопросы гинекологии, акушерства и перинатологии. 2021;20(2):26-32 [Raspopin YuS, Shifman EM, Belinina AA, et al. Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part II. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2021;20(2):26-32 (in Russian)].
DOI:10.20953/1726-1678-2021-2-26-32
23. Alomar O, Abu-Zaid A, Jamjoom MZ, et al. Prophylactic vasopressin to reduce intraoperative blood loss and associated morbidities during myomectomy: A systematic review and meta-analysis of 11 controlled trials. J Gynecol Obstet Hum Reprod. 2022;51(10):102485. DOI:10.1016/j.jogoh.2022.102485
24. Protopapas A, Giannoulis G, Chatzipapas I, et al. Vasopressin during Laparoscopic Myomectomy: Does It Really Extend Its Limits? J Minim Invasive Gynecol. 2019;26(3):441-9. DOI:10.1016/j.jmig.2018.05.011
25. Cohen SL, Senapati S, Gargiulo AR, et al. Dilute versus concentrated vasopressin administration during laparoscopic myomectomy: a randomised controlled trial. BJOG. 2017;124(2):262-8. DOI:10.1111/1471-0528.14179
26. Schulz KF, Grimes DA, Christensen DD. Vasopressin reduces blood loss from second trimester dilatation and evacuation abortion. Lancet. 1985;2(8451):353-6.
DOI:10.1016/s0140-6736(85)92496-1
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1. Grippo A, Zhang J, Chu L, et al. Air pollution exposure during pregnancy and spontaneous abortion and stillbirth. Rev Environ Health. 2018;33(3):247-64. DOI:10.1515/reveh-2017-0033
2. García-Enguídanos A, Calle ME, Valero J, et al. Risk factors in miscarriage: a review. Eur J Obstet Gynecol Reprod Biol. 2002;102(2):111-9. DOI:10.1016/s0301-2115(01)00613-3
3. Linnakaari R, Helle N, Mentula M, et al. Trends in the incidence, rate and treatment of miscarriage-nationwide register-study in Finland, 1998–2016. Hum Reprod. 2019;34(11):2120-8. DOI:10.1093/humrep/dez211
4. Nelson DB, Bellamy S, Nachamkin I, et al. First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women. Fertil Steril. 2007;88(5):1396-403. DOI:10.1016/j.fertnstert.2007.01.035
5. Sneider K, Christiansen OB, Sundtoft IB, Langhoff-Roos J. Recurrence of second trimester miscarriage and extreme preterm delivery at 16–27 weeks of gestation with a focus on cervical insufficiency and prophylactic cerclage. Acta Obstet Gynecol Scand. 2016;95(12):1383-90. DOI:10.1111/aogs.13027
6. McNamee KM, Dawood F, Farquharson RG. Mid-trimester pregnancy loss. Obstet Gynecol Clin North Am. 2014;41(1):87-102. DOI:10.1016/j.ogc.2013.10.007
7. Garofalo G, Garofalo A, Sochirca O, et al. Maternal outcomes in first and second trimester termination of pregnancy: which are the risk factors? J Perinat Med. 2018;46(4):373-8. DOI:10.1515/jpm-2017-0106
8. Jacques L, Heinlein M, Ralph J, et al. Complication rates of dilation and evacuation and labor induction in second-trimester abortion for fetal indications: A retrospective cohort study. Contraception. 2020;102(2):83-6. DOI:10.1016/j.contraception.2020.04.018
9. Grossman D, Blanchard K, Blumenthal P. Complications after second trimester surgical and medical abortion. Reprod Health Matters. 2008;16(31 Suppl.):173-82.
DOI:10.1016/S0968-8080(08)31379-2
10. Dahlke JD, Mendez-Figueroa H, Maggio L, et al. Prevention and management of postpartum hemorrhage: a comparison of 4 national guidelines. Am J Obstet Gynecol. 2015;213(1):76.e1-10. DOI:10.1016/j.ajog.2015.02.023
11. Zhou X, Tripathi D, Song T, et al. Terlipressin for the treatment of acute variceal bleeding: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018;97(48):e13437. DOI:10.1097/MD.0000000000013437
12. Abbas MS, Mohamed KS, Ibraheim OA, et al. Effects of terlipressin infusion on blood loss and transfusion needs during liver resection: A randomised trial. Acta Anaesthesiol Scand. 2019;63(1):34-9. DOI:10.1111/aas.13226
13. Rouholamin S, Hashemi M, Haghshenas S. The Effect of Vasopressin during Hysteroscopic Myomectomy in Patients with Submucosal Myoma: A Randomized Controlled Trial. Adv Biomed Res. 2021;10:22. DOI:10.4103/abr.abr_70_20
14. Song T, Kim MK, Kim M-L, et al. Use of vasopressin vs epinephrine to reduce haemorrhage during myomectomy: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2015;195:177-81. DOI:10.1016/j.ejogrb.2015.10.003
15. Lee EJ, Park SJ, Kim Y, et al. Effect and safety of diluted vasopressin injection on bleeding during robot-assisted laparoscopic myomectomy: a protocol for a randomised controlled pilot trial. BMJ Open. 2022;12(9):e056145. DOI:10.1136/bmjopen-2021-056145
16. Wong ASW, Cheung CW, Yeung SW, et al. Transcervical intralesional vasopressin injection compared with placebo in hysteroscopic myomectomy: a randomized controlled trial. Obstet Gynecol. 2014;124(5):897-903. DOI:10.1097/AOG.0000000000000515
17. Ascher-Walsh CJ, Capes T, Smith J, Michels A. Cervical vasopressin compared with no premedication and blood loss during vaginal hysterectomy: a randomized controlled trial. Obstet Gynecol. 2009;113(2 Pt 1):313-8. DOI:10.1097/AOG.0b013e3181954c44
18. Ghomi A, Makhlouf F, Kasturi S, Einarsson JI. Intramyometrial injection of vasopressin in laparoscopic supracervical hysterectomy. J Minim Invasive Gynecol. 2008;15(2):197-201. DOI:10.1016/j.jmig.2007.12.002
19. Hafidh B, Latifah HM, Gari A, et al. Vasopressin to Control Blood Loss during Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Minim Invasive Gynecol. 2022;29(3):355-64.e2. DOI:10.1016/j.jmig.2021.10.003
20. Александрович Ю.С., Ростовцев А.В., Кононова Е.С., и др. Эффективность низких доз терлипрессина для профилактики интраоперационной кровопотери в акушерстве. Вестник анестезиологии и реаниматологии. 2020;17(4):78-84 [Aleksandrovich YuS, Rostovtsev AV, Kononova ES, et al. Efficacy of low doses of terlipressin to prevent intra-operative blood loss in obstetrics. Messenger of Anesthesiology and Resuscitation. 2020;17(4):78-84 (in Russian)]. DOI:10.21292/2078-5658-2020-17-4-78-84
21. Распопин Ю.С., Шифман Е.М., Белинина А.А., и др. Эффективность и безопасность применения терлипрессина при кесаревом сечении у беременных с высоким риском кровотечения: многоцентровое всенаправленное когортное исследование Terli-Bleed. Часть I. Вопросы гинекологии, акушерства и перинатологии. 2021;20(1):11-20 [Raspopin YuS, Shifman EM, Belinina AA, et al. Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2021;20(1):11-20 (in Russian)].
DOI:10.20953/1726-1678-2021-1-11-20
22. Распопин Ю.С., Шифман Е.М., Белинина А.А., и др. Эффективность и безопасность применения терлипрессина при кесаревом сечении у беременных с высоким риском кровотечения: многоцентровое всенаправленное когортное исследование Terli-Bleed. Часть II. Вопросы гинекологии, акушерства и перинатологии. 2021;20(2):26-32 [Raspopin YuS, Shifman EM, Belinina AA, et al. Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part II. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2021;20(2):26-32 (in Russian)].
DOI:10.20953/1726-1678-2021-2-26-32
23. Alomar O, Abu-Zaid A, Jamjoom MZ, et al. Prophylactic vasopressin to reduce intraoperative blood loss and associated morbidities during myomectomy: A systematic review and meta-analysis of 11 controlled trials. J Gynecol Obstet Hum Reprod. 2022;51(10):102485. DOI:10.1016/j.jogoh.2022.102485
24. Protopapas A, Giannoulis G, Chatzipapas I, et al. Vasopressin during Laparoscopic Myomectomy: Does It Really Extend Its Limits? J Minim Invasive Gynecol. 2019;26(3):441-9. DOI:10.1016/j.jmig.2018.05.011
25. Cohen SL, Senapati S, Gargiulo AR, et al. Dilute versus concentrated vasopressin administration during laparoscopic myomectomy: a randomised controlled trial. BJOG. 2017;124(2):262-8. DOI:10.1111/1471-0528.14179
26. Schulz KF, Grimes DA, Christensen DD. Vasopressin reduces blood loss from second trimester dilatation and evacuation abortion. Lancet. 1985;2(8451):353-6.
DOI:10.1016/s0140-6736(85)92496-1
1 ФГБОУ ВО «Красноярский государственный медицинский университет им. проф. В.Ф. Войно-Ясенецкого» Минздрава России, Красноярск, Россия;
2 КГБУЗ «Красноярский краевой клинический центр охраны материнства и детства», Красноярск, Россия;
3 ФГБУ «Федеральный Сибирский научно-клинический центр» ФМБА России, Красноярск, Россия; 4 КГБУЗ «Красноярский межрайонный родильный дом №1», Красноярск, Россия
*tсhai@yandex.ru
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Vitaly B. Tskhay*1–3, Pavel K. Yametov1,4, Yuriy S. Raspopin1,2, Natalia M. Yametova1, Galina N. Polstyanaya1, Daniil A. Ryabinin4
1 Voino-Yasenetsky Krasnoyarsk State Medical University. Krasnoyarsk, Russia;
2 Krasnoyarsk Regional Clinical Centre for Maternal and Child Health, Krasnoyarsk, Russia;
3 Federal Siberian Research Clinical Center, Krasnoyarsk, Russia;
4 Krasnoyarsk Interdistrict Maternity Hospital №1, Krasnoyarsk, Russia
*tсhai@yandex.ru