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
Authors:   Krasnoyarsk Regional Clinical Center of Maternal and Child Health, Krasnoyarsk, Russian Federation, Raspopin Yu.S. ,   Prof. V.F.Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation, Shifman E.M. ,   M.F.Vladimirsky Moscow Regional Research and Clinical Institute (MONIKI), Moscow, Russian Federation, Belinina A.A. ,   Altaу Regional Clinical Perinatal Center, Barnaul, Russian Federation, Rostovtsev A.V. ,   Voronezh Сity Сlinical Emergency Hospital No 8, Voronezh, Russian Federation, Artymuk N.V. ,   Kemerovo State Medical University, Kemerovo, Russian Federation, Olenev A.S. ,   City Clinical Hospital No 24, Moscow, Russian Federation,   Medical Institute of the Peoples’ Friendship University of Russia, Moscow, Russian Federation, Tskhai V.B. ,   Prof. V.F.Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russian Federation,   Federal Medical-Biological Agency of Russia, Krasnoyarsk, Russian Federation, Аleksandrovich Yu.S. ,   Saint Petersburg State Pediatric Medical University, Saint Petersburg, Russian Federation, Molchanova I.V. ,   Altaу Regional Clinical Perinatal Center, Barnaul, Russian Federation, Novikova O.N. ,   Kemerovo State Medical University, Kemerovo, Russian Federation, Pylaeva N.Yu. ,   V.I.Vernadsky Crimean Federal University, Simferopol, Russian Federation
Published: July 2021

Severe and massive bleeding remains one of the main causes of maternal mortality and morbidity. The use of terlipressin has proved to be effective in the prevention of postpartum haemorrhage in the high-risk group. Given that terlipressin is a potent vasopressor, there are concerns about its use in parturient women with hypertension. Objective. To evaluate the hemodynamic effects of terlipressin when it is injected into the myometrium during caesarean section. Patients and methods. This publication is a continuation of the research work on the effectiveness of terlipressin in the prevention of postpartum haemorrhage in high-risk pregnant women, which was conducted between February and December 2020 with the participation of 5 medical centers. The study included 454 pregnant women who delivered by caesarean section. They were divided into two groups: control group I (n = 351) and study group II (n = 103), with local application of terlipressin injected into the thickness of the myometrium. During the study, the parameters of non-invasive hemodynamics were assessed. Results. When assessing the indicators of non-invasive blood pressure, no statistically significant difference was found between the groups. The analysis of heart rate showed slight statistical difference at the stage of operation and in the postoperative period. A significant difference in values of shock index in dynamics was found between the groups, which, nevertheless, were within acceptable limits, and the difference had no clinical significance. Conclusion. The study showed that the use of terlipressin does not significantly affect the parameters of non-invasive hemodynamics, which can complicate the operation or the labor outcome. Key words: obstetric haemorrhage, terlipressin, hemodynamics