УДК 618.36–007.4–005.2–089 Golyanovskiy O., Ivankova I., Kulchickiy D., Rubinshtein A. Shupik National Medical Academy of Post-Graduate Education, Kiev, Ukraine Голяновский О. <...> Шупика, Киев, Украина Combined staged surgical hemostasis in case of placenta previa alone and with partial Placenta accreta Комбинированный поэтапный хирургический гемостаз в случае самостоятельного предлежания плаценты и в сочетании с частичной Placenta accreta ______________________ Abstract __________________________________________________________________________ The article is dedicated to the developed delivery algorithm with the priority of organ-saving operation (ligation of main uterine vessels and internal iliac arteries; the use of argon-plasma tissue coagulation, agonists of oxytocin and vasopressors) in case of pathological placentation and abnormally invasive placenta. <...> During the study it was proved, that the use of the delivery algorithm in a case of Placenta previa alone or with partial Placenta accreta saved the uterus, reduced intraoperative blood loss, prevented the development of massive hemorrhage and created secure hemostasis. <...> Keywords: surgical hemostasis, massive obstetric hemorrhage, abnormally invasive placenta, main uterine vessels ligation, hysterectomy. ______________________ Резюме __________________________________________________________________________ В статье описан усовершенствованный алгоритм родоразрешения при предлежании плаценты и частичной Рlacenta accreta с приоритетом выполнения органосохраняющей операции (билатеральное перевязывание внутренних подвздошных артерий и магистральных сосудов матки, использование аргоно-плазменной коагуляции, современных агонистов окситоцина и вазопрессоров). <...> Оригинальные исследования INTRODUCTION Unfortunately, obstetric hemorrhages (OH) remain the main cause of maternal morbidity and mortality. <...> About 14 million of OH cases are annually registered all over the world; most of them occur at postpartum period, 130.000 of them lead to maternal mortality [3, 17]. <...> One of the main OH risk factors stays abnormally invasive placenta (AIP), which causes 1–2% of OH, almost half of them are life-threatening massive hemorrhages [15, 16]. <...> The AIP frequency has increased in ten times for the last 20 years worldwide and nowadays reaches 9.3–10% in a combination with Placenta previa and 0.004% in pregnant women without Placenta previa [8]. <...> C-section in anamnesis quite frequently becomes the reason of the decidual membrane’s defect, therefore the increase <...>