The article describes the analysis of the causes of massive obstetric hemorrhage, treatment features, possible errors made by conservative and surgical treatment. The main causes of massive obstetric hemorrhage were postpartum atony of the uterus, detachment of a normally located placenta and placenta previa. The amount of lost blood averaged 2,410.45 ± 520.55 ml. Mistakes made during the clinical examination, surgical, conservative treatment and organizational issues led to 5 cases of maternal mortality and a deterioration in the quality of life of a woman in the study group.

massive obstetric bleeding, placenta detachment, uterine atony, infusion-transfusion therapy, total hysterectomy.

Barkagan Z.S., Momot A.P. Modern aspects of the pathogenesis, diagnosis and therapy of DIC. Bulletin of hematology. 2005; 1 (2): 5-14.

Ermolova Y. V., Modern achievements and prospects in maintaining the health of women. MORION Publishing House No. 3 (95) - V / VI 2013

Kurtser M.A., Breslav I.Y., Lukashina M.V. and others. True growth of the placenta (placenta accreta). Conservative therapy. Obstetrics and gynecology. 2011; (4): 118-122.

Marleen Temmerman, Director, WHO Department of Reproductive Health and Research. Sources: United Nations News Center, April 10, 2015.

National standards to improve the quality of perinatal care in obstetric institutions of the healthcare system of the Republic of Uzbekistan. Tashkent. 2018

On the approval of the rules for the clinical use of donated blood and its components. Order of the Ministry of Health of the Russian Federation № 183n dated April 2, 2013

The main indicators of maternal and child health, the activities of the child welfare and obstetric care service in the Russian Federation. M .: FSBI CRIOIHC Ministry of Health of the Russian Federation, 2017.168 p.

Prevention, treatment and management algorithm for obstetric bleeding: Clinical Protocol of the Ministry of Health of the Russian Federation № 15-4 / 10 / 2-3881 of 05.29.2014.

Statistics Ministry of Health of the Republic of Uzbekistan. Department of confidential analysis of maternal mortality of the republican perinatal center - Tashkent. 2017.

Fedorova T.A., Rogachevsky O.V., Strelnikova E.V. Massive obstetric hemorrhage with placenta previa and ingrowth: view of a transfusiologist. Magazine after named N.V. Sklifosovsky Emergency medical care. 2018; 7 (3): 253-259. DOI: 10.23934 / 2223-9022-2018-7-3-2253-259

Blomberg M. Maternal obesity and risk of postpartum hemorrhage. Obstet Gynecol. 2011; 118(3): 561-568. PMID: 21860284. DOI: 10.1097/ AOG.0b013e31822a6c59

COCHRANE COLLABORATION «The use of antifibrinolytics to minimize perioperative allogeneic blood transfusion» David A Henry, Paul A Carless, Annette J Moxey, Dianne O’Connell, Barrie J Stokes, Dean A Fergusson, Katharine Ker. 2011

El-Aroud K.A., Abushoffa A.M., Abdellatef H.E. Spectrophotometric and spectrofluorimetric methods for the determination of tranexamic acid in pharmaceutical formulation. Chem Pharm Bull (Tokyo). 2007; 55 (3): 364-7.

Global Causes of Maternal Death: A WHO Systematic Analysis.

Kozek-Langenecker S.A., Achmed A.B., Afshari A., et al. Management of severe perioperative bleeding. Guidelines from the European Society of Anaesthesiology : First update 2016. Eur J Anaesthesiol. 2017; 34(6): 332-395. PMID: 28459785. DOI: 10.1097/EJA.0000000000000630].

Marx G., Schindler A.W., Mosch C., et al. Intravascular volume therapy in adults: Guidelines from the Association of the Scientific Medical Societies in Germany. Eur. J. Anaesthesiol. 2016; 33(7): 488-521. PMID: 2704393. DOI: 10.1097/EJA.0000000000000447.

Raman M., Mitchell C.G., Biccard B.M., Rodseth R.N. Comparison of hydroxyethyl starch colloids with crystalloids for surgical patients: A systematic review and meta-analysis. Eur J Anaest. 2016; 33(1): 42-48. PMID: 26351826. DOI: 10.1097/EJA.0000000000000328.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels JD, et al. Lancet Global Health. 2014;2(6): e323-e333.

Hanif M., Nourei S.M., Dunning J. Doesthe use of topical tranexamic acid in cardiac surgery reduce the incidence of post-operative mediastinal bleeding? Interact Cardiovasc Thorac Surg. 2004; 3 (4): 603-5.

Maddali M.M., Rajakumar M.C. Tranexamic Acid and primary coronary artery bypass surgery: a prospective study. Asian Cardiovasc Thorac Ann. 2007; 15 (4): 313-9.

Global Causes of Maternal Death: A WHO Systematic Analysis.

Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels JD, et al. Lancet Global Health. 2014;2(6): e323-e333.

O'Brien KL, Uhl L. How do we manage blood product support in the massively hemorrhaging obstetric patient? Transfusion. 2016; 56(9): 2165-2171. PMID: 27488384. DOI: 10.1111/trf.13753.