MODERN PRINCIPLES OF MANAGEMENT OF WOMEN WITH ABNORMAL UTERINE BLEEDING, TAKING INTO ACCOUNT THE BLOOD COAGULATION SYSTEM STATE

Abnormal uterine bleeding in women of childbearing potential requires effective emergency care. To determine the features of disorders in the hemostasis system, 120 women were directly examined at the time of bleeding on admission to the hospital, during treatment on days 5−7 of the menstrual cycle, as well as after 6−12 months from the end of treatment. Determination of congenital and acquired defects of the hemostasis system became the main criterion for the selection of combined and isolated forms of abnormal uterine bleeding. Treatment measures for patients were etiopathogenetically selected and individually the intensity of bleeding, the degree of anemia, coagulation parameters were taken into account. The staged treatment involved stopping the bleeding, regulating the menstrual cycle and further preventing the bleeding. It has been found that uterine bleeding in reproductive age in the absence of etiopathogenetic treatment leads to the development of posthemorrhagic anemia. The severity and nature of bleeding is determined by the presence of defects in the platelet system of the hemostasis system with impaired platelet aggregation function. The study of total coagulation potential, primary hemostasis and the state of intravascular hemocoagulation in the patients using the methods for estimating the amount of platelet aggregation allows to detect and differentiate disorders in the hemostasis system. According to the results of the study, it can be concluded that the use of fibrinolysis inhibitors in the patients with abnormal uterine bleeding helps to increase the activity of the blood coagulation system and complete cessation of bleeding on the 2nd−5th day. Prophylactic administration of antifibrinolytic drugs from the first day of the menstrual cycle reduces blood loss, stabilizes menstrual function and significantly improves the psycho−emotional state of patients. Key words: abnormal uterine bleeding, blood clotting, fibrinolysis inhibitors.