V.F.Snegirev Archives of Obstetrics and Gynecology
type: channel
description: ISSN (print): 2313-8726, ISSN (online): 2687-1386 Founder: Joint Stock Company "Publishing house "Medicina", Limited Liability Company "Eco-Vector" Editor-in-Chief: prof. Elena A. Sosnova, MD, Dr. Sci. (Med.) Frequency / Access: 4 issues per year / Hybrid Included in: Higher Attestation Commission List, RISC
publisher: Eco-Vector
language: ru-RU
publication name: V.F.Snegirev Archives of Obstetrics and Gynecology
issn: 2313-8726
copyright: Authors who publish with this journal agree to the following terms: Authors retain copyright and grant the journal exclusive license to first publication. Authors are able to distribute the manuscript and/or the article in accordance with Self-Archiving policy of the journal (see details). The manuscript can be accepted for publication only by decision of the Editor-in-Chief and the Editorial board of the journal in accordance with the Manuscript stelection policy of the journal (see details). Published Article will be distributed in print and electronic version an will be available under subscription with Delayed Open Access or in Immediate Open Access under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0). The access model depends on the publisher's decision or is determined by a separate Open Access publishing agreement with the authors. An exclusive license for publication granted by authors allows the publisher to use the article in the following ways: Reproduction of the Article or its sections or parts, as well as the metadata of the Article in any languages, in any material form, including on paper and electronic media, as a separate work in the journal and/or databases (local or in the Internet) of the publisher and/or other persons, at the discretion of the publisher; Distribution of the Article or its sections or parts, as well as the metadata of the Article in any languages, on any medium as part of the journal and/or databases of the publisher or other persons, at the discretion of the publisher, or as an independent work around the world whether on Open-Access terms or for a fee without remuneration to the Author; Making the Article or any of its sections or parts, as well as the Article’s metadata in any languages, publicly available in such a way that any person can access the Article from any place, including via the Internet, and at any time of their own choosing; Granting permission/s for the…
items: Correction of vitamin status in pregnant women: current approaches and clinical significance
items: Evolution of concepts of platinum resistance in ovarian cancer and current therapeutic opportunities
items: Chronic endometritis as a multifactorial cause of reproductive loss: current diagnostic criteria and therapeutic options
items: Genetic markers of endometrial hyperplasia: from pathogenesis to personalized therapy
items: Personalized 3D printed obstetric pessaries
items: Perinatal outcomes in pregnant women with COVID-19 at different gestational ages and disease severities
items: Evolution of treatment approaches for cesarean scar pregnancy
items: A contemporary perspective on predicting early postpartum hemorrhage: risk factor stratification for developing a predictive scoring system
items: Effect of menopausal hormone therapy and phytoestrogens on the oxidant/antioxidant profile of blood plasma in peri- and postmenopausal women
items: Aortic coarctation in pregnant women
items: Port-site hernia after repeat staging procedures in a patient with a borderline ovarian tumor: a case report
items: Temporary balloon occlusion of the common iliac arteries during hysterectomy for giant cervical fibroid

Correction of vitamin status in pregnant women: current approaches and clinical significance
type: item
description: This systematic review aims to summarize current evidence on vitamin deficiencies in pregnant women, their clinical consequences, and approaches to nutritional status correction during gestation. Given the increasing prevalence of hypovitaminosis among pregnant women, particularly deficiencies of folic acid, vitamin D, and vitamin B12, the clinical importance of early diagnosis and individualized therapy is growing. The article analyzes studies published over the past 5 years by Russian and international authors, including randomized controlled trials, meta-analyses, cohort studies, and international clinical guidelines. Key micronutrients, their effects on the course of pregnancy, maternal and fetal outcomes, and factors contributing to impaired vitamin metabolism, including genetic polymorphisms (MTHFR, VDR, TCN2), were evaluated. The review presents approaches to laboratory diagnosis of vitamin deficiencies, principles of rational dietary therapy, and the use of vitamin–mineral supplements, as well as the potential of personalized nutritional correction. The need for incorporating vitamin status assessment into preconception care and antenatal management algorithms for women at risk is substantiated. The findings of this review emphasize the role of nutritional support as an essential component in the prevention of obstetric and perinatal conditions.
creator: Maria A. Sukhanova
creator: Anastasia O. Kiryanova
creator: Mikhail B. Ageev
creator: Evgeniia A. Svidinskaya
creator: Natalia S. Zemlina
creator: Guzel F. Proklova
creator: Elena A. Sosnova
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-10
publication date: 2025-12-10
volume: 12
number: 4
starting page: 381
ending page: 394
doi: 10.17816/aog689443

Evolution of concepts of platinum resistance in ovarian cancer and current therapeutic opportunities
type: item
description: Ovarian cancer remains one of the leading causes of mortality among gynecological cancers. The major challenge in its treatment is the development of resistance to platinum-based agents. Traditionally, platinum sensitivity of the tumor was assessed based on the treatment-free interval. However, with the introduction of targeted and maintenance therapies, such as PARP inhibitors and antiangiogenic drugs, these criteria require reevaluation. Current evidence indicates that platinum resistance arises from complex biological processes involving homologous recombination deficiency, activation of DNA repair pathways, alterations in the tumor microenvironment, increased expression of drug transporters, evasion of apoptosis, as well as the involvement of cancer stem cells and clonal evolution. The elucidation of these mechanisms has provided the basis for new therapeutic strategies. A key focus is on ATR and WEE1 inhibitors, epigenetic agents, antibody–drug conjugates, immunotherapy, and combination approaches that act simultaneously on multiple pathogenic pathways. A promising direction involves integrating molecular profiling and biomarker assessment to select patients most sensitive to specific therapeutic modalities. Thus, the evolving concept of platinum resistance in ovarian cancer reflects a shift from time-based clinical criteria toward molecular and biological stratification. This transition opens new opportunities for personalized treatment, which can enhance not only treatment efficacy but also long-term outcomes for patients with an unfavorable prognosis.
creator: Arina A. Nikandrova
creator: Kheda M.E. Musaeva
creator: Anna V. Denisova
creator: Artem K. Manzurov
creator: Anna A. Popova
creator: Shakhban R. Pezuev
creator: Muslim A. Khorumov
creator: Eliza D. Mazhidova
creator: Saida S. Khubaeva
creator: Yulia A. Molchanova
creator: Arina Yu. Kulakova
creator: Maхim I. Timush
creator: Aleхandra E. Fomenko
creator: Anastasiia A. Bezlepkina
creator: Angelina I. Mustafina
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-27
publication date: 2025-11-27
volume: 12
number: 4
starting page: 395
ending page: 411
doi: 10.17816/aog690082

Chronic endometritis as a multifactorial cause of reproductive loss: current diagnostic criteria and therapeutic options
type: item
description: Chronic endometritis is one of the most significant and relevant challenges in reproductive medicine. This disease is associated with reduced pregnancy rates and an increased risk of spontaneous miscarriage and implantation failure in in vitro fertilization. Chronic endometritis is generally asymptomatic, which hiders timely diagnosis and treatment. This review summarizes current knowledge on the pathogenetic mechanisms, diagnostic capabilities, and treatment strategies for chronic endometritis, as well as their impact on reproductive outcomes. The analysis was based on data from 27 publications for 2021–2025 retrieved from international and Russian databases, encompassing meta-analyses, systematic reviews, and original clinical studies. The leading pathogenetic factors of chronic endometritis include microbial dysbiosis characterized by polymicrobial associations, neutrophil hyperactivation with the formation of neutrophil extracellular traps, cytokine imbalance, and activation of the USF2/TREM1 and miR-92b/PTEN signaling pathways. These alterations impair endometrial receptivity and hinder successful embryo implantation. Although a histological examination identifying CD138+ plasma cells remains the diagnostic gold standard, variability in threshold values complicates interpretation. Diagnostic evaluation is further complemented by hysteroscopy and promising noninvasive methods, including artificial intelligence-based analysis of hysteroscopic images and serum biomarker assessment. Antibiotic therapy remains the mainstay of treatment, though its effectiveness is undermined by rising antimicrobial resistance. Modern therapeutic approaches involve the use of recombinant type III collagen and antifibrotic therapy, which improve endometrial structure and receptivity, increasing pregnancy rates up to 73.9%. This review highlights the need for standardization of diagnostic algorithms, integration of molecular technologies, and adoption of combined therapeutic regimens t…
creator: Kamil R. Bakhtiyarov
creator: Tatyana D. Kapyrina
creator: Dana V. Andrianova
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-27
publication date: 2025-11-27
volume: 12
number: 4
starting page: 412
ending page: 422
doi: 10.17816/aog686423

Genetic markers of endometrial hyperplasia: from pathogenesis to personalized therapy
type: item
description: Endometrial hyperplasia, particularly in perimenopause, constitutes a major clinical challenge in gynecology due to its high risk of malignant transformation into endometrial cancer, which is driven by a complex interplay between genetic alterations and hormonal imbalance. Evidence suggests that certain genetic markers (ESR1, C-MYC, PIK3CA, PTENP1, MTHFR, EGFR) contribute to the pathogenesis of endometrial hyperplasia by disrupting the regulation of proliferation, apoptosis, and DNA methylation. ESR1 polymorphisms increase estrogen receptor density, thereby enhancing the proliferative response of the endometrium. C-MYC overexpression correlates with progression to atypical forms, although it is also observed during physiologic regeneration. PIK3CA mutations result in constitutive activation of the PI3K/AKT/mTOR pathway and are associated with therapeutic resistance. Loss of function of the pseudogene PTENP1 disrupts regulation of the tumor suppressor PTEN, thereby promoting uncontrolled cellular proliferation. MTHFR polymorphisms impair DNA methylation and heighten susceptibility to epigenetic dysregulation. EGFR overexpression enhances proliferation through the MAPK/ERK pathway, particularly in obesity. The clinical significance of these markers is often influenced by underlying conditions, and their role remains ambiguous due to population differences and methodological heterogeneity across studies. A promising direction in the management of this condition is the development of integrative prognostic models that combine genetic testing with clinical parameters for risk stratification and early prevention of endometrial cancer.
creator: Alexey V. Overko
creator: Tatiana F. Kovalenko
creator: Lyudmila A. Ozolinya
creator: Svetlana A. Khlynova
creator: Tatiana N. Savchenko
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-11-27
publication date: 2025-11-27
volume: 12
number: 4
starting page: 423
ending page: 433
doi: 10.17816/aog692195

Personalized 3D printed obstetric pessaries
type: item
description: Since its emergence in the 1980s, three-dimensional (3D) printing has become a representative manufacturing assist technology. It was first developed for rapid prototyping and is widely used in a variety of fields. Since the early 2000s, 3D bioprinting using biological materials such as cells and biomolecules has been successfully applied in tissue engineering to directly create living structures. Over the past several decades, advances in three-dimensional (3D) printing technologies and the development of specialized biomaterials have facilitated the precise fabrication of biological components and complex 3D shapes. In obstetrics and gynecology, pessaries are increasingly used for stress urinary incontinence, pelvic organ prolapse, and cervical insufficiency. Commercially available pessaries come in a variety of sizes, following a “one size fits all” approach that fails to take into account the unique anatomical characteristics of each woman. The effectiveness of these pessaries is limited by poor fit and the lack of easy adjustment. The aim of this study was to analyze literature on the feasibility of individualized pessary selection for stress urinary incontinence, рelvic organ prolapse and cervical insufficiency using 3D printing. We analyzed Russian and international publications in the PubMed, ScienceDirect, Elseiver, e-library databases, covering searches from 2015 to 2025.
creator: Irina V. Ignatko
creator: Dmitry V. Telyshev
creator: Petеr S. Timashov
creator: Svetlana V. Pesegova
creator: Anastasia A. Churganova
creator: Elvira R. Gafarova
creator: Tatiana V. Rasskazova
creator: Emil D. Askerov
creator: Elizaveta N. Dedova
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-12
publication date: 2025-12-12
volume: 12
number: 4
starting page: 434
ending page: 442
doi: 10.17816/aog692798

Perinatal outcomes in pregnant women with COVID-19 at different gestational ages and disease severities
type: item
description: BACKGROUND: Investigation of the impact of gestational age and the severity of Coronavirus Disease 2019 (COVID-19) on pregnancy outcomes is of particular importance in the context of the continuing relevance of this issue, as well as for the development of preventive strategies and therapeutic approaches aimed at reducing adverse maternal and fetal outcomes. AIM: To evaluate perinatal outcomes in pregnant women who developed COVID-19 at different gestational ages and with varying degrees of disease severity. METHODS: Perinatal outcomes were analyzed in pregnant women from three clinical groups: group 1, patients who developed COVID-19 during the first trimester (n = 119); group 2, patients infected during the second trimester (n = 121); group 3, patients infected during the third trimester of pregnancy (n = 120). Each clinical group was further divided into three subgroups according to the severity of COVID-19 (mild, moderate, and severe). Statistical analysis of the clinical data was performed using StatSoft software (Russia). Differences were considered statistically significant at p < 0.05. RESULTS: The analysis showed that severe SARS-CoV-2 infection occurring in the first trimester of gestation contributes to pregnancy termination in more than 50% of clinical cases. At the same time, patients who had mild COVID-19 in early gestation significantly more frequently delivered infants with normal birth weight and favorable early neonatal adaptation compared with those born to mothers with moderate or severe COVID-19. SARS-CoV-2 infection during the second trimester identified pregnant women as a high-risk group for adverse perinatal outcomes, including fetal growth restriction, and increased the likelihood of complicated early neonatal adaptation. In pregnant women who developed COVID-19 during the third trimester, a high risk of acute fetal hypoxia and abdominal delivery was observed, not only for obstetric indications but also due to a more severe COVID-19 course.…
creator: Sergey P. Sinchikhin
creator: Maria A. Kuzmina
creator: Onsi Nasri
creator: Olga G. Chernikina
creator: Ekaterina S. Alexandrova
creator: Gevork O. Magakyan
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-07
publication date: 2025-12-07
volume: 12
number: 4
starting page: 443
ending page: 450
doi: 10.17816/aog691730

Evolution of treatment approaches for cesarean scar pregnancy
type: item
description: BACKGROUND: Cesarean scar pregnancy is a relevant problem in modern obstetrics and gynecology. This condition may lead to life-threatening complications requiring urgent medical intervention. Hysteroscopic resection using the cold loop technique in combination with vacuum aspiration of the gestational sac is an effective and safe surgical method for the treatment of cesarean scar pregnancy. AIM: This study aimed to evaluate treatment approaches for cesarean scar pregnancy and to determine optimal surgical strategies, as well as to analyze morphological findings in surgical specimens obtained from patients with cesarean scar pregnancy. METHODS: The study was conducted at the Moscow Regional Research Institute of Obstetrics and Gynecology named after Academician V.I. Krasnopolsky. Between 2016 and 2025, surgical treatment was performed in 41 patients with cesarean scar pregnancy. Management strategies used in 2016–2019 were compared with those applied over the subsequent 5 years. Clinical characteristics, preoperative ultrasound findings, and surgical treatment methods were analyzed (including laparotomic metroplasty, vacuum aspiration of the gestational sac, hysteroscopic resection using a cold loop, and hysterectomy). RESULTS: More than half of the examined women had a history of more than two cesarean deliveries performed with cervical dilation greater than 5 cm. Ultrasound examination demonstrated localization of the gestational sac within the scar area in all patients (COS-1 sign). Signs of chorionic invasion were identified in 22.7% of cases. Both organ-preserving and radical treatment approaches were applied. Over the past five years, a trend toward increased use of minimally invasive surgical techniques has been observed at the institute, resulting in reduced duration of hospitalization and postoperative rehabilitation. The complex of morphological features identified within scar niches containing ectopic pregnancies was characteristic of placenta accreta spec…
creator: Daria V. Suslikova
creator: Roman G. Shmakov
creator: Irina V. Barinova
creator: Marina Yu. Shakhina
creator: Tatyana A. Batenkova
creator: Anton A. Fedorov
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-10
publication date: 2025-12-10
volume: 12
number: 4
starting page: 451
ending page: 461
doi: 10.17816/aog692922

A contemporary perspective on predicting early postpartum hemorrhage: risk factor stratification for developing a predictive scoring system
type: item
description: BACKGROUND: Early postpartum hemorrhage is a life-threatening complication that requires emergency care and a multidisciplinary approach. In addition to the main etiological causes of hemorrhage (the 4T concept), the influence of other factors has been identified, the study of which allows for the development of predictive scoring systems, differentiated preventive strategies, and minimization of the risk of early postpartum hemorrhage. AIM: To identify factors influencing the development of early postpartum hemorrhage, stratify the obtained data, and develop a risk assessment scoring system for this complication. METHODS: A retrospective case–control study was conducted. The main group (n = 219) included women whose deliveries were complicated by early postpartum hemorrhage, whereas the control group (n = 219) consisted of women without postpartum hemorrhage. A list of potential factors determining the risk of postpartum hemorrhage (comprising 38 parameters in total) was compiled. The effect of each parameter on hemorrhage risk was assessed using odds ratios with 95% confidence intervals, p values for statistical significance, and the Student t test. Logistic regression analysis was used to stratify the impact of predictors on the development of early postpartum hemorrhage. RESULTS: Statistical analysis identified 25 factors that significantly increased the risk of postpartum hemorrhage. Oligohydramnios at the time of hospitalization increased the risk of postpartum hemorrhage by 1.6 times, polyhydramnios by 1.7 times, premature rupture of membranes by 1.7 times, class I obesity by 1.9 times, class II obesity by 2.2 times, gestational diabetes mellitus by 2.0 times, and the presence of a uterine scar after cesarean delivery or myomectomy by 2.2 times. Using logistic regression analysis and odds ratio data, these predictors were successfully stratified and integrated into a unified scoring system for assessing the risk of early postpartum hemorrhage. CONCLUSION: The…
creator: Vladimir Gutsu
creator: Elena V. Timokhina
creator: Irina V. Ignatko
creator: Dzhamilia Kh. Sarakhova
creator: Yulia M. Popova
creator: Stanislav G. Reshetnikov
creator: Natalya I. Lyubchich
creator: Irina A. Fedyunina
creator: Anastasia A. Churganova
creator: Nikolay N. Kovalev
creator: Elizaveta N. Dedova
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-12-07
publication date: 2025-12-07
volume: 12
number: 4
starting page: 462
ending page: 473
doi: 10.17816/aog690539

Effect of menopausal hormone therapy and phytoestrogens on the oxidant/antioxidant profile of blood plasma in peri- and postmenopausal women
type: item
description: BACKGROUND: One of the most significant consequences of altered estrogen levels during the peri- and postmenopausal periods is the development of oxidative stress, which plays a key role in the pathogenesis of age-associated diseases. At present, the effects of menopausal hormone therapy and phytoestrogen therapy on antioxidant homeostasis are actively discussed. Available data are inconsistent, indicating that estrogen may exert both pro-oxidant and antioxidant effects, which makes this issue particularly relevant. AIM: To investigate the effects of menopausal hormone therapy and phytoestrogens (soy isoflavones and resveratrol) on the oxidant/antioxidant profile of blood plasma in peri- and postmenopausal women. METHODS: The study included 92 patients with climacteric syndrome who were divided into four groups: group 1, menopausal hormone therapy (n = 25); group 2, soy isoflavone therapy (n = 23); group 3, resveratrol therapy (n = 24); and a control group, no drug therapy (n = 20). The severity of climacteric syndrome was assessed using questionnaire-based scales before treatment and after 3 months. The antioxidant profile of blood plasma was analyzed using kinetic luminol-enhanced chemiluminescence. RESULTS: The most pronounced reduction in climacteric syndrome severity was observed with menopausal hormone therapy using estradiol and dydrogesterone combination therapy. A positive clinical trend was also noted in the resveratrol group. Soy isoflavone therapy did not have a significant effect on the course of climacteric syndrome. Neither menopausal hormone therapy nor soy isoflavone therapy influenced antioxidant profile parameters. Resveratrol exerted a favorable effect on the thiol antioxidant system, and a correlation was identified between the status of the thiol antioxidant system and the severity of climacteric symptoms. CONCLUSION: The findings demonstrate high clinical relevance and indicate the safety of menopausal hormone therapy and resveratrol with resp…
creator: Olga O. Kabanova
creator: Elena V. Proskurnina
creator: Liya N. Shcherbakova
creator: Natalia A. Novitskaya
creator: Andrey E. Bugerenko
creator: Dmitriy S. Ogay
creator: Olga B. Panina
rights: Copyright (c) 2025 Eco-Vector https://creativecommons.org/licenses/by-nc-nd/4.0
license: https://creativecommons.org/licenses/by-nc-nd/4.0
date: 2025-12-07
publication date: 2025-12-07
volume: 12
number: 4
starting page: 474
ending page: 483
doi: 10.17816/aog695385

Aortic coarctation in pregnant women
type: item
description: This article presents a review of the etiology, pathogenesis, clinical manifestations, and diagnostic approaches to aortic coarctation, which accounts for approximately 6%–7% of all congenital heart defects and occurs in pregnancy with a frequency of about 1 case per 4500 deliveries. For a long time, pregnancy in women with aortic coarctation was considered extremely high risk, and pregnancy termination was often recommended. Pregnancy in women with unrepaired aortic coarctation is frequently associated with various complications, including uncontrolled hypertension, preeclampsia, hypertensive crisis, congestive heart failure, stroke, and aortic rupture or dissection. At present, there are no clear guidelines or a unified approach to the management of pregnancy in women with aortic coarctation. Recent studies indicate that, with appropriate management, pregnancy may proceed without serious complications. The main reasons for hospitalization during pregnancy in these patients include heart failure, uncontrolled hypertension, and supraventricular arrhythmias. Therefore, strict blood pressure control appears to be a key component in the management of pregnant women with this condition. A clinical case describing pregnancy management and delivery in a patient with newly diagnosed aortic coarctation is also presented.
creator: Vera S. Belousova
creator: Amalia A. Arakelyants
creator: Yulia E. Mokrova
creator: Yulia A. Sergienko
creator: Irina M. Bogomazova
creator: Madina A. Kardanova
creator: Svetlana V. Pesegova
creator: Oksana V. Skorobogatova
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-12
publication date: 2025-12-12
volume: 12
number: 4
starting page: 484
ending page: 494
doi: 10.17816/aog691728

Port-site hernia after repeat staging procedures in a patient with a borderline ovarian tumor: a case report
type: item
description: Laparoscopic surgery has become the gold standard in gynecology owing to its minimal invasiveness and low complication rate. However, its widespread use makes awareness of rare but potentially serious risks, such as port-site hernia, critically important. This complication, reported in 0.34%–5.40% of cases, may develop even with flawless surgical technique and no apparent predisposing factors. We present a rare case involving a 47-year-old patient. After an initial laparoscopic procedure for an ovarian cyst, histological examination revealed a serous borderline ovarian tumor. The patient subsequently underwent a repeat laparoscopy with hysterectomy, bilateral salpingo-oophorectomy, and omentectomy. No intraoperative complications occurred; ports were inserted in the standard manner, and the resected tissue was removed transvaginally in an endobag. Nevertheless, in the postoperative period, the patient developed dyspeptic symptoms refractory to conservative therapy. During follow-up, progressive partial high small-bowel obstruction was identified. On postoperative day 12, laparotomy revealed a loop of small intestine incarcerated in a port-site defect of the anterior abdominal wall. Hernioplasty was performed. Analysis of the case suggests that despite the absence of classical risk factors (obesity, diabetes), enlargement of the trocar port during extraction of a bulky specimen in the first operation was likely the predisposing event. This observation underscores that the risk of port-site hernia persists even when technique is optimal. Nonspecific symptoms such as dyspepsia may mask a life-threatening condition—intestinal obstruction. Careful fascial closure of trocar-site wounds, particularly in middle-aged and older patients, remains the key preventive measure of such complications.
creator: Sergey V. Anpilogov
creator: Andrey V. Semenov
creator: Elena A. Chulkova
creator: Elena V. Tikhomirova
creator: Maria A. Orlyuk
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-11-27
publication date: 2025-11-27
volume: 12
number: 4
starting page: 495
ending page: 501
doi: 10.17816/aog692592

Temporary balloon occlusion of the common iliac arteries during hysterectomy for giant cervical fibroid
type: item
description: Surgical treatment of giant uterine fibroids with cervical localization represents one of the most challenging tasks in operative gynecology. The main difficulties are associated with distorted pelvic anatomy, limited space for manipulations, and a high risk of massive intraoperative bleeding, which necessitates the use of modern blood loss control techniques. Among these approaches, temporary endovascular balloon occlusion of the major pelvic vessels has proven to be a highly effective technique for minimizing hemorrhagic risk and ensuring the safety of radical surgery. This article presents a clinical case describing successful treatment of a 56-year-old woman with a giant uterine fibroid of a 20-week gestational size, cervical localization of the lesion, and severe comorbidities. The patient’s medical history was complicated by an episode of massive uterine bleeding in February 2024 that required emergency uterine artery embolization. Considering the patient’s age, fibroid size, complex localization, and comorbidity burden, a two-stage treatment strategy was chosen. During the first stage, preoperative preparation with a gonadotropin-releasing hormone agonist was carried out for three months to reduce fibroid volume. At the second stage, panhysterectomy was performed with prior temporary balloon occlusion of the common iliac arteries. With temporary vascular occlusion, hysterectomy with bilateral adnexectomy was successfully completed. A critical outcome was minimal intraoperative blood loss of only 200 mL, which did not require blood transfusion. The arterial occlusion lasted 40 minutes, which prevented ischemic complications. This clinical case clearly demonstrates the effectiveness of temporary balloon occlusion of the major pelvic vessels as a key method for preventing massive intraoperative blood loss during hysterectomy for giant uterine fibroids with complex localization. The technique appears promising and may be considered a standard of care in similar c…
creator: Vasilii B. Osadchev
creator: Yulia V. Denisova
creator: Natalia E. Safonova
creator: Alyona S. Franchuk
rights: Copyright (c) 2025 Eco-Vector https://eco-vector.com/for_authors.php#07
date: 2025-12-12
publication date: 2025-12-12
volume: 12
number: 4
starting page: 502
ending page: 509
doi: 10.17816/aog692772