Вариантная анатомия артерий матки

Козлов, С.В. and Дворецкий, Д.Д. and Алексеенко, Л.А. and Омельченко, A. and Картамышева, В.Д. (2018) Вариантная анатомия артерий матки. Український журнал медицини, біології та спорту, Т. 3 (№ 4). pp. 32-37. ISSN 2415-3060 (Print), 2522-4972 (Online)


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Abstract. Postpartum and gynecological hemorrhages remain the leading cause of maternal death and severe morbidity in all the developing countries of the world. Although the uterus atony is the most common cause of bleeding in peripartum, abnormal placenta, impaired coagulation and trauma to the genital tract lead to adverse effects on the health and life of the woman. Therefore, the study of variants of branching of the uterus arteries has not only theoretical interest, but is also of great practical importance. Exactly fundamental research in the area of scientific exploration of the female reproductive system will become the basis for the development of new approaches in the diagnosis and treatment of uterine bleeding among women with not only gynecological pathology, but also amongst women in childbirth with obstetric hemorrhages in the positions of bounding time of rendering medical care. Uterine artery anatomic variants have been the subject of detailed study, since the beginning of last century. The aim of the research was to study the sources of divergence and variants embranchments of uterine arteries. Material and methods. The materials for the exploration were complexes of internal genital organs of adult women (21–35 years) in the number of 19 who died from diseases not related to the pathology of the reproductive system. The distribution of anatomical material was carried out on the basis of the scheme of the age periodization of human life. To accomplish the goal of the research, a set of methods was used which includes anatomical preparation, injection of the arterial bed of the uterus followed by corrosion. The internal genital organs with the abdominal aorta, the common and internal iliac arteries and their branches in the complex were removed from the cavity of the small pelvis of the corpses of the women of the studied groups. After washing the preparation under running water, it was placed in a 10% formalin solution and fixed for two to three days. After fixation we proceeded to anatomical preparation. Results and discussion. To study the spatial distribution of the arterial channel of the uterus, the vascular channel was injected through the uterine arteries with the help of the cannula by injection mass based on the self-hardening dental plastics followed by the preparation of corrosive preparations. After preliminary ligation of the round and funnel-pelvic ligament of the uterus and injection of dental plastics through the uterine arteries, the uterus with fallopian tubes and ovaries was placed in a 28–30% solution of hydrochloric acid for two days. During the examination of the extraorganic uterine bed, the shape of the uterine arteries, their quantity and caliber of the current branches of the uterine arteries, the level of their divergence according to the different parts of the uterus, the direction of the ordinal branches in various planes, and the character of the anastomosis between the uterine and ovarian arteries were taken into account. Among women 21–35 years, there are essentially changes in the arterial blood supply of the internal genital organs, which are associated with the reproductive function of women`s body, what leads to an alternation in angioarchitectonics, an increasing number of embranchment vessels, changes in the topography of the vessels on the grounds of the previous pregnancy and depending on the location of the placental site. The uterus is supplied by two pairs of uterine and ovarian arteries, small branches of the ovarian arteries and arteries of the round ligament of the uterus. In 60% of cases, the uterine arteries were branches of the anterior trunks of the internal iliac arteries. In a number of cases, the uterine artery was a branch of the untertered part of the umbilical artery (27%), inferior vesical artery (3%), middle rectal artery (2%), and in rare cases could leave the common trunk with umbilical (1.8%), (1.6%), the superior gluteal (1.6%), the inferior gluteal (1.6%) and the upper vesical artery (1.4%). Резюме. Матка кровопостачаєтся за рахунок двох пар маткових і яєчникових артерій, дрібних гілок яєчникових артерій і артерій круглих зв'язок матки. У 60% випадків маткові артерії були гілками передніх стовбурів внутрішніх клубових артерій. За нашими даними маткова артерія була гілкою необлітерованої частини пупкової артерії (27%), нижньої міхурової артерії (3%), середньої ректальної артерій (2%), а в окремих випадках могла відходити загальним стовбуром з пупковою (1,8%), внутрішньої статевої (1,6%), верхньою сідничною (1,6%), нижньою сідничною (1,6%) і верхньою міхуровою артеріями (1,4%). В артеріальному кровопостачанні матки нами виділені низка характерних особливостей. По-перше це наявність основних і додаткових джерел кровопостачання, чисельність як екстра-, так і внутрішньоорганних анастомозів маткових артерій; асиметрія в кровопостачанні правої і лівої половин матки, наявність мало- і безсудинних зон, нерівноцінність артеріального притоку до передньої і задньої стінок матки. У всіх випадках від маткових артерій відходили вагінальні, цервікальні, корпоральні, яєчникові і трубні артерії, артерії круглих зв'язок матки. Цервікальні гілки розгалужувалися або по розсипному, або по магістральному типу. Яєчникова, трубна і фундальна артерії були кінцевими гілками маткової артерії в 56% випадків, яєчникова і фундальна – в 23%, яєчникова і трубна – в 21%.

Item Type: Article
Additional Information: DOI: 10.26693/jmbs03.04.032
Uncontrolled Keywords: маточная артерия, анатомический вариант, маточные кровотечения; маткова артерія, анатомічний варіант, маткова кровотеча; uterine artery, anatomical variant, uterine hemorrhage.
Subjects: Forensic medicine
Divisions: Departments > Department of Pathological Anatomy and Forensic Medicine
Depositing User: Елена Шрамко
Date Deposited: 25 Apr 2019 13:18
Last Modified: 25 Apr 2019 13:18
URI: http://repo.dma.dp.ua/id/eprint/4037

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