GynecologyGynecology2079-56962079-5831Consilium Medicum35255810.26442/20795696.2023.1.202116Research ArticleTerlipressin in obstetric and gynecological practice: a case of a missed miscarriage in late pregnancy complicated by bleeding. Case reportTskhayVitaly B.<p>D. Sci. (Med.), Prof.</p>mail.rurwap@mail.ruhttps://orcid.org/0000-0003-2228-3884YametovPavel K.<p>Assistant</p>mail.rurwap@mail.ruhttps://orcid.org/0000-0001-9470-185XRaspopinYuriy S.<p>Assistant</p>oar24@mail.ruhttps://orcid.org/0000-0001-5550-1628YametovaNatalia M.<p>Assistant</p>tejrus@mail.ruhttps://orcid.org/0000-0002-6097-1496PolstyanayaGalina N.<p>Cand. Sci. (Med.)</p>g.polstianaia@yandex.ruhttps://orcid.org/0000-0002-2974-3196RyabininDaniil A.<p>Department Head</p>ppdan@yandex.ruhttps://orcid.org/0000-0001-6764-1134Voino-Yasenetsky Krasnoyarsk State Medical UniversityKrasnoyarsk Regional Clinical Centre for Maternal and Child HealthFederal Siberian Research Clinical CenterKrasnoyarsk Interdistrict Maternity Hospital №1270420232511161202704202327042023Copyright © 2023, Consilium Medicum2023<p>A few randomized multicenter studies indicate that prophylactic vasopressin in obstetric and gynecological surgeries is mainly safe and associated with a significant reduction in intraoperative blood loss. This article reviews recent scientific papers describing the use of vasopressin in obstetric and gynecological practice with an assessment of its effectiveness depending on the dose and route of administration. We present a clinical case demonstrating that drugs with a vasopressor effect, in particular terlipressin, in a patient with uterine bleeding after a late induced miscarriage allowed to obtain an excellent hemostatic effect and avoid the need for additional methods of surgical hemostasis.</p>bleedinglate abortiondrug hemostasisvasopressinterlipressinкровотечениепоздний абортмедикаментозный гемостазвазопрессинтерлипрессин[Grippo A, Zhang J, Chu L, et al. Air pollution exposure during pregnancy and spontaneous abortion and stillbirth. Rev Environ Health. 2018;33(3):247-64. DOI:10.1515/reveh-2017-0033][García-Enguídanos A, Calle ME, Valero J, et al. Risk factors in miscarriage: a review. Eur J Obstet Gynecol Reprod Biol. 2002;102(2):111-9. DOI:10.1016/s0301-2115(01)00613-3][Linnakaari R, Helle N, Mentula M, et al. Trends in the incidence, rate and treatment of miscarriage-nationwide register-study in Finland, 1998–2016. Hum Reprod. 2019;34(11):2120-8. 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Effects of terlipressin infusion on blood loss and transfusion needs during liver resection: A randomised trial. Acta Anaesthesiol Scand. 2019;63(1):34-9. DOI:10.1111/aas.13226][Rouholamin S, Hashemi M, Haghshenas S. The Effect of Vasopressin during Hysteroscopic Myomectomy in Patients with Submucosal Myoma: A Randomized Controlled Trial. Adv Biomed Res. 2021;10:22. DOI:10.4103/abr.abr_70_20][Song T, Kim MK, Kim M-L, et al. Use of vasopressin vs epinephrine to reduce haemorrhage during myomectomy: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2015;195:177-81. DOI:10.1016/j.ejogrb.2015.10.003][Lee EJ, Park SJ, Kim Y, et al. Effect and safety of diluted vasopressin injection on bleeding during robot-assisted laparoscopic myomectomy: a protocol for a randomised controlled pilot trial. BMJ Open. 2022;12(9):e056145. DOI:10.1136/bmjopen-2021-056145][Wong ASW, Cheung CW, Yeung SW, et al. Transcervical intralesional vasopressin injection compared with placebo in hysteroscopic myomectomy: a randomized controlled trial. Obstet Gynecol. 2014;124(5):897-903. DOI:10.1097/AOG.0000000000000515][Ascher-Walsh CJ, Capes T, Smith J, Michels A. Cervical vasopressin compared with no premedication and blood loss during vaginal hysterectomy: a randomized controlled trial. Obstet Gynecol. 2009;113(2 Pt 1):313-8. DOI:10.1097/AOG.0b013e3181954c44][Ghomi A, Makhlouf F, Kasturi S, Einarsson JI. Intramyometrial injection of vasopressin in laparoscopic supracervical hysterectomy. J Minim Invasive Gynecol. 2008;15(2):197-201. DOI:10.1016/j.jmig.2007.12.002][Hafidh B, Latifah HM, Gari A, et al. Vasopressin to Control Blood Loss during Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Minim Invasive Gynecol. 2022;29(3):355-64.e2. DOI:10.1016/j.jmig.2021.10.003][Александрович Ю.С., Ростовцев А.В., Кононова Е.С., и др. Эффективность низких доз терлипрессина для профилактики интраоперационной кровопотери в акушерстве. Вестник анестезиологии и реаниматологии. 2020;17(4):78-84 [Aleksandrovich YuS, Rostovtsev AV, Kononova ES, et al. Efficacy of low doses of terlipressin to prevent intra-operative blood loss in obstetrics. Messenger of Anesthesiology and Resuscitation. 2020;17(4):78-84 (in Russian)]. DOI:10.21292/2078-5658-2020-17-4-78-84][Распопин Ю.С., Шифман Е.М., Белинина А.А., и др. Эффективность и безопасность применения терлипрессина при кесаревом сечении у беременных с высоким риском кровотечения: многоцентровое всенаправленное когортное исследование Terli-Bleed. Часть I. Вопросы гинекологии, акушерства и перинатологии. 2021;20(1):11-20 [Raspopin YuS, Shifman EM, Belinina AA, et al. Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I. 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