Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации9826Conference ProceedingsClinical experience of using organ-preserving surgery for placenta accreta in a patient with monochorionic diamniotic twinsSaenkoJulia Sergeevnajulia.saenko@list.ruPolishchukValentin Valentinovichdr-polishchuk@list.ruMogorovskayaAnna Valerievnadr_mogorovskaya@list.ruLyashenkoElena Nikolaevnahelen.lyashen@mail.ruOTKZ Medical Institute named after S.I. GeorgievskyPerinatal center of GBUZ RK "RKB named after N.A. Semashko"1904202413S131352102202410042024Copyright © 2024, Saenko J.S., Polishchuk V.V., Mogorovskaya A.V., Lyashenko E.N.2024<p>Introduction. The main reason why researchers and practitioners are interested in such an anomaly as placenta accreta is the risk of massive postpartum hemorrhage due to the inability to separate the placenta, which has grown into the uterine wall. A hysterectomy is often required to correct this bleeding. Placenta accreta also increases the risk of pelvic organ damage, coagulopathy, and maternal and perinatal mortality. Aim. Study of a clinical case of a patient with monochorionic diamniotic twins and placenta accreta, as well as methods of delivery. Materials and methods. The successful clinical experience of organ-preserving surgical treatment of placenta accreta carried out at the Perinatal Center in Simferopol, excluding the stage of bottom caesarean section, is presented. Results. Pregnant N., hospitalized in the department of pathology of pregnant women of the Perinatal Center in Simferopol due to the development of placental dysfunction (3rd degree of disturbance of placental circulation (combined disturbance of utero-placental and fetal-placental blood flow)). Observation and treatment were carried out for 20 days in the conditions of the pregnancy pathology department of the Perinatal Center in Simferopol. Taking into account the CTG conclusion (deceleration in the 2nd fetus up to 60 beats/min), the ultrasound conclusion (impaired blood flow grade 1B in the 1st fetus, impaired blood flow grade 3 (critical) in the 2nd fetus with reverse venous blood flow), as well as antenatal distress of both fetuses , the decision was made to complete the birth by emergency caesarean section at 31 weeks and 4 days. Pfannenstiel laparotomy, corporal cesarean section, metroplasty, and surgical sterilization were performed at the patient's request. Two female fetuses were recovered. Due to prematurity, the children were transferred to the pediatric intensive care unit. The mother and children were discharged on the 7th day after surgery in satisfactory condition. Conclusions. Our example proves the possibility of successfully performing organ-preserving surgery - metroplasty - in a pregnant woman with monochorionic diamniotic twins and placenta accreta.</p>monochorionic diamniotic twins, antenatal fetal distress, transverse fetal position, metroplasty, preterm birth, cesarean section.монохориальная диамниотическая двойня, антенатальный дистресс плода, поперечное положение плода, метропластика, преждевременные роды, кесарево сечение.[1. Cali, G. Value of first-trimester ultrasound in prediction of third-trimester sonographic stage of placenta accreta spectrum disorder and surgical outcome / G. Cali, F. Forlani, C. Lees, I. Timor-Tritsch, J. Palacios-Jaraquemada, A. Dall'Asta, A. Bhide, M. E. Flacco, L. Manzoli, F. Labate, A. 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