Состояние здоровья и субъективная оценка качества жизни у женщин перед оперативным лечением (миомэктомией)

Abstract

Abstract Aim. To evaluate the health status and quality of life of women before surgical treatment (myomectomy). Design. Cross-sectional study. Materials and methods. The study was conducted in 2022–2023 at the clinical sites of the Department of Obstetrics and Gynecology with a course of perinatology at the Medical Institute of the RUDN University in the State Clinical Hospital named after. V.M. Buyanova, gynecological department and antenatal clinic No. 5 of the State Budgetary Healthcare Institution City Clinical Hospital No. 1 named after. N.I. Pirogov. Based on an analysis of medical records using a continuous sampling method, 90 women of reproductive age (15–49 years according to the World Health Organization classification) with uterine fibroids were included in the study. An analysis of complaints, general and obstetric-gynecological anamnesis, clinical, laboratory and instrumental examinations of patients was carried out, and women were questioned using the UFS-QOL questionnaire. Results. The average age of the studied patients was 41.4 years. 44 (48.9%) women had heavy menstruation. In the structure of extragenital diseases, the most common history cases were iron deficiency anemia — 42 (46.7%) cases, hypertension — 9 (10%) and obesity — 12 (13.3%), and among gynecological diseases, abnormal uterine bleeding prevailed — in 39 (43.3%) patients. Analysis of clinical blood test data showed that 11 (12.2%) women had moderate anemia, and 39 (43.3%) had mild anemia. A decrease in hemoglobin level was accompanied by the presence of microcytosis (MCV — 76.5 ± 4.2 pg) and hypochromia (MCH — 24.8 ± 4.2 pg). Complaints of weakness, decreased ability to work and endurance were detected in 43 (47.8%) patients with anemia, 8 (8.9%) women noted dizziness, and 2 (2.2%) had episodes of chest discomfort and rapid heartbeat . It was noted that, according to the UFS-QOL questionnaire, all patients determined the severity of symptoms of uterine fibroids as moderate (43.02 ± 18.39 points) with fairly low indicators of all quality of life parameters in most women: in 31 (34.4%) women the score did not exceed 50 points, which can be regarded as low quality of life, 38 (42.2%) had no more than 75 points — moderately reduced. Analysis of data from women with uterine fibroids according to the odds ratio theory revealed the following patterns: when the size of the myomatous node is 40 mm or more, the chance of heavy menstruation statistically significantly increased (odds ratio (OR) = 6.333, 95% confidence interval (CI) — 1.884–15.025, p <0.05), with 35 mm or more, the risk of IDA increased (OR = 3.167, 95% CI — 1.291–7.769, p < 0.05). There was no statistically significant relationship between the development of anemia and the location of myomatous nodes (p > 0.05). Conclusion. Reduced quality of life, increased levels of anxiety, sexual dysfunction, heavy menstruation associated with uterine fibroids determine the need for early diagnosis and comprehensive treatment of such patients. Key words: uterine fibroids, abnormal uterine bleeding, iron deficiency anemia.