Профілактика ускладнень перебігу вагітності та пологів у жінок із лейоміомою матки

Abstract

Purpose - to evaluate the clinical effectiveness of the proposed preventive and therapeutic complex using modern drugs and organ-preserving methods of surgical treatment in pregnant women with uterine leiomyoma FIGO (International Federation of Gynecology and Obstetrics) type 3-6. Materials and methods. This prospective study was conducted with a comprehensive examination, selection of optimal tactics for pregnancy management and delivery in 70 pregnant women with uterine leiomyoma using the complex developed by us (main group), 41 pregnant women with uterine leiomyoma with standard pregnancy management (comparison group) and 50 pregnant women without uterine leiomyomas in the II-III trimesters of pregnancy and after childbirth at 4 clinical bases of the Department of Obstetrics and Gynecology No. 1 of the Shupyk National Healthcare University of Ukraine for 3 years - 2020-2023. Results. 70 pregnant women of the main group, who used the treatment and prevention complex developed by us, had significantly lower rates of iron deficiency anemia, the frequency of the threat of premature birth, fetal distress, and hypotonic labor compared to the comparison group and approached the rates of the control group (p<0.05). A 1.8-fold decrease in the risk of premature birth among women in the main group was also noted, as well as a 1.3-fold decrease in the cesarean section rate. PPH volume during vaginal delivery and cesarean section in the main group was significantly lower compared to the comparison group (p<0.01) and had no statistical difference with the control group (p>0.05). Conclusions. Pregnant women with uterine leiomyoma have an increased risk of iron-deficiency anemia, the threat of premature birth, weakness in labor, fetal distress, cesarean section, and PPH development. The treatment and prevention complex proposed by us and the optimal technique for performing cesarean sections allowed not only to reduce the frequency of complications during pregnancy and childbirth, but also to reduce the rate of PPH and reduce the indicators of maternal morbidity. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.