Миомэктомия при абдоминальном родоразрешении: клинические особенности и исходы

Abstract

Objective. To study the clinical features and outcomes of myomectomy during cesarean delivery, including in the effect of progestogens. Patients and methods. The study enrolled 61 patients who gave birth by cesarean section. Among them there were 41 women with multiple uterine fibroids and/or a node diameter >50 mm. The patients were divided into three groups: group 1 included 22 women who took progestogens in the first and second trimesters of pregnancy; group 2 consisted of 19 women who did not receive hormone therapy; the control group included 20 women without uterine fibroids. Results. The duration of operation did not differ cumulatively between three patient groups, including the control group. A strong positive correlation between operation duration and blood loss was found in patients with uterine fibroids. The length of stay was determined both by myomectomy performed during cesarean section and by progestogen intake during the current pregnancy. The location of myomatous nodes had an impact on discharge day when comparing patients with fibroid types 4 and 5 according to FIGO. The length of stay was statistically significantly longer in fibroid type 4 (intramural). Conclusion. Progestogen administration did not directly affect the size of myomatous nodes removed during delivery and the duration of postoperative hospital stay in patients who underwent myomectomy, while intraoperative blood loss was 100 mL greater than in the control group without myomectomy. Key words: discharge day, operation duration, cesarean section, blood loss, myomectomy during delivery, progestogens