RESEARCH OF THE PROCESS OF PREGNANCY AND DELIVERY IN WOMEN WHO HAVE TRANSFERED RECONSTRUCTIVE OPERATIONS ON THE UTERUS

Abstract

This article presents the results of study of the course of pregnancy and labor in women who underwent reconstructive operations on the uterus. In order to identify the algorithm, aimed at reducing the frequency of obstetric and perinatal pathology in women who underwent reconstructive operations on the uterus before pregnancy, reconstructive operations on the uterus on the basis of studying and evaluating the clinical, echographic, hemodynamic, hormonal and morphological features of the myometrium and fetoplacental complex state, as well as the improvement of the diagnostic and therapeutic algorithm -prophylactic measures.Material and methods. The study examined the clinical course of pregnancy and childbirth in 150 women with uterine myoma in combination or without endometriosis. All studied were divided into three groups. All the examined patients underwent conventional medical and prophylactic measures in the amount of conservative myomectomy which included the following: combined preoperative and postoperative treatment according to the Order of the Ministry of Health of Ukraine No. 582, including the use of gonadotropin-releasing hormone agonists, antioxidant, symptomatic therapy.Results of the study and their discussion. Based on the results of the study, it was found that carrying out a conservative myomectomy during cesarean section leads to increased duration of the operation and increased in amount of blood loss (p <0.05). Also, the frequency of massive blood loss increases (more than 0.7% of body weight). Expansion of the operation size leads to an increase in the frequency of transfusions of blood components, the use of additional techniques to reduce blood loss.Conclusions. When combining uterine myoma with the size of more than 5 cm and endometriosis, the risk of developing threatening premature births increases. The frequency of placental dysfunction depends on the size of the uterine fibroids. Delivery of women with leiomyoma of the uterus and endometriosis has always been accompanied by a high risk of bleeding and the size of the node positively correlates with the volume of blood loss during the operation.