FEATURES OF THE SECOND HALF OF PREGNANCY IN WOMEN OF REPRODUCTIVE AGE AFTER DIFFERENT METHODS OF TREATMENT OF UTERINE LEIOMYOMA
DOI:
https://doi.org/10.11603/24116-4944.2023.2.14387Keywords:
pregnancy, uterine leiomyoma, conservative myomectomy, pregnant women of reproductive ageAbstract
The aim of the study – to investigate the features of the second half of pregnancy in women after various methods of treatment of uterine leiomyoma.
Materials and Methods. 300 pregnant women in the 2nd and 3rd trimester of pregnancy were examined. Among them – 219 with uterine leiomyoma, (group 1, main group). 114 pregnant women underwent conservative treatment of UL, (group 1a) before pregnancy. 105 pregnant women underwent conservative myomectomy before pregnancy. Of them, 59 women were after laparoscopic myomectomy of the subserosal node or hysteroscopic myomectomy of the submucosal node with coagulation of the bed (group 1 b) and 46 pregnant women – after laparotomy myomectomy with suturing of the bed of the node with vicryl sutures (group 1c). Control group 2 consisted of 81 pregnant women without leiomyoma.
Results and Discussion. The conducted studies indicate that the most frequent complication of pregnancy in the 2–3 trimester in women with UL was the threat of premature birth at 22–27 weeks (47.0 %), (OR: 2.897; 95% CI: 1.625–5.167), and the threat of miscarriage at 12–21.6 weeks (37.4 %), (OR: 3.809; 95% CI: 1.906–7.610). Moreover, in pregnant women with conservative treatment of UL, these complications were almost twice as frequent as in pregnant women after conservative myomectomy (p<0.05). Preeclampsia was present in 29.7 % of patients in the main group, in 6.2 % of the control group (OR 6.416; 95 % CI: 2.481–16.592). Gestation almost did not differ in pregnant women depending on the treatment of leiomyoma before pregnancy. Placental dysfunction was present in 27.9% of pregnant women in the main group versus 7.4 % in controls (OR 4.826; 95 % CI: 1.997–11.664).
Conclusions. In pregnant women with UL in the 2nd and 3rd trimesters of pregnancy, the threat of premature birth and the threat of miscarriage are more common, and these complications prevail in women with conservative treatment of UL compared to patients after conservative myomectomy, which indicates the need for surgical treatment in women with uterine leiomyoma in the pregravid stage stage.
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