PREGNANCY WITH UTERINE MYOMA AND AFTER MYOMECTOMY: RESULTS OF THE COHORT STUDY

Objective - to identify risk factors, complications, and pregnancy outcomes in patients with uterine fibroid (myoma) and after myomectomy. Material and methods. Investigated 100 pregnancy and delivery stories, where 1st group consists of 40 patients with uterine myoma from 3 to 12 cm, 2nd group - 30 patients with a history of myomectomy, 3rd group - control of 30 patients. Results. The average age of patients from group 1 is 34.9 years, group 2 - 35.7 years. Both in group 1 and group 2 there is a large percentage of surgical interventions on the uterus: a history of abortion (35%/20%) and miscarriage (15%/36.6%). Significant sizes of fibroids contribute to incorrect fetal position - breech presentation (17.5%/3.3%), transverse (2.5%), oblique (2.5%). The presence of fibroids is associated with certain complications: the growth of the placenta in the myomatous node (5%), disorder of blood supplying and ischemic changes of the nodes during pregnancy (2.5%), late postpartum hemorrhage (2.5%), fetal distress (12.5%). Surgical delivery by Cesarean section (85%) is the method of choice for uterine myoma, based on a combination of another relative indications. Caesarean section in such patients is associated with an increase in the volume of surgical intervention, in the form of conservative myomectomy according to indications (58.8%), which may be a factor in pathological blood loss (2.5%). Pregnancy and delivery after myomectomy is accompanied by the occurrence of specific complications: scar failure after myomectomy, the threatening of uterine rupture in the scar (6.7%), adhesions in the pelvis III-IV degrees (16.7%).