Clinical and statistical analysis of detection of the incidence of uterine leiomyoma in patients during pregnancy and childbirth

Authors

  • V.L. Dronova SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Ukraine
  • O.I. Dronov SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine»; Bogomolets National Medical University; Kyiv City Clinical Hospital No.10, Ukraine
  • R.S. Tesliuk SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Ukraine
  • O.M. Mokryk SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Ukraine
  • L.O. Roshchyna SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine», Ukraine
  • Yu.P. Bakunets SI «Institute of Pediatrics, Obstetrics and Gynecology named of academician O.M. Lukyanova NAMS of Ukraine»; Bogomolets National Medical University; Kyiv City Clinical Hospital No.10, Ukraine

DOI:

https://doi.org/10.15574/PP.2020.82.35

Keywords:

clinical and statistical analysis, uterine leiomyoma, pregnancy, labor, surgical interventions

Abstract

Purpose. This article is devoted to the problem of the incidence of uterine leiomyoma at gravidants. Clinical and statistical analysis included the course of pregnancy and labor, the features of somatic and reproductive health at gravidants, complications of pregnancy, perenatal surgical care, the condition of newborns.

Materials and methods. The case histories of 405 pregnant women with uterine leiomyoma were analyzed; 205 of which gave birth, and 200 were hospitalized in the period 2009-2018.

Results and Conclusions. In the examined patients, leiomyomatous nodes were found at 96 (46.8%), at 109 (53.2%) women, uterine leiomyoma was diagnosed before pregnancy. Fibromatous nodes of the uterus were more often subserous (at 59% of pregnant women) and intramural (at 41%). The submucosal nodes were not detected. From the patients at whom have taken place labor — 79 (38.5%) women were delivered by cesarean section, and conservative myomectomy was performed at 53 (25.8%) women. At seven cases, during cesarean section surgery, the incomplete hysterectomy without uterine appendages was performed, in one case was performed the complete hysterectomy with tubes. In a population of pregnant women who were hospitalized, leiomatous nodes were detected at 86 women (43%). At 114 (57%) women, the uterine leiomyoma was diagnosed before pregnancy. The nodes on the uterus were more often located subserosally (at 56% of pregnant women) and intramurally (at 44%). The submucous nodes were not detected. Surgical interventions at women regarding the ectomia of leiomatous nodes during pregnancy were carried out in only three cases: in two pregnant women with giant intramural-subserous fibromioma; the nodes were squeezed, the uterine cavity was deformed, and the right segment of the liver was squeezed. In the third case, the necrosis of a node that was located subserous was diagnosed.

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 this Institute. The informed consent of the patient was obtained for conducting the studies.

 

References

Buyanova SN, Logutova LS, Gukasyan SA, Yudina NV. (2012). Miomektomiya vo vremya beremennosti — osoznannaya neobhodimost. Materialyi VI Vserossiyskogo foruma «Mat i ditya». Moskva: 20–21.

Buyanova SN, Logutova LS, Schukina NA i dr. (2012). Miomektomiya vne i vo vremya beremennosti: pokazaniya, osobennosti hirurgicheskoy taktiki i anestezii, predoperatsionnaya podgotovka i reabilitatsiya. Posobie dlya vrachey. Moskva: MAKS-Press: 18.

Vasilchenko NP, Firichenko VN. (2015). Lechenie bolnyih miomoy matki i ego effektivnost. Akusherstvo i ginekologiya. 2: 7–10.

Vihlyaeva EM. (2014). O strategii i taktike vedeniya bolnyih s miomoy matki. Vestnik Rossiyskoy assotsiatsii akusherov-ginekologov. 3: 21–23.

Dolyk PS. (2016). Pidvyshchennia vidnovlennia reproduktyvnoi funktsii u zhinok z leiomiomoiu matky pislia laparoskopichnoi miomektomii. Zbirnyk naukovykh prats spivrobitnykiv NMAPO imeni P.L. Shupyka. 25; 5 (2): 98–101.

Makarenko MV, Hovsieiev DO, Sysa OM, Tian OV. (2015). Osoblyvosti perebihu vahitnosti, polohiv ta pisliapolohovoho periodu u vahitnykh z leiomiomoiu matky health of woman. 6 (102): 111–113.

Mamedova ZT, Kurbonova MH, Davlyatova GK, Yuldasheva AK. (2009). Akusherskaya taktika pri vedenii beremennyih s miomoy matki. Dokladyi Akademii nauk Respubliki Tadzhikistan. 52; 8: 651—655.

Mihalevich SI, Kapusta AV. (2011). Beremennost, rodyi i poslerodovoy period u zhenschin s miomoy matki. Meditsinskie novosti. 2: 18—25.

Petrakova SA, Buyanova SN, Mgeliashvili MV. (2009). Vozmozhnosti miomektomii v korrektsii reproduktivnogo zdorovya zhenschin s miomoy matki. Rossiyskiy vestnik akushera-ginekologa. 1: 30–35.

Rozhkovska NM, Zhelezov DN, Kossei TV. (2018). Doslidzhennia perebihu vahitnosti ta polohiv u zhinok, yaki perenesly rekonstruktyvni operatsii na mattsi. Zbirnyk naukovykh prats AAHU. 2/42: 138–143.

Samsonov AE, Ryimashevskiy AN, Volkov AE, Terehina LA. (2013). Osobennosti vliyaniya miomyi matki na techenie beremennosti. Tavricheskiy mediko-biologicheskiy vestnik. 16; 2; 1 (62): 205–207.

Semeniak AV, Yuzko OM, Nitsovych IR. (2018, VII). Leiomioma matky ta vahitnist. Neonatolohiia, khirurhiia ta perynatalna medytsyna. 2 (28): 93–98.

Smirnova TA, Pavshuk LI. (2014). Sovremennyie podhodyi k lecheniyu miomyi matki u molodyih zhenschin s tselyu sohraneniya reproduk-tivnoy funktsii. Byulleten sibirskoy meditsinyi. 13 (1): 145–152.

Startseva MN, Tshay VB, Geyman AG. (2007). Blizhayshie i otdalennyie oslozhneniya pri laparoskopicheskihi operatsiyah v ginekologicheskoy praktike. Sibirskoe meditsinskoe obozrenie. 3 (44): 83–86.

Tihomirov AL, Lubin DM. (2006). Mioma matki. Moskva: 176.

Hripunova GI. (2011). Taktika rodorazresheniya beremennyih s miomoy matki. Saratovskiy nauchno-meditsinskiy zhurnal. 7; 2: 401–403.

Schukina NA, Buyanova SN, Babunashvili EL i dr. (2012). Vzaimosvyaz retseptornogo statusa polovyih steroidov, vaskulyarizatsii i tempa rosta miomyi matki. Materialyi VI Rossiyskogo foruma «Mat i ditya». Moskva: 260–261.

Bulun SE. (2013). Uterine fibroids. N Engl J Med. 369 (14): 1344–1355. https://doi.org/10.1056/NEJMra1209993; PMid:24088094.

Euzebus Chinonye Ezugwu, Chukwuemeka Anthony Iyoke, Frank Okechukwu Ezugwu, George Ugwu. (2014). Successful pregnancy following myomectomy for giant uterine fibroid in an infertile woman. J reprod infertil. 15; 4: 233–236.

Kaymak O. (2009). Myomectomy during cesarean section. Obstet gynecol. 114; 3: 611–615.

Kinugasa-Taniguchi Y, Ueda Y, Hara-Ohyagi C. (2011). Impared delivery outcomes in pregnancies following myomectomy compared to myoma-complicated pregnancies. J Reprod Med. 56; 3–4: 142–148.

Mas A, Tarazona M, Dasi Carrasco J, Estaca G, Cristobal I, Monleon J. (2017). Updated approaches for management of uterine fibroids. Int J of Womens Health. 9: 607–617. https://doi.org/10.2147/IJWH.S138982; PMid:28919823 PMCid:PMC5592915.

Nappi L, Matteo M, Giardina S et al. (2008). Management of uterine giant myoma. Arch gynecol obs. 78 (1): 61–63. https://doi.org/10.1007/s00404-007-0523-1; PMid:18066710

Practice Committee of American Society for Reproductive Medicine in collaboration with Society of Reproductive Surgeons. (2008). Myomas and reproductive function. Fertil. Steril. 90; 5: 125–130.

Redecha MJr, Mizickova M, Javorka V et al. (2013). Pregnancy after uterine artery embolization for the treatment of myomas: a case series. Arch Gynecol Obstet. 287; 1: 71–76. https://doi.org/10.1007/s00404-012-2512-2; PMid:22907793

Vitale SG, Tropea A, Rossetti D et al. (2013). Management of uterine leiomyomas in pregnancy: review of literature. Updates Surg. 30. https://doi.org/10.1007/s13304-013-0198-z

Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. (2012). Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Women's Health. 12 (1): 6. https://doi.org/10.1186/1472-6874-12-6; PMid:22448610 PMCid:PMC3342149.

Downloads

Published

2020-06-29

Issue

No. 2(78) (2020): Ukrainian Journal of Perinatology and Pediatrics

Section

Original articles

License

The policy of the Journal “Ukrainian Journal of Perinatology and Pediatrics” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license(СС BY-NC).

Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.

Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.

The use of published materials for commercial purposes is strongly prohibited.