The course and outcomes of pregnancy in patients with hysteromyoma in different treatment methods
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The need to study the effect of uterine arteries (EUA) embolization on fertility is due to the fact that the reproductive behavior of a modern woman supposes planning to become pregnant after the age of 30 and older, when hysteromyoma is observed in every 4 women. This fact requires a search for the best types of organ-saving myoma treatment, with a guarantee of consecutive pregnancy and childbirth. The aim of the study was to compare the course and outcome of pregnancy in women with hysteromyoma after EUA and myomectomy to determine the choice of the most optimal treatment method in women with unrealized motherhood. The course and outcomes of pregnancy and condition of newborns of 147 patients were studied: after EUA (main group) and after myomectomy (comparison group 1), as well as patients with intact myomas (comparison group 2), and women without hysteromyoma (comparison group 3). The material was accumulated retrospectively by examining the medical documentation: medical records, notification cards of pregnant and maternity women, birth records and records of infant development. It was found that women treated by myomectomy and EUA had differences in the nature of complications during pregnancy, the course of puerperal period, method of delivery. The risks for subsequent pregnancies were more real in patients after myomectomy due to myoma recurrence in 50% of cases during pregnancy, scars on the uterus (after myomectomy and cesarean). No new knots, growth and vascularization of the existing myoma were observed after EUA, which makes it possible to regard EUA as the method of choice, especially in cases of motherhood not finally realized.
KEY WORDS: Hysteromyoma - Fertility - Embolization of uterine arteries - Myomectomy - Pregnancy outcomes.