Течение беременности и родов у пациенток с миомой матки
- Авторы: Доброхотова Ю.Э.1, Хачатрян А.С.2, Ильина И.Ю.1, Ибрагимова Д.М.1, Нариманова М.Р.1, Платова Е.С.1, Каусева О.И.3
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Учреждения:
- Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
- Ереванский государственный медицинский университет
- Городская клиническая больница № 1 им. Н.И. Пирогова
- Выпуск: Том 12, № 1 (2025)
- Страницы: 5-14
- Раздел: Научные обзоры
- URL: https://journal-vniispk.ru/2313-8726/article/view/310004
- DOI: https://doi.org/10.17816/aog630676
- ID: 310004
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Аннотация
В представленном обзоре обсуждаются вопросы этиологии, патогенеза, клинических проявлений и влияния миомы матки на репродуктивную функцию женщины. Особое внимание уделяется проблемам бесплодия, беременности и родов при наличии миомы. Отмечается, что данное заболевание может протекать бессимптомно или сопровождаться различными жалобами, такими как нарушения менструального цикла, болевой синдром и другие. Также обсуждается влияние миомы матки на возможность забеременеть, на развитие плода, на частоту осложнений беременности и родов. Влияние миомы матки на наступление и течение беременности определяется локализацией, размерами и количеством узлов. В настоящее время возраст женщин, планирующих беременность, постепенно растёт, в связи с чем увеличивается вероятность наличия у них миомы матки. Поэтому основным хирургическим направлением являются органосохраняющие операции с целью подготовки пациенток к беременности и уменьшения рисков развития осложнений. Какое именно лечение может привести к оптимальному результату, наименьшему количеству осложнений, уменьшению симптомов, на сегодняшний день окончательно не установлено, это зависит от многих факторов и требует тщательного отбора и обследования пациенток. В заключение обзора подчёркивается важность раннего выявления и предотвращения осложнений беременности при миоме матки, отмечается, что дальнейшие исследования в этой области могут помочь в разработке эффективных методов профилактики и лечения данного заболевания.
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Юлия Эдуардовна Доброхотова
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Email: pr.dobrohotova@mail.ru
ORCID iD: 0000-0002-7830-2290
SPIN-код: 2925-9948
д-р мед. наук, профессор
Россия, 117513, Москва, ул. Островитянова, д. 1/6Азнар Сааковна Хачатрян
Ереванский государственный медицинский университет
Email: aznardoc@yahoo.com
ORCID iD: 0009-0000-2767-8995
SPIN-код: 7707-5981
канд. мед. наук, доцент
Армения, ЕреванИрина Юрьевна Ильина
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Email: iliyina@mail.ru
ORCID iD: 0000-0001-8155-8775
SPIN-код: 5753-4380
д-р мед. наук, профессор кафедры
Россия, 117513, Москва, ул. Островитянова, д. 1/6Джамиля Магомедовна Ибрагимова
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Email: dgam81@mail.ru
ORCID iD: 0000-0002-8738-868X
SPIN-код: 7962-4941
канд. мед. наук, доцент
Россия, 117513, Москва, ул. Островитянова, д. 1/6Метанат Рафиговна Нариманова
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Автор, ответственный за переписку.
Email: safarovametanat@yandex.ru
ORCID iD: 0000-0003-0677-2952
SPIN-код: 2723-5711
канд. мед. наук, доцент
Россия, 117513, Москва, ул. Островитянова, д. 1/6Елена Сергеевна Платова
Российский национальный исследовательский медицинский университет им. Н.И. Пирогова
Email: lena.platova2015@yandex.ru
ORCID iD: 0009-0009-6999-4553
канд. мед. наук, доцент
Россия, 117513, Москва, ул. Островитянова, д. 1/6Ольга Игоревна Каусева
Городская клиническая больница № 1 им. Н.И. Пирогова
Email: olga.kauseva@gmail.com
ORCID iD: 0000-0002-7117-7642
SPIN-код: 5387-8115
врач ультразвуковой диагностики
Россия, МоскваСписок литературы
- Adamyan LV, Andreeva EN, Suhih GT, et al. Uterine fibroids: diagnosis, treatment and rehabilitation. Russian Journal of Human Reproduction. 2017;23(S3):466–515. EDN: XPBMBV
- Yarmolinskaya MI, Ivashchenko TE, Kusevickaya MB, Osinovskaya NS. Analysis of MMP1 gene polymorphism depending on clinical features of uterine myoma. Russian Journal of Human Reproduction. 2020;26(1):73–82. EDN: SIGNGM doi: 10.17116/repro20202601173
- Kashani BN, Centini G, Morelli SS, et al. Role of medical management for uterine leiomyomas. Best Pract Res Clin Obstet Gynaecol. 2016;34:85–103. doi: 10.1016/j.bpobgyn.2015.11.016
- Marsh EE, Al-Hendy A, Kappus D, et al. Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. J Womens Health (Larchmt). 2018;27(11):1359–1367. doi: 10.1089/jwh.2018.7076
- Yashchuk AG, Dautova LA, Tyurina AA, Imelbaeva AG. Evaluation of the results of simultaneous myomectomy and cesarean section. Creative Surgery and Oncology. 2018;8(1):45–51. EDN: RVZLFF doi: 10.24060/2076-3093-2018-8-1-45-51
- Middelkoop MA, Harmsen MJ, Manyonda I, et al. Uterine artery embolization versus surgical treatment in patients with symptomatic uterine fibroids: Protocol for a systematic review and meta-analysis of individual participant data. Eur J Obstet Gynecol Reprod Biol. 2021;256:179–183. doi: 10.1016/j.ejogrb.2020.11.027
- Akisheva AB, Ceplyaeva EYu. Features of the course and management of pregnancy and labor in patients with uterine myoma. The Sciencosphere. 2021;(6-1):12–15. EDN: XHBCIU
- Uterine fibroids. Clinical recommendations. 2020. (In Russ.)
- Buyanova SN, Shchukina NA, Chechneva MA, et al. Atypical uterine myoma in young women: diagnostics, treatment, rehabilitation. Russian Bulletin of the Obstetrician-Gynecologist. 2019;19(6):77–83. doi: 10.17116/rosakush20191906177 EDN: MGOFFK
- Melis GB, Neri M, Piras B, et al. Vilaprisan for treating uterine fibroids. Expert Opinion on Investigational Drugs. 2018;27(5):497–505. doi: 10.1080/13543784.2018.1471134
- Giuliani E, As-Sanie S, Marsh EE. Epidemiology and management of uterine fibroids. Int J Gynaecol Obstet. 2020;149(1):3–9. doi: 10.1002/ijgo.13102
- Shapovalova AI, Polyakova VO, Kleimenova TS. Age changes in the expression level of tight junctions markers in women after myomectomy. Siberian Journal of Sciences and Agriculture. 2021;13(2):32–46. doi: 10.12731/2658-6649-2021-13-2-32-46 EDN: TRKFAS
- Yashchuk AG, Musin II, Gumerova IA. Current aspects of the study of uterine myoma etiology. Russian Bulletin of the Obstetrician-Gynecologist. 2019;19(3):49–56. doi: 10.17116/rosakush20191903149 EDN: RSNMDE
- Sidorova IS, Kogan EA, Unanyan AL, et al. Clinical and morphological correlations for different types of uterine myoma growth. Russian Bulletin of the Obstetrician-Gynecologist. 2019;19(3):29–36. doi: 10.17116/rosakush20191903129 EDN: DODZKL
- Khamidullina EF, Davidyan LYu, Markevich MP. Characteristics of the first trimester of pregnancy in women with uterine fibroids. Ulyanovsk Medical and Biological Journal. 2020;(4):40–50. doi: 10.34014/2227-1848-2020-4-40-50 EDN: GLFFDI
- Bazhenova LG, Shramko SV, Sabantsev MA, Gulyaeva LF. Modern view on the pathogenesis of proliferative diseases of the uterus. Russian Bulletin of the Obstetrician-Gynecologist. 2018;18(6):31–40. doi: 10.17116/rosakush20181806131 EDN: MJFCSD
- Levakov SA, Azadova GYa, Mamedova AE, et al. A modern view on the etiopathogenesis of uterine fibroids. In: Russian Science: goals and objectives. Ekaterinburg; 2021. P. 18–23. doi: 10.18411/sr-10-08-2021-03 EDN: ESEEIW
- De La Cruz MS, Buchanan EM. Uterine fibroids: diagnosis and treatment. Am Fam Physician. 2017;95(2):100–107. EDN: YXVQXR
- Grube M, Neis F, Brucker SY, et al. Uterine Fibroids — Current Trends and Strategies. Surg Technol Int. 2019;34:257–263.
- Tiemtore-Kambou BM, Baguiya A, Lamien PD, et al. Myoma, fortuitous discovery or metrorrhagia: Which is more revealing? Pan Afr Med J. 2021;38:388. doi: 10.11604/pamj.2021.38.388.20314
- Munro MG, Critchley HOD, Fraser IS. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018;143(3):393–408. doi: 10.1002/ijgo.12666
- Jeldu M, Asres T, Arusi T, Gutulo MG. Pregnancy rate after myomectomy and associated factors among reproductive age women who had myomectomy at Saint Paul’s Hospital Millennium Medical College, Addis Ababa: retrospective cross-sectional study. International Journal of Reproductive Medicine. 2021;(2021):6680112. doi: 10.1155/2021/6680112 EDN: ZCUGSC
- Archegova ZU, SHalina RI, Kasyanova GV, et al. In vitro fertilization and embryo transfer in patients who had gone surgical treatment of uterine fibroids. Gynecology, Obstetrics and Perinatology. 2020;19(5):70–76. doi: 10.20953/1726-1678-2020-5-70-76 EDN: HUXJGQ
- El Shamy T, Amer SA, Mohamed AA, et al. The impact of uterine artery embolization on ovarian reserve: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2020;99(1):16–23. doi: 10.1111/ aogs.13698
- Podzolkova NM, Korennaya VV, Koloda YuA, et al. Functional outcomes of myomectomy. Russian Journal of Human Reproduction. 2020;26(3):31–38. doi: 10.17116/repro20202603131 EDN: IABMVL
- Kameda S, Toyoshima M, Tanaka K, et al. Utility of laparoscopic uterine myomectomy as a treatment for infertility with no obvious cause except for uterine fibroids. Gynecol Minim Invasive Ther. 2018;7(4):152–155. doi: 10.4103/GMIT.GMIT_2_18
- Kuharchik YuV, Kolesnikova TA, Cupik AV. Pregnancy and childbirth outcomes in women with uterine fibroids. In: Actual problems of medicine. Grodno; 2019. P. 334–337. (In Russ.) EDN: JCXCYH
- Ilina IYu, Dobrokhotova YuE, Burdin DV. Features of the course of pregnancy and childbirth in patients with uterine fibroids after treatment and without it. Russian Journal of Human Reproduction. 2023;29(3):61–69. doi: 10.17116/repro20232903161 EDN: XNGTBK
- Korotkih IN, Lapteva TN, Kuranosova IYu. Analysis of risk factors affecting the complicated gestation course and fate of the pregnancy among women with hysteromyoma. System Analysis and Management in Biomedical Systems. 2019;18(1):40–44. doi: 10.25987/VSTU.2019.18.1.006 EDN: PUVCKH
- Bajdujsenova AN, Vorobeva RV. Analysis of the course and outcomes of pregnancy in women with uterine fibroids. Modern Innovations. 2017;5(19):60–62. (In Russ.) EDN: YNEOWH
- Makarenko LV, Puchkov KV, Krutova VA, Kulakova RA. Opportunities of modern surgery in the treatment of uterine myoma in women of reproductive age. Modern science: actual problems of theory and practice. Series: Natural and Technical Sciences. 2018;(11):163–168. EDN: VPRGPU
- Abramova SV, Mironova IN, Kurganova OYu, et al. Clinical-epidemiological aspects of uterine fibroid (literature review). Bulletin of Science and Practice. 2018;4(4):69–74. doi: 10.5281/zenodo.1218227 EDN: UNYQPB
- Revazova ZV, Manukyan LM, Arslanyan KN, Loginova ON. Up-to-date management of preoperative treatment before laparoscopic miomectomy. Colloquium-Journal. 2019;(27-3):59–63. EDN: CSDWZY
- Dobrokhotova YuE, Ilina IYu. Uterine fibroids in premenopausal patients. Medical Council. 2019;(13):123–128. doi: 10.21518/2079-701X-2019-13-123-128 EDN: RIXHHZ
- Lethaby A, Puscasiu L, Vollenhoven B. Preoperative medical therapy before surgery for uterine fibroids. Cochrane Database of Systematic Reviews. 2017;11(11):CD000547. doi: 10.1002/14651858.CD000547.pub2
- Chaava LI, Kahiani EI, Tsygan VN, et al. Endocrine and metabolic consequences of surgical interventions in uterine myoma: pathogenetic characteristic. Pediatrician. 2019;10(2):75–82. doi: 10.17816/PED10275-82 EDN: IEQKRW
- Shcherbakova ES, Lusevich AI, Faustova YuP. Various approaches to performing hysterectomy in gynecology. Alley of Science. 2021;2(12):129–132. (In Russ.) EDN: SXBJJV
- Management of Symptomatic Uterine Leiomyomas: ACOG Practice Bulletin, Number 228. Obstet Gynecol. 2021;137(6):e100–e115. doi: 10.1097/AOG.0000000000004401
- Zaydieva YaZ, Gulieva LN. Treatment of patients with uterine myoma in the period of menopausal transition. Russian Bulletin of the Obstetrician-Gynecologist. 2020;20(1):32–38. doi: 10.17116/rosakush20202001132 EDN: RMJSNV
- Yin X, Cheng J, Ansari SH, et al. Hysteroscopic tissue removal systems for the treatment of intrauterine pathology: a systematic review and meta-analysis. Facts, Views & Vision in Obgyn. 2018;10(4):207–213.
- Gil Y, Badeghiesh A, Suarthana E, et al. Risk of uterine rupture after myomectomy by laparoscopy or laparotomy. J Gynecol Obstet Hum Reprod. 2020;49(8):101843. doi: 10.1016/j.jogoh.2020.101843
- Davydov AI, Shakhlamova MN, Pashkov VM. Uterine leiomyoma in the reproductive period. A treatment strategy. Gynecology, Obstetrics and Perinatology. 2020;19(1):143–150. doi: 10.20953/1726-1678-2020-1-143-150 EDN: CKKHBX
- Savelyeva GM, Kurtcer MA, Breslav IYu. Uterine rupture after myomectomy performed before pregnancy. Gynecology, Obstetrics and Perinatology. 2021;20(6):5–11. doi: 10.20953/1726-1678-2021-6-5-11 EDN: QSTHPB
- Hur C, Falcone T. Fertility and pregnancy outcomes following robotic-assisted laparoscopic myomectomy in a canadian cohort. J Minim Invasive Gynecol. 2022;29(1):1–2. doi: 10.1016/j.jmig.2021.11.001
- Tarabanova OV, Krutova VA, Kovalenko YaA, et al. Conservative surgery for uterine leiomyoma. Doctor.ru. 2017;(13-14):12–18. EDN: YMELXS
- Karavaev YuE, Arslanyan KN, Loginova ON. Features of the course of pregnancy and childbirth in patients with a scar on the uterus after reconstructive plastic surgery performed by different approaches. Lechaschi Vrach. 2019;(8):68–71. EDN: LHVAVE
- Popov AA, Fedorov AA, Sopova YuI, et al. The effect of hysteromyoma and myomectomy on the peristaltic activity of the myometrium and reproductive outcomes. Russian Bulletin of the Obstetrician-Gynecologist. 2020;20(3):71–77. doi: 10.17116/rosakush20202003171 EDN: VVPGKQ
- Milazzo GN, Catalano A, Badia V, et al. Myoma and myomectomy: Poor evidence concern in pregnancy. J Obstet Gynaecol Res. 2017;43(12):1789–1804. doi: 10.1111/jog.13437
- Saleh HS, Mowafy HE, Hameid AAAE, et al. Does uterine fibroid adversely affect obstetric outcome of pregnancy? Biomed Res Int. 2018;2018:8367068. doi: 10.1155/2018/8367068
- Chao AS, Chang YL, Yang LY, et al. Laparoscopic uterine surgery as a risk factor for uterine rupture during pregnancy. PLoS One. 2018;13(5):e0197307. doi: 10.1371/journal.pone.0197307
- Gambacorti-Passerini Z, Penati C, Carli A, et al. Vaginal birth after prior myomectomy. Eur J Obstet Gynecol Reprod Biol. 2018;231:198–203. doi: 10.1016/j.ejogrb.2018.10.007
- Fox NS. Pregnancy outcomes in patients with prior uterine rupture or dehiscence: a 5-year update. Obstet Gynecol. 2020;135(1):211–212. doi: 10.1097/AOG.0000000000003622
- Gimovsky AC, Frangieh M, Phillips J, et al. Perinatal outcomes of women undergoing cesarean delivery after prior myomectomy. J Matern Fetal Neonatal Med. 2020;33(13):2153–2158. doi: 10.1080/14767058.2018.1542680
- Babunashvili EL, Buyanova SN, Novikova SV, et al. Cesarean section and a myomectomy of a giant atypical uterine fibroid. Russian Bulletin of the Obstetrician-Gynecologist. 2019;19(5): 68–71. doi: 10.17116/rosakush20191905168 EDN: KQYRXX
- Timokhina EV, Gubanova EV, Silayeva TM. Pregnancy with uterine myoma and after myomectomy: results of the cohort study. V.F. Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):132–139. doi: 10.18821/2313-8726-2019-6-3-132-139 EDN: WLMITJ
- Rani P, Vishalakshi LA, Lopamudra BJ. Myomectomy in pregnancy: feasibility and safety. Int J Reprod, Contracept, Obstet Gynecol. 2017;6(10):4204–4208. doi: 10.18203/2320-1770.ijrcog20174394
- Gurinovich EA, Tsareva SN. Conservative myomectomy and pregnancy: features of the course, perinatal risk factors and their prediction. Young Scientist. 2016;(19):143–147. (In Russ.) EDN: WNECZX
- Tsareva SN, Leshkovich AS, Varigo NV. Influence of pre-preparatory preparation on the course of pregnancy and delivery in women with myoma uterus. Medical Journal. 2020;(2):115–117. EDN: RKYEJL
- Fatkullin IF, Orlov YuV, Fatkullin FI. Modern approaches to the management of pregnancy in uterine myoma. Medical Herald of the South Of Russia. 2023;14(2):44–51. doi: 10.21886/2219-8075-2023-14-2-44-51 EDN: CZZMPD
- Gardella B, Dominoni M, Iacobone AD, et al. What is the role of barbed suture in laparoscopic myomectomy? A meta-analysis and pregnancy outcome evaluation. Gynecol Obstet Invest. 2018;83(6):521–532. doi: 10.1159/000488241
- Kim M. Spontaneous complete regression of large uterine fibroid after the second vaginal delivery: Case report. Medicine (Baltimore). 2018;97(45):e13092. doi: 10.1097/MD.0000000000013092
- Delli Carpini G, Morini S, Papiccio M, et al. The association between childbirth, breastfeeding, and uterine fibroids: an observational study. Sci Rep. 2019;9(1):10117. doi: 10.1038/s41598-019-46513-0
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