Pregnancy and childbirth in women with multiple uterine fibroids
Tyurina N.A., Viryasova A.A., Otochina N.A., Kuznetsova A.A., Chepoy M.O., Toporkova V.R.
Multiple uterine fibroids (MUFs) are benign hormone-dependent neoplasms with two or more myomatous nodes that affect all stages of the reproductive process. The article presents the analysis of literature data and aims at studying the clinical aspects of complications during the gestational period, delivery and postpartum course in women with MUFs. This pathology has been found to be associated with an increased risk of gestational complications, including spontaneous miscarriage, preterm labor and placental dysfunction. The labor process in patients with MUFs is often complicated by poor uterine contractility and the need for operative delivery. In the postpartum period, uterine hypotonia or atony, massive hemorrhage, infectious and inflammatory complications as well as delayed recovery processes are observed. The article discusses the various factors that determine the prognosis for both mother and child. These factors include the size, localization and number of myomatous nodes. It is evident that personalized approach to the management of patients diagnosed with MUFs is necessary. The paper discusses the association of MUFs with a high incidence of caesarean section due to anatomical changes in the uterus and poor contractility of the myometrium. Infectious and inflammatory complications requiring antibiotic therapy and intensive monitoring are described. It is necessary to conduct further studies in order to identify risk factors and develop clinical guidelines for improving perinatal outcomes in female patients.
Conclusion: The reproductive process in women with MUFs is characterized by an increased risk of complications affecting the gestational, intrapartum and postnatal periods. The patients with this pathology are more likely to have preterm labor, placental dysfunction and other gestational complications, which require careful monitoring during the whole gestational period. Labor in women with MUFs is often accompanied by the need for operative delivery, especially in case of large or low-lying nodes. The postpartum period is characterized by an increased risk of uterine hypotonia, massive hemorrhage and infectious and inflammatory complications that require an individualized approach to monitoring and therapy.
Authors’ contributions: Tyurina N.A., Viryasova A.A. – developing the concept and design of the study; Otochina N.A., Kuznetsova A.A., Chepoy M.O., Toporkova V.R. – collecting and processing the material; Viryasova A.A., Otochina N.A., Kuznetsova A.A. – writing the text; Tyurina N.A., Viryasova A.A., Chepoy M.O. – editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Tyurina N.A., Viryasova A.A., Otochina N.A., Kuznetsova A.A., Chepoy M.O., Toporkova V.R.
Pregnancy and childbirth in women with multiple uterine fibroids.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (4): 158-163 (in Russian)
https://dx.doi.org/10.18565/aig.2024.312
Keywords
References
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Received 05.12.2024
Accepted 24.03.2025
About the Authors
Natalуa A. Tyurina, PhD, Associate Professor at the Department of Obstetrics and Gynecology named after Prof. A.P. Marusov, Ogarev National Research Mordovia State University, 430005, Russia, Saransk, Bolshevistskaya str., 68, natali.belle@rambler.ru, https://orcid.org/0000-0001-5933-4089Anastasia A. Viryasova, specialist degree, Ogarev National Research Mordovia State University, 430005, Russia, Saransk, Bolshevistskaya str., 68,
nastia.pankova2015@yandex.ru, https://orcid.org/0000-0002-3228-3880
Natalya A. Otochina, specialist degree, Ogarev National Research Mordovia State University, 430005, Russia, Saransk, Bolshevistskaya str., 68, otochina.nata@yandex.ru, https://orcid.org/0009-0000-5575-7201
Anastasia A. Kuznetsova, specialist degree, Ogarev National Research Mordovia State University, 430005, Russia, Saransk, Bolshevistskaya str., 68, nastuqsha2003@bk.ru, https://orcid.org/0009-0007-9140-3831
Mihail O. Chepoy, specialist degree, Ogarev National Research Mordovia State University, 430005, Russia, Saransk, Bolshevistskaya str., 68, misha.chepoy@icloud.com,
https://orcid.org/0000-0002-7323-20
Valeria R. Toporkova, specialist degree, Ogarev National Research Mordovia State University, 430005, Russia, Saransk, Bolshevistskaya str., 68, lera.udarova@mail.ru,
https://orcid.org/0009-0003-5579-977X
Corresponding author: Natalуa A. Tyurina, natali.belle@rambler.ru