Myomectomy during pregnancy
Background: The incidence of uterine fibroids in reproductive-aged women is 70%. At the same time, every year there is an increase in the incidence of uterine fibroids in women younger than 30 years, and, accordingly, an increasing number of pregnant women with uterine fibroids. In most cases, uterine fibroids during pregnancy are asymptomatic. Clinical cases that require surgical treatment during pregnancy deserve attention. These are generally complications due to the large size of the node(s), necrosis of the node, torsion of the nodal pedicle, and development of peritoneal symptoms.Bushtyreva I.O., Kuznetsova N.B., Doroshenko T.A., Voronova O.V., Barinova V.V.
Case report: The paper describes a clinical case of myomectomy surgery at the Clinic of Professor Bushtyreva LLC for large uterine fibroids complicated by pain syndrome at 16 weeks’ gestation, which made it possible to prolong pregnancy to full term and to give birth to a healthy baby weighing 2700 g.
Conclusion: Pregnancy management in the presence of uterine fibroids needs a personalized approach, is an important and difficult stage that requires the unity of the specialty of obstetrics and gynecology. The myoma nodules that pose a real threat to the successful prolongation of pregnancy are to be surgically treated. These pregnant women should be followed up in the facilities where organ-sparing surgery can be performed with subsequent pregnancy prolongation.
Keywords
uterine fibroids
pregnancy
myomectomy
References
- Коротких И.Н., Бельских О.Л., Лаптева Т.Н. Миомэктомия во время беременности. Системный анализ и управление в биомедицинских системах. 2019; 18(1): 89-93. [Korotkikh I.N., Belskikh O.L., Lapteva T.N. Myomectomy during pregnancy. Systems analysis and management in biomedical systems. 2019; 18 (1): 89-93. (in Russian)]. https://dx.doi.org/10.25987/VSTU.2019.18.1.015.
- Буянова С.Н., Юдина Н.В., Гукасян С.А., Ермолаева Е.Е. Показания к миомэктомии во время беременности и ее исходы. Акушерство и гинекология. 2019; 6: 70-7. [Buyanova S.N., Yudina N.V., Gukasyan S.A., Ermolaeva E.E. Indications for myomectomy during pregnancy and its outcomes. Obsterics and Gynecology. 2019; 6: 70-7. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.6.70-77.
- Зиганшин А.М., Кулаковский В.А., Латыпова Р.Р. Случай успешной консервативной миомэктомии больших размеров во время беременности. Практическая медицина. 2017; 7: 170-2. [Ziganshin A.M., Kulakovsky V.A., Latypova R.R. A case of successful conservative large myomectomy during pregnancy. Practical medicine. 2017; 7: 170-2. (in Russian)].
- Гутикова Л.В., Кухарчик Ю.В. Миома матки больших размеров: тактика ведения на этапе прегравидарной подготовки, вынашивания беременности и родоразрешения. РМЖ. Мать и дитя. 2020; 3(2): 83-7. [Gutikova L.V., Kukharchik Yu.V. Large uterine fibroids: management tactics at the stage of pregravid preparation, gestation and delivery. Breast cancer. Mother and Child. 2020; 3(2): 83-7. (in Russian)]. https://dx.doi.org/10.32364/2618-8430-2020-3-2-83-87.
- Алтухова О.Б., Радзинский В.Е., Полякова И.С., Чурносов М.И. Вовлеченность полиморфизма генов рецепторов эстрогенов и прогестерона в развитие миомы матки. Акушерство и гинекология. 2020; 3: 127-32. [Altukhova O.B., Radzinsky V.E., Polyakova I.S., Churnosov M.I. The involvement of estrogen and progesterone receptor gene polymorphism in the development of uterine fibroids. Obstetrics and Gynecology. 2020; 3: 127-32. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.3.127-132.
- Адамян Л.В., Буянова С.Н., Краснова И.А. Беременность и миома матки. В кн.: Савельева Г.М., Сухих Г.Т., Серов В.Н., Радзинский В.Е., ред. Акушерство: Национальное руководство. М.: МЕДпресс-информ; 2015: 660-7. [Adamyan L.V., Buyanova S.N. Krasnova I.A. Pregnancy and uterine fibroids. In: Savelyeva G.M., Sukhikh G.T., Serov V.N., Radzinsky V.E. Obsterics: National Guide. M.: MEDpress-inform; 2015: 660-7. (in Russian)].
- Буянова С.Н., Бабунашвили Е.Л., Гукасян С.А. Гигантская интралигаментарная миома матки и беременность. РМЖ. Мать и дитя. 2015; 1: 53-4. [Buyanova S.N., Babunashvili E.L., Gukasyan S.A. Giant intraligamentary uterine fibroids and pregnancy. Breast cancer. Mother and Child. 2015; 1: 53-4. (in Russian)].
- Козаченко А.В., Буянова С.Н., Краснова И.А. Беременность и миома матки. Акушерство и гинекология: новости, мнения, обучение. 2015. 2: 61-5. [Kozachenko A.V., Buyanova S.N., Krasnova I.A. Pregnancy and uterine fibroids. Obstetrics and Gynecology: News, Opinions, Training. 2015; 2: 61-5. (in Russian)].
- Атаянц К.М., Курманбаев Т.Е., Тимошкова Ю.Л., Шмидт А.А., Кубасов М.В., Куженьязов А.А. Клинико-морфологические особенности миомы матки у пациенток репродуктивного. Медицинский вестник Башкортостана. 2021; 16(1): 16-20. [Atayants K.M., Kurmanbaev T.E., Timoshkova Yu.L., Schmidt A.A., Kubasov M.V., Kuzhenyazov A.A. Clinical and morphological features of uterine fibroids in patients of reproductive age. Medical Bulletin of Bashkortostan. 2021; 16(1): 16-20. (in Russian)].
- Российское общество акушеров-гинекологов. Миома матки: диагностика, лечение и реабилитация. Клинические рекомендации (протокол лечения). 2015. [Russian Society of Obstetricians and Gynecologists. Uterine fibroids: Uterine fibroids: diagnosis, treatment and rehabilitation. Clinical guidelines. 2015. (in Russian)].
- Хамидуллина Э.Ф., Давидян Л.Ю., Маркевич М.П. Особенности течения первого триместра беременности у женщин с миомой матки. Ульяновский медико-биологический журнал. 2020; 4: 40-50. [Khamidullina E.F., Davidyan L.Yu., Markevich M.P. Characteristics of the first trimester of pregnancy in women with uterine fibroids. Ulyanovsk medical and biological journal. 2020; 4: 40-50. (in Russian)]. https://dx.doi.org/10.34014/2227-1848-2020-4-40-50.
- Egbe T.O., Badjang T.G., Tchounzou R., Egbe E.N., Ngowe M.N. Uterine fibroids in pregnancy: prevalence, clinical presentation, associated factors and outcomes at the Limbe and Buea Regional Hospitals, Cameroon: a cross-sectional study. BMC Res. Notes. 2018; 11(1): 889. https://dx.doi.org/10.1186/s13104-018-4007-0.
- Гутикова Л.В., Кеда Л.Н., Гурин А.Л., Кухарчик Ю.В. Ведение беременности и родоразрешение женщины с множественной миомой матки после лапароскопической и лапаротомной миомэктомий в анамнезе (клиническое наблюдение). Акушерство и гинекология Санкт-Петербурга. 2018; (3-4): 25-8. [L.V. Gutikova, L.N. Keda, A.L. Gurin, Yu.V. Kukharchik. Pregnancy management and delivery of a woman with multiple uterine myoma after laparoscopic and laparotomic myomectomy in history (clinical observation). Obstetrics and Gynecology of St. Petersburg. 2018; (3-4): 25-8. (in Russian)].
- Chill H.H., Karavani G., Rachmani T., Dior U., Tadmor O., Shushan A. Growth pattern of uterine leiomyoma along pregnancy. BMC Womens Health. 2019; 19(1): 100. https://dx.doi.org/10.1186/s12905-019-0803-5.
- Буянова С.Н., Бабунашвили Е.Л., Логутова Л.С., Щукина Н.А., Юдина Н.В., Гукасян С.А., Кащук М.Г., Ермолаева Е.Е., Ахвледиани К.Н., Магилевская Е.В., Стоцкая Т.В. Взгляд на проблему миомэктомии при беременности и во время кесарева сечения. Акушерство и гинекология. 2020; 8: 22-8. [Buyanova S.N., Babunashvili E.L., Logutova L.S., Shchukina N.A., Yudina N.V., Gukasyan S.A., Kashchuk M.G., Ermolaeva E.E., Akhvlediani K.N., Magilevskaya E.V., Stotskaya T.V. A look at the problem of myomectomy during pregnancy and during cesarean section. Obstetrics and Gynecology. 2020; 8: 22-8. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.8.22-28.
- Lee H.J., Norwitz E.R., Shaw J. Contemporary management of fibroids in pregnancy. Rev. Obstet. Gynecol. 2010; 3(1): 20-7.
- Министерство здравоохранения Российской Федерации. Клинические рекомендации «Миома матки». Российское общество акушеров-гинекологов (РОАГ); 2020. [Russian Society of Obstetricians and Gynecologists. Clinical guidelines "Uterine fibroids". 2020. (in Russian)].
- Баринов С.В., Шамина И.В., Тирская Ю.И., Лазарева О.В., Дудкова Г.В., Фрикель Е.А., Ледовских И.О., Шишкина М.И., Стоцкая Т.А. Опыт ведения беременных с миомой матки больших размеров. Фундаментальная и клиническая медицина. 2018; 3(2): 34-41. [Barinov S.V., Shamina I.V., Tirskaya Y.I., Lazareva O.V., Dudkova G.V., Frikel E.A., Ledovskikh I.O., Shishkina M.I., Stotskaya T.A. Experience in the management of pregnant women with large uterine fibroids. Fundamental and clinical medicine. 2018; 3(2): 34-41. (in Russian)]. https://dx.doi.org/10.23946/2500-0764-2018-3-2-34-41.
- Миннуллина Ф.Ф., Мухаметзянова Л.М., Ахметшина Л.Р. Консервативная миомэктомия во время беременности. Norweg. J. Dev. Int. Sci. 2021; 58: 27-31. [Minnullina F., Mukhametzyanova L., Akhmetshina L. Myomectomy in pregnancy. Norweg. J. Dev. Int. Sci. 2021; (58): 27-31 (in Russian)].
Received 31.08.2021
Accepted 29.12.2021
About the Authors
Irina O. Bushtyreva, Dr. Med. Sci., Professor, Director of the Clinic of Professor Bushtyreva, +7(928)296-15-97, kio4@mail.ru,344011, Russia, Rostov-on-Don, Sobornyi str., 58/7.
Natalya B. Kuznetsova, Dr. Med. Sci., Professor at the Center for Simulation Training, RostSMU, Ministry of Health of Russia; Chief Physician, Clinic of Professor Bushtyreva, +7(928)770-97-62, lauranb@inbox.ru, https://orcid.org/0000-0002-0342-8745, 344022, Russia, Rostov-on-Don, Nakichevanskiy str., 29;
344011, Russia, Rostov-on-Don, Sobornyi str., 58/7.
Tatiana A. Doroshenko, obstetrician-gynekologist, Clinic of Professor Bushtyreva, +7(988)896-50-27, tanya.doroshenko.94@bk.ru,
https://orcid.org/0000-0002-2931-4455, 344011, Russia, Rostov-on-Don, Sobornyi str., 58/7.
Olga V. Voronova, Head of Laboratory, Clinical hospital “RZD medicine” in Rostov-on-Don, 344011, Russia, Rostov-on-Don, Varfolomeeva str., 82a.
Viktoriya V. Barinova, Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology No. 1, RostSMU, Ministry of Health of Russia, +7(928)909-55-68,
victoria-barinova@yandex.ru, https://orcid.org/0000-0002-8584-7096, 344022, Russia, Rostov-on-Don, Nakhichevanskiy str., 29.
Authors’ contributions: Bushtyreva I.O., Kuznetsova N.B. – concept and design of the investigation; Kuznetsova N.B., Voronova O.V., Doroshenko T.A., Barinova V.V. – material collection and processing, writing the text; Kuznetsova N.B., Doroshenko T.A. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: There is no funding for this investigation.
Ethical approval: The study was reviewed and approved by the Research Ethics Committee of the Rostov State Medical University, Ministry of Health of Russia.
Patients’ Consent for Publication: The patient provided informed consent for the publication of her data.
For citation: Bushtyreva I.O., Kuznetsova N.B., Doroshenko T.A.,
Voronova O.V., Barinova V.V. Myomectomy during pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 2: 125-32 (in Russian)
https://dx.doi.org/10.18565/aig.2022.2.125-132
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