UTERINE FIBROIDS IN EARLY REPRODUCTIVE AGE WOMEN: FEATURES OF MORPHOLOGY, HORMONAL STATUS AND REHABILITATION
The object of the study: Uterine fibroids (UF) in women of early reproductive age.
The problem to be solved: Improving the effectiveness of postoperative rehabilitation in women of early reproductive age with uterine fibroids based on the study of its morphological features and improvement of rehabilitation measures.
The main scientific results: It was found that in women of early reproductive age with UF the most common complaints are posthemorrhagic anemia (61.0 %, or 61 women). Regarding the menstrual cycle, the most common dysmenorrhea – 26.0 % (in 26 women). The importance of heredity in the development of such pathology in young women (32.0 %, or 32 women) was confirmed. The most common localization of fibroids is interstitial – 79.0 % (in 79 women).
Morphological study found that women of early reproductive age most often have a simple UF, namely 96 % (96 women). Uterine leiomyoma was present in 56 % (56 women).
A study of the hormonal status of women of early reproductive age found that the mean values of hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol, progesterone, prolactin and testosterone were higher before surgery than after. When comparing rehabilitation methods (combined oral contraceptives (COCs) or gonadotropin-releasing hormone agonists (GnRH agonists), it was found that postoperative rehabilitation by using COCs for 6-12 months provides significantly better indicators of recovery of hormonal status, indicating the effectiveness of rehabilitation method.
Scope of practical application of research results: Practical medicine specializing in the diagnosis, treatment and prevention of recurrence of uterine fibroids.
Innovative technological product: Improved algorithm of postoperative rehabilitation measures by applying COC for 6-12 months after myomectomy, which provides significantly better results in restoring hormonal status during rehabilitation.
Scope of application of innovative technological product: clinical medical practice related to the diagnosis, treatment and prevention of recurrence of uterine fibroids.
Vilos, G. A., Allaire, C., Laberge, P.-Y., Leyland, N., Vilos, A. G., Murji, A., Chen, I. (2015). The Management of Uterine Leiomyomas. Journal of Obstetrics and Gynaecology Canada, 37 (2), 157–178. doi: http://doi.org/10.1016/s1701-2163(15)30338-8
Bulun, S. E. (2013). Uterine Fibroids. New England Journal of Medicine, 369 (14), 1344–1355. doi: http://doi.org/10.1056/nejmra1209993
Doherty, L., Mutlu, L., Sinclair, D., Taylor, H. (2014). Uterine fibroids: clinical manifestations and contemporary management. Reproductive sciences, 21 (9), 1067–1092. doi: http://doi.org/10.1177/1933719114533728
Zepiridis, L. I., Grimbizis, G. F., Tarlatzis, B. C. (2016). Infertility and uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology, 34, 66–73. doi: http://doi.org/10.1016/j.bpobgyn.2015.12.001
Stewart, E., Cookson, C., Gandolfo, R., Schulze-Rath, R. (2017). Epidemiology of uterine fibroids: a systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 124 (10), 1501–1512. doi: http://doi.org/10.1111/1471-0528.14640
Reis, F. M., Bloise, E., Ortiga-Carvalho, T. M. (2016). Hormones and pathogenesis of uterine fibroids. Best Practice & Research Clinical Obstetrics & Gynaecology, 34, 13–24. doi: http://doi.org/10.1016/j.bpobgyn.2015.11.015
Commandeur, A. E., Styer, A. K., Teixeira, J. M. (2015). Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and growth. Human Reproduction Update, 21 (5), 593–615. doi: http://doi.org/10.1093/humupd/dmv030
Bahrii, M. M., Dibrova, V. A., Hryshchuk, M. I. (2016). Metodyky morfolohichnykh doslidzhen. Vinnytsia: Nova knyha, 328.
Bober, G. S. (2020). Profilaktyka retsydyviv u zhinok rannoho reproduktyvnoho viku z miomoiu matky. Reproductive health of woman, 3, 18–20.
Rusanovskii, V. V., Blokh, M. E., ZHeleznov, I. A., Udodova, I. N., Rusanovskii, G. V. (2012). Psikhologicheskie osobennosti zhenschin s endometriozom i miomoi matki. Vestnik Orlovskogo gosudarstvennogo universiteta. Seriia: Novye gumanitarnye issledovaniia, 3, 131–135.
Whynott, R., Vaught, K., Segars, J. (2017). The Effect of Uterine Fibroids on Infertility: A Systematic Review. Seminars in Reproductive Medicine, 35 (6), 523–532. doi: http://doi.org/10.1055/s-0037-1607295
McWilliams, M., Chennathukuzhi, V. (2017). Recent Advances in Uterine Fibroid Etiology. Seminars in Reproductive Medicine, 35 (2), 181–189. doi: http://doi.org/10.1055/s-0037-1599090
Rice, K. E., Secrist, J. R., Woodrow, E. L., Hallock, L. M., Neal, J. L. (2012). Etiology, Diagnosis, and Management of Uterine Leiomyomas. Journal of Midwifery & Women’s Health, 57 (3), 241–247. doi: http://doi.org/10.1111/j.1542-2011.2012.00176.x
Goetsch, A. L., Kimelman, D., Woodruff, T. K. (2017). Uterine Fibroids. Fertility Preservation and Restoration for Patients with Complex Medical Conditions, 227–230. doi: http://doi.org/10.1007/978-3-319-52316-3_13
Välimäki, N., Kuisma, H., Pasanen, A., Heikinheimo, O., Sjöberg, J., Bützow, R. et. al. (2018). Genetic predisposition to uterine leiomyoma is determined by loci for genitourinary development and genome stability. eLife, 7. doi: http://doi.org/10.7554/elife.37110
Karlsen, K., Mogensen, O., Humaidana, P., Kesmodel, U. S., Ravn, P. (2019). Uterine fibroids increase time to pregnancy: a cohort study. The European Journal of Contraception Reproductive Health Care, 25 (1), 37–42. doi: http://doi.org/10.1080/13625187.2019.1699047
Dolmans, M., Donnez, J., Fellah, L. (2019). Uterine fibroid management: Today and tomorrow. Journal of Obstetrics and Gynaecology Research, 45 (7), 1222–1229. doi: http://doi.org/10.1111/jog.14002
De La Cruz, M. S. D., Buchanan, E. M. (2017). Uterine fibroids: diagnosis and treatment. American family physician, 95 (2), 100–107.
Sohn, G. S., Cho, S., Kim, Y. M., Cho, C.-H., Kim, M.-R., Lee, S. R. (2018). Current medical treatment of uterine fibroids. Obstetrics & Gynecology Science, 61 (2), 192–201. doi: http://doi.org/10.5468/ogs.2018.61.2.192
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