Management of uterine fibroids and its complications during pregnancy

Abstract

Introduction. Uterine fibroids are a very common finding in women of reproductive age. The major complication of myomas in pregnancy is recurrent pain, however, miscarriage is the main threat. The negative impact of fibroids on the course of pregnancy may also result in uterine bleeding, preterm labor, placenta abruption, cesarean delivery, higher incidence of maternal-fetal incommunicability, an incorrect position of the fetus and its deformities. Aim of study. Studying the evolution of uterine fibroids in pregnancy to highlight the most common complications. Analyzing the screening, diagnosis, and treatment criteria to reveal their effect on maternal and neonatal outcomes. Methods and materials. A systematic review of the literature was performed, using the databases PubMed, Google Scholar, Hinari, and NCBI, to identify relevant articles, concerning " uterine fibroids", " pregnancy", and "complications". This review represents an analysis of actual information on the publication from the last 5 years. Results. Several studies have shown that women with uterine fibroids have a higher risk of imminent premature labor, premature rupture of the amniotic membranes, insufficient contraction forces, and hypotonic hemorrhage. Most authors point out that uterine fibroids favor primary or secondary insufficiency of the birth activity. The complicated evolution of pregnancy and birth determines the high frequency of surgical interventions and obstetric procedures in pregnant women with uterine fibroids. Among the indications for cesarean section, uterine fibroids constitute about 0.4 - 0.8%. If the fibroids are small, birth can occur naturally, but if the fibroids are large and have a topography that affects the mechanism of birth, then a cesarean section is required. At the same time, cesarean section in the presence of uterine myoma can be completed by expanding the volume of the intervention (myomectomy, hysterectomy). Conclusion. Analyzing the selected publications, we concluded that observational studies have shown that uterine fibroids in pregnancy may be associated with complications affecting the course of pregnancy and labor. So, pregnancy must be cautiously monitored in the antenatal period, through regular follow-up. major complication of myomas in pregnancy is recurrent pa in, however, miscarriage is the main threat. The negative impact of fibroids on the course of pregnancy may also result in uterine bleeding, preterm labor, placenta abruption, cesarean deliver y, higher incidence of maternal-fetal incommunicability, an incorrect position of the fetus and its deformities. Aim of study. Studying the evolution of uterine fibroids in pregnancy to highlight the most common complications. Analyzing the screening, diagnosis, a nd treatment criteria to reveal their effect on maternal and neonatal outcomes. Methods and materials. A systematic review of the literature was performed, usin g the databases PubMed, Google Scholar, Hinari, and NCBI, to identify relevan t articles, concerning " uterine fibroids", " pregnancy", and "complications". This revi ew represents an analysis of actual information on the publication from the last 5 years. Results. Several studies have shown that women with uterine fibro ids have a higher risk of imminent premature labor, premature rupture of the amnioti c membranes, insufficient contraction forces, and hypotonic hemorrhage. Most authors point out th at uterine fibroids favor primary or secondary insufficiency of the birth activity. The compli cated evolution of pregnancy and birth determines the high frequency of surgical interventions an d obstetric procedures in pregnant women with uterine fibroids. Among the indications for cesarean section, uterine fibroids constitute about 0.4 - 0.8%. If the fibroids are small, bi rth can occur naturally, but if the fibroids are large and have a topography that affects the mechanism of birth, then a cesarean section is required. At the same time, cesarean section in the pre sence of uterine myoma can be completed by expanding the volume of the intervention (myomectomy, hysterectomy). Conclusion. Analyzing the selected publications, we concluded that observa tional studies have shown that uterine fibroids in pregnancy may be assoc iated with complications affecting the course of pregnancy and labor. So, pregnancy must be cautiously mo nitored in the antenatal period, through regular follow-up.