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Page 46
Volume 08
June 28-29, 2019 | Oslo, Norway
Joint Event
Journal of Medical and Health Sciences | ISSN : 2319-
Breast Pathology and Cancer, Gynecology and Obstetrics Pathology, Palliativecare and Gerontology 2019
Breast Pathology & Cancer
Palliativecare & Gerontology
Gynecology and Obstetrics Pathology
Belkina N N et al., RRJMHS 2019, Volume 08
Successful myomectomy of giant uterine myoma at 15-16 weeks of
pregnancy and prolonged primary infertility
U
terine fibroids are the most common types of benign tumor of the female
reproductive system. The incidence of uterine myoma diseases according to
various authors is from 15 to 50%. In 15-17% of women, uterine fibroids occur at
the age of 30 years and older. The average age to reveal uterine fibroids is 32 years.
Despite the active arrangement of medical examinations, there are patients with
uterine myoma of large and sometimes gigantic size combined with pregnancy.
Also it is known that at presence of pregnancy the nodes of fibroids can grow,
reaching a large and gigantic size and leading to the disruption of adjacent
vital organs. As a rule, at presence of large uterine fibroids, the development of
pregnancy is very problematic and it finishes with its termination. According to
the data of FGU NCAAAP named after academician V.I. Kulakov, all surgical
interventions in gynecology performed for uterine fibroids in 60.9-95.5% are of a
radical nature. However, the experience of our clinic has shown that not only the
preservation of the uterus, but also further gestation of the full-term pregnancy
and following delivery is possible. An example of such a case is the story of the
patient L. A 32-year-old patient suffering from primary infertility was admitted
to the gynecological department urgently with complaints of genital tract
bleeding, weakness, dizziness. She presented some uterine fibroids of gigantic
size and severe iron deficiency anemia (HB-39g/L). According to the uterus USI
results, a pregnancy of five to six weeks was diagnosed against the background
of interstitial uterine fibroids of 13-14cm in size. Given the long-term infertility,
the patient refused to terminate the pregnancy, conducted antianemic and
preserving therapy. At 15-16 weeks, the patient's condition worsened; there were
complaints about dysfunction of adjacent organs, frequent urination, pain in the
iliac areas, the impossibility of a long stay in an upright position. According to the
ultrasound study, the growth of the myoma node is up to 20cm. An emergency
treatment was performed: A laparotomy myomectomy of a giant interstitial
myoma (myoma weight-2kg) during pregnancy 15-16 weeks without opening the
cavity with preservation of the fetus, using blood-saving technologies. At 37-38
weeks, planned delivery was by cesarean section. A live, full-term girl was taken
out (weight-2800gr, height-48cm). Thus, patients with uterine myoma should
be thoroughly carried out with pregravid preparation and, if necessary, undergo
indications myomectomy at the planning stage of pregnancy. During pregnancy,
myomectomy should be performed by a highly skilled surgical team with the
obligatory observance of surgical rules and the use of modern blood-saving
technologies.
Biography
Natalya Belkina, born in 1978, graduated from the Military Medical Institute of the Federal
Border Troops of the Russian Federation at the Nizhny Novgorod Medical Academy.
jaznn@mail.ruNatalya Belkina
GBUZ NO “Dzerzhinsky
Perinatal Center”, Russia
Co-Authors
Ryzhova N K
1
, Rodin N V
2
and Pasina
O B
2
1
GBUZ NO “Dzerzhinsky Perinatal Center”,
Russia
2
NUZ "Railway Clinical Hospital", Russia