Courses of pregnancy in women witha uterine scar after conservative myomectomy

Abstract

Introduction. Uterine fibroids are the most common disease of the female reproductive system. If indicated, the main organpreserving method of treatment is myomectomy. However, according to many researchers, women who have undergone conservative myomectomy are at a higher risk of developing complications during pregnancy such as placenta previa, placental disorders, and uterine scar failure.Aim. To identify the features of the course of pregnancy, childbirth and perinatal outcome in women with a uterine scar after conservative myomectomy who received pregravid preparation.Materials and methods. A retrospective study included an analysis of 159 outpatient histories of women planning pregnancy after conservative myomectomy, including the birth histories of 109 pregnant women aged 29–40 years who delivered at the Perinatal Center of the Regional Clinical Hospital in Khanty-Mansiysk from 2011 to 2021 in order to study the characteristics of the course of pregnancy in women with a scar on the uterus after conservative myomectomy.Results. When analyzing the data, the following statistically significant differences between the groups were revealed: the first trimester of pregnancy in women with a uterine scar compared with the control group was more often complicated by chorion presentation, threatened miscarriage, urinary tract infection and early toxicosis (p < 0.05); in the second trimester of pregnancy in group 1, there were more often threatening preterm labor and placental disorders (p < 0.05), the majority of women with a scar on the uterus after myomectomy (77.8%) were delivered by caesarean section, in contrast to the control group (9.7%) (p < 0.05).Conclusion. The data we obtained on the course of pregnancy, childbirth and perinatal outcomes after myomectomy reflected the need and effectiveness of preconception preparation in this contingent of women.