Uterine fibroids are the most common benign tumor that occurs in 20–40% of women of reproductive age. The rate of growth of fibroids is determined by hormonal profile of women, especially estrogen, progesterone, prolactin, growth factors that have an impact on tumor volume in the preoperative phase through the appointment agonists releasing hormones. The aim of study was to evaluate the dynamics of growth of myoma nodes on pre-gravid stage of formation models with predicting their growth according to clinical monitoring data.
Material and methods. The research was conducted at the Regional Perinatal Center (Odessa, Ukraine). There were analyzed 565 stories of women giving birth, matched birth within 3 2010 to 2016 and had verified uterine fibroids at the pre-gravid stage. There were valuated the results of ultrasound examination performed during pregnancy and before. Statistical analysis was performed using regression and multivariate analysis using software Statistics 10.0 (Deii StatSoft Inc., USA).
Results. According to a retrospective analysis the average age of women was (33.4±1.4) years. Number of myoma nodes was averaged at (2.2±0.2). The average size of units comprised (6.3±0.2)´(4.2±0.1)´(4.4±0.1) mm, which corresponds to the average volume of (0.49±0.02) cm3. Only 112 (19.8%) women in the documentation were indications of prior clinical and research tools that are allowed to determine the size and scope of fibroids dynamics. It was found that the most women had fibroids with geometric dimensions which were unchanged (D<10.0%), but 49 (8.7%) has experienced the increase of myoma nodes by (28.6±1.3)%. As for the frequency of complications of pregnancy and childbirth, the retrospective analysis of medical records showed that 499 (88.3%) occurred during the first trimester threatened miscarriage. Other frequent complications were malposition — 124 (21.9%), placenta dysfunction (337 or 59.6%), anemia (89 or 15.7%), preeclampsia (7.8%), intrauterine syndrome of fetal development retardation (10.3%). In 13.6% cases they experienced childbirth prenatal rupture of membranes, at 7.2% — the weakness of labor. Much of the women delivered per via naturaies (75.2%), and in some cases, a cesarean section was applicated combined with conservative myoectomy (9.6%), supracervical hysterectomy without appendages (6.2%) and one of the appendages (2.3%). In the developed prognostic model we took into the account data on the hormonal profile of women, disease duration, presence of previous pregnancies, ultrasound data, including doplerometric characteristics. The correctness of the model prognosis was 88.1%. This allows to recommend it for clinical needs.