3 research outputs found
ΠΠ¦ΠΠΠΠ Π ΠΠΠ£ΠΠ¬Π’ΠΠ’ΠΠ ΠΠΠΠΠΠΠΠΠΠ’ΠΠΠ ΠΠΠΠΠΠΠ’ΠΠΠΠ ΠΠ Π ΠΠΠ‘ΠΠ ΠΠΠΠ Π‘ΠΠ§ΠΠΠΠ
Introduction. Myoma of the uterus is the most common neoplasm of the female reproductive system. The frequency of combination of uterine fibroids and pregnancy varies from 1.6% to 10.7%, often fibroids occur in pregnant women of late reproductive age. Traditionally, myomectomy during caesarean section was not recommended because of the risk of bleeding and postoperative complications. To assess the safety and feasibility of a one-stage myomectomy in a caesarean section, this study was conducted.Materials and methods. From 2010 to 2015, we examined 260 pregnant women with uterine myoma, who had a cesarean section with a single-stage myomectomy. The data obtained during the survey were compared with the data of 96Β women from the control group. We study assessment of intraoperative blood loss, pre- and postoperative hemoglobin levels, duration of hospitalization.Results. Statistically significant differences in intraoperative blood loss, changes in hemoglobin levels and in the duration of hospitalization between the examined groups of women were not revealed. A prognostic model has been developed to assess risk factors for intraoperative blood loss of more than 1000 ml.Conclusion. The size, localization of myomatous nodes are not risk factors for high blood loss in abdominal delivery with a one-stage myomectomy. The factor of risk of hemorrhage is multiple uterine fibroids, whereas the size of myomatous nodes less than 5 cm can be regarded as a protective factor for blood loss. The study showed that a one-stage myomectomy with a caesarean section is safe and can be performed with the surgeonβs experience.Β ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. ΠΠΈΠΎΠΌΠ° ΠΌΠ°ΡΠΊΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠ°ΡΡΠΎ Π²ΡΡΡΠ΅ΡΠ°ΡΡΠΈΠΌΡΡ Π½ΠΎΠ²ΠΎΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΠΆΠ΅Π½ΡΠΊΠΎΠΉ ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ. ΠΡΠΈΠΌΠ΅ΡΠ½ΠΎ Ρ 25% ΠΆΠ΅Π½ΡΠΈΠ½ ΠΌΠΈΠΎΠΌΠ° ΠΌΠ°ΡΠΊΠΈ ΠΏΡΠΎΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠ°ΡΠΈΡΠ΅ΡΠΊΠΈ. Π§Π°ΡΡΠΎΡΠ° ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΡ ΠΌΠΈΠΎΠΌΡ ΠΌΠ°ΡΠΊΠΈ ΠΈ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΠΎΡΡΠΈ Π²Π°ΡΡΠΈΡΡΠ΅Ρ ΠΎΡ 1,6 Π΄ΠΎ 10,7%, ΠΏΡΠΈΡΠ΅ΠΌ ΡΠ°ΡΠ΅ ΠΌΠΈΠΎΠΌΠ° Π²ΡΡΡΠ΅ΡΠ°Π΅ΡΡΡ Ρ Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
ΠΏΠΎΠ·Π΄Π½Π΅Π³ΠΎ ΡΠ΅ΠΏΡΠΎΠ΄ΡΠΊΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΎΠ·ΡΠ°ΡΡΠ°. Π’ΡΠ°Π΄ΠΈΡΠΈΠΎΠ½Π½ΠΎ ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΡ Π²ΠΎ Π²ΡΠ΅ΠΌΡ ΠΊΠ΅ΡΠ°ΡΠ΅Π²Π° ΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΡ Π½Π΅ ΡΠ΅ΠΊΠΎΠΌΠ΅Π½Π΄ΠΎΠ²Π°Π»ΠΎΡΡ Π² ΡΠ²ΡΠ·ΠΈ Ρ ΡΠΈΡΠΊΠΎΠΌ ΠΊΡΠΎΠ²ΠΎΡΠ΅ΡΠ΅Π½ΠΈΡ ΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. Π‘ ΡΠ΅Π»ΡΡ ΠΎΡΠ΅Π½ΠΊΠΈ Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΠΈ ΠΈ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΠΎΡΡΠΈ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎΠΉ ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΠΈ ΠΏΡΠΈ ΠΊΠ΅ΡΠ°ΡΠ΅Π²ΠΎΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠΈ Π±ΡΠ»ΠΎ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π΄Π°Π½Π½ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅.ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π‘ 2010 ΠΏΠΎ 2015 Π³. Π±ΡΠ»ΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ 260 Π±Π΅ΡΠ΅ΠΌΠ΅Π½Π½ΡΡ
Ρ ΠΌΠΈΠΎΠΌΠΎΠΉ ΠΌΠ°ΡΠΊΠΈ, ΠΊΠΎΡΠΎΡΡΠΌ ΠΏΡΠΎΠΈΠ·Π²Π΅Π΄Π΅Π½ΠΎ ΠΊΠ΅ΡΠ°ΡΠ΅Π²ΠΎ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ Ρ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎΠΉ ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΠ΅ΠΉ. ΠΠ°Π½Π½ΡΠ΅, ΠΏΠΎΠ»ΡΡΠ΅Π½Π½ΡΠ΅ ΠΏΡΠΈ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠΈ, ΡΡΠ°Π²Π½ΠΈΠ²Π°Π»ΠΈΡΡ Ρ Π΄Π°Π½Π½ΡΠΌΠΈ 96 ΠΆΠ΅Π½ΡΠΈΠ½ ΠΈΠ· Π³ΡΡΠΏΠΏΡ ΠΊΠΎΠ½ΡΡΠΎΠ»Ρ, Π½Π΅ ΠΈΠΌΠ΅ΡΡΠΈΡ
ΠΌΠΈΠΎΠΌΡ ΠΌΠ°ΡΠΊΠΈ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Ρ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎΠΉ ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΠΈ ΠΏΡΠΈ ΠΊΠ΅ΡΠ°ΡΠ΅Π²ΠΎΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠΈ Π² ΡΡΠ°Π²Π½Π΅Π½ΠΈΠΈ Ρ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ ΠΊΠ΅ΡΠ°ΡΠ΅Π²Π° ΡΠ΅ΡΠ΅Π½ΠΈΡ Π±Π΅Π· ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΠΈ: ΠΎΡΠ΅Π½ΠΊΠ° ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ, ΠΏΡΠ΅Π΄- ΠΈ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΡΡΠΎΠ²Π½Π΅ΠΉ Π³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½Π° ΠΈ Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ.Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. Π‘ΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΡΠ΅ ΠΎΡΠ»ΠΈΡΠΈΡ Π² ΠΎΠ±ΡΠ΅ΠΌΠ΅ ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ, ΠΈΠ·ΠΌΠ΅Π½Π΅Π½ΠΈΠΈ ΡΡΠΎΠ²Π½Ρ Π³Π΅ΠΌΠΎΠ³Π»ΠΎΠ±ΠΈΠ½Π° Π² ΡΠ΅Π·ΡΠ»ΡΡΠ°ΡΠ΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ²Π° ΠΈ Π² Π΄Π»ΠΈΡΠ΅Π»ΡΠ½ΠΎΡΡΠΈ Π³ΠΎΡΠΏΠΈΡΠ°Π»ΠΈΠ·Π°ΡΠΈΠΈ ΠΌΠ΅ΠΆΠ΄Ρ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½Π½ΡΠΌΠΈ Π³ΡΡΠΏΠΏΠ°ΠΌΠΈ ΠΆΠ΅Π½ΡΠΈΠ½ Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½Ρ. Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Π° ΠΏΡΠΎΠ³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΌΠΎΠ΄Π΅Π»Ρ Π΄Π»Ρ ΠΎΡΠ΅Π½ΠΊΠΈ ΡΠ°ΠΊΡΠΎΡΠΎΠ² ΡΠΈΡΠΊΠ° ΠΈΠ½ΡΡΠ°ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ Π±ΠΎΠ»Π΅Π΅ 1000 ΠΌΠ».ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. Π Π°Π·ΠΌΠ΅Ρ, Π»ΠΎΠΊΠ°Π»ΠΈΠ·Π°ΡΠΈΡ ΠΌΠΈΠΎΠΌΠ°ΡΠΎΠ·Π½ΡΡ
ΡΠ·Π»ΠΎΠ² ΠΈ ΠΈΡ
ΡΠ°ΡΠΏΠΎΠ»ΠΎΠΆΠ΅Π½ΠΈΠ΅ Π² Π½ΠΈΠΆΠ½Π΅ΠΌ ΡΠ΅Π³ΠΌΠ΅Π½ΡΠ΅ ΠΌΠ°ΡΠΊΠΈ Π½Π΅ ΡΠ²Π»ΡΡΡΡΡ ΡΠ°ΠΊΡΠΎΡΠ°ΠΌΠΈ ΡΠΈΡΠΊΠ° Π±ΠΎΠ»ΡΡΠΎΠΉ ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ ΠΏΡΠΈ Π°Π±Π΄ΠΎΠΌΠΈΠ½Π°Π»ΡΠ½ΠΎΠΌ ΡΠΎΠ΄ΠΎΡΠ°Π·ΡΠ΅ΡΠ΅Π½ΠΈΠΈ Ρ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½ΠΎΠΉ ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΠ΅ΠΉ. Π€Π°ΠΊΡΠΎΡΠΎΠΌ ΡΠΈΡΠΊΠ° ΠΊΡΠΎΠ²ΠΎΠΏΠΎΡΠ΅ΡΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΌΠ½ΠΎΠΆΠ΅ΡΡΠ²Π΅Π½Π½Π°Ρ ΠΌΠΈΠΎΠΌΠ° ΠΌΠ°ΡΠΊΠΈ, Π° ΡΠ°ΠΊΠΆΠ΅ ΡΠ°Π·ΠΌΠ΅Ρ ΠΌΠΈΠΎΠΌΠ°ΡΠΎΠ·Π½ΡΡ
ΡΠ·Π»ΠΎΠ² Π±ΠΎΠ»Π΅Π΅ 5 ΡΠΌ. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎΠΊΠ°Π·Π°Π»ΠΎ, ΡΡΠΎ ΠΎΠ΄Π½ΠΎΠΌΠΎΠΌΠ΅Π½ΡΠ½Π°Ρ ΠΌΠΈΠΎΠΌΡΠΊΡΠΎΠΌΠΈΡ ΠΏΡΠΈ ΠΊΠ΅ΡΠ°ΡΠ΅Π²ΠΎΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠΈ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΈ ΠΌΠΎΠΆΠ΅Ρ Π²ΡΠΏΠΎΠ»Π½ΡΡΡΡΡ ΠΏΡΠΈ Π½Π°Π»ΠΈΡΠΈΠΈ ΠΎΠΏΡΡΠ° ΠΈ ΠΊΠ²Π°Π»ΠΈΡΠΈΠΊΠ°ΡΠΈΠΈ Ρ Ρ
ΠΈΡΡΡΠ³Π°.
ΠΡΠΎΠΌΠΎΠ½ΡΠΎΡΠΈΠΊΡΠ°ΡΠΈΡ Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠ°ΡΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅Π·Π° Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠΈ Ρ ΠΏΡΠΎΠ»Π°ΠΏΡΠΎΠΌ Π³Π΅Π½ΠΈΡΠ°Π»ΠΈΠΉ: ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ
Introduction. Pelvic organ prolapse is increasingly spreading around the world. Therefore, surgical interventions in this pathology are becoming more frequent. Non-mesh surgery for pelvic organ prolapse is reported to have a higher incidence of disease recurrence, and polypropylene mesh implants appear to cause implant-associated complications, thereby limiting their application in clinical practice. Materials and methods. When a patient with an apical prolapse and high risk of postoperative complications sought medical care in the Clinic, the specialists decided to perform promontofixation using a titanium mesh implant. Results and discussion. The present paper describes a clinical case of surgical treatment of genital prolapse using a titanium mesh implant. Since the patient who was admitted for surgical treatment had a family history of genital prolapse, an application of non-mesh technologies implied a high probability of genital prolapse recurrence, as well as a high risk of the vaginal erosion after surgery. Therefore, a promontofixation was performed using a titanium mesh implant, and the 6-month follow-up period showed no postoperative complications. Conclusion. Analysis of postoperative complications demonstrated a considerable potential of using titanium mesh implants for the prevention of implant-associated complications.ΠΠ²Π΅Π΄Π΅Π½ΠΈΠ΅. Π£Π²Π΅Π»ΠΈΡΠ΅Π½ΠΈΠ΅ ΡΠ°ΡΠΏΡΠΎΡΡΡΠ°Π½Π΅Π½ΠΈΡ ΠΏΡΠΎΠ»Π°ΠΏΡΠ° ΡΠ°Π·ΠΎΠ²ΡΡ
ΠΎΡΠ³Π°Π½ΠΎΠ² ΠΏΠΎ Π²ΡΠ΅ΠΌΡ ΠΌΠΈΡΡ ΠΏΡΠΈΠ²ΠΎΠ΄ΠΈΡ ΠΊ ΡΠ²Π΅Π»ΠΈΡΠ΅Π½ΠΈΡ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΡΡ
Π²ΠΌΠ΅ΡΠ°ΡΠ΅Π»ΡΡΡΠ² ΠΏΡΠΈ ΡΡΠΎΠΉ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΠΈ. ΠΠ΅ΡΡΠ΅ΡΡΠ°ΡΠ°Ρ Ρ
ΠΈΡΡΡΠ³ΠΈΡ ΠΏΡΠΎΠ»Π°ΠΏΡΠ° ΡΠ°Π·ΠΎΠ²ΡΡ
ΠΎΡΠ³Π°Π½ΠΎΠ² ΠΏΡΠΎΠ΄Π΅ΠΌΠΎΠ½ΡΡΡΠΈΡΠΎΠ²Π°Π»Π° Π±ΠΎΠ»Π΅Π΅ Π²ΡΡΠΎΠΊΡΡ ΡΠ°ΡΡΠΎΡΡ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²ΠΎΠ² Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ, Π° ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΏΠΎΠ»ΠΈΠΏΡΠΎΠΏΠΈΠ»Π΅Π½ΠΎΠ²ΡΡ
ΡΠ΅ΡΡΠ°ΡΡΡ
ΠΈΠΌΠΏΠ»Π°Π½ΡΠΎΠ² ΠΏΡΠΈΠ²Π΅Π»ΠΎ ΠΊ ΠΏΠΎΡΠ²Π»Π΅Π½ΠΈΡ ΠΈΠΌΠΏΠ»Π°Π½Ρ-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΡΡΠΎ ΠΎΠ³ΡΠ°Π½ΠΈΡΠΈΠ²Π°Π΅Ρ ΠΈΡ
ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ Π² ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΏΡΠ°ΠΊΡΠΈΠΊΠ΅. ΠΠ°ΡΠ΅ΡΠΈΠ°Π»Ρ ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. Π Π½Π°ΡΠ΅ ΠΎΡΠ΄Π΅Π»Π΅Π½ΠΈΠ΅ ΠΎΠ±ΡΠ°ΡΠΈΠ»Π°ΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΊΠ° Ρ Π°ΠΏΠΈΠΊΠ°Π»ΡΠ½ΡΠΌ ΠΏΡΠΎΠ»Π°ΠΏΡΠΎΠΌ ΠΈ Π²ΡΡΠΎΠΊΠΈΠΌ ΡΠΈΡΠΊΠΎΠΌ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ, ΡΠ΅ΡΠ΅Π½ΠΎ Π±ΡΠ»ΠΎ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΏΡΠΎΠΌΠΎΠ½ΡΠΎΡΠΈΠΊΡΠ°ΡΠΈΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠ°ΡΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅Π·Π°. Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ ΠΈ ΠΎΠ±ΡΡΠΆΠ΄Π΅Π½ΠΈΠ΅. Π ΡΡΠ°ΡΡΠ΅ ΠΎΠΏΠΈΡΠ°Π½ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ Π³Π΅Π½ΠΈΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ»Π°ΠΏΡΠ° Ρ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠ°ΡΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅Π·Π°. ΠΠ°ΡΠΈΠ΅Π½ΡΠΊΠ°, ΠΏΠΎΡΡΡΠΏΠΈΠ²ΡΠ°Ρ Π½Π° ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠ²Π½ΠΎΠ΅ Π»Π΅ΡΠ΅Π½ΠΈΠ΅, ΠΈΠΌΠ΅Π»Π° ΡΠ΅ΠΌΠ΅ΠΉΠ½ΡΠΉ Π°Π½Π°ΠΌΠ½Π΅Π· Π³Π΅Π½ΠΈΡΠ°Π»ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΎΠ»Π°ΠΏΡΠ°, ΡΡΠΎ ΠΎΠ±ΡΡΠ»Π°Π²Π»ΠΈΠ²Π°Π΅Ρ Π²ΡΡΠΎΠΊΡΡ ΡΠ°ΡΡΠΎΡΡ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π° ΠΏΡΠΎΠ»Π°ΠΏΡΠ° Π³Π΅Π½ΠΈΡΠ°Π»ΠΈΠΉ Π² ΡΠ»ΡΡΠ°Π΅ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΡ Π±Π΅ΡΡΠ΅ΡΡΠ°ΡΡΡ
ΡΠ΅Ρ
Π½ΠΎΠ»ΠΎΠ³ΠΈΠΉ, Π° ΡΠ°ΠΊΠΆΠ΅ ΠΈΠΌΠ΅Π»Π° Π²ΡΡΠΎΠΊΠΈΠΉ ΡΠΈΡΠΊ ΡΡΠΎΠ·ΠΈΠΈ ΡΡΠ΅Π½ΠΊΠΈ Π²Π»Π°Π³Π°Π»ΠΈΡΠ° ΠΏΠΎΡΠ»Π΅ ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΈ. ΠΡΠ»Π° ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½Π° ΠΏΡΠΎΠΌΠΎΠ½ΡΠΎΡΠΈΠΊΡΠ°ΡΠΈΡ Ρ ΠΈΡΠΏΠΎΠ»ΡΠ·ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠ°ΡΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅Π·Π°, ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ Π² ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ 6 ΠΌΠ΅ΡΡΡΠ΅Π² ΠΏΠΎΠΊΠ°Π·Π°Π» ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ. ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ½Π°Π»ΠΈΠ· ΠΏΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ ΠΏΡΠΈΠΌΠ΅Π½Π΅Π½ΠΈΠ΅ ΡΠΈΡΠ°Π½ΠΎΠ²ΠΎΠ³ΠΎ ΡΠ΅ΡΡΠ°ΡΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅Π·Π° ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΠ΅ΡΡΠΏΠ΅ΠΊΡΠΈΠ²Π½ΠΎ Π² ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠ΅ ΠΈΠΌΠΏΠ»Π°Π½Ρ-Π°ΡΡΠΎΡΠΈΠΈΡΠΎΠ²Π°Π½Π½ΡΡ
ΠΎΡΠ»ΠΎΠΆΠ½Π΅Π½ΠΈΠΉ
EVALUATION OF RESULTS OF SIMULTANEOUS MYOMECTOMY AND CESAREAN SECTION
Introduction. Myoma of the uterus is the most common neoplasm of the female reproductive system. The frequency of combination of uterine fibroids and pregnancy varies from 1.6% to 10.7%, often fibroids occur in pregnant women of late reproductive age. Traditionally, myomectomy during caesarean section was not recommended because of the risk of bleeding and postoperative complications. To assess the safety and feasibility of a one-stage myomectomy in a caesarean section, this study was conducted.Materials and methods. From 2010 to 2015, we examined 260 pregnant women with uterine myoma, who had a cesarean section with a single-stage myomectomy. The data obtained during the survey were compared with the data of 96Β women from the control group. We study assessment of intraoperative blood loss, pre- and postoperative hemoglobin levels, duration of hospitalization.Results. Statistically significant differences in intraoperative blood loss, changes in hemoglobin levels and in the duration of hospitalization between the examined groups of women were not revealed. A prognostic model has been developed to assess risk factors for intraoperative blood loss of more than 1000 ml.Conclusion. The size, localization of myomatous nodes are not risk factors for high blood loss in abdominal delivery with a one-stage myomectomy. The factor of risk of hemorrhage is multiple uterine fibroids, whereas the size of myomatous nodes less than 5 cm can be regarded as a protective factor for blood loss. The study showed that a one-stage myomectomy with a caesarean section is safe and can be performed with the surgeonβs experience