Методы Лечения Миом Матки На Стадии Планирования И Во Время Беременности

Uterine myoma is the most common monoclonal benign tumour of the pelvis, originating from the smooth muscle cells of the uterine body and cervix. In many cases (70-80%), uterine myoma is asymptomatic, but depending on its size and location, it can cause symptoms that significantly impact a woman’s health and quality of life. The connection between uterine myoma and infertility has been discussed for decades. It is generally accepted that the closer the myoma is to the uterine cavity and endometrium, the more negative is its effect on fertility, reducing the chances of successful implantation and pregnancy. The prevalence of uterine myoma in pregnant women ranges from 3% to 12%, and in 10-30% of cases, it can cause significant obstetric complications. Given the negative impact of uterine myoma on fertility and pregnancy outcomes, the question arises: how should women prepare for a planned pregnancy? Symptomatic myomas are treated using surgical, pharmacological and interventional radiology methods. The choice of treatment depends on the type, size, location, and number of myomas, as well as the overall condition of the woman. To optimize pregnancy outcomes, submucosal and intramural myomas that deform the uterine cavity should be removed. However, the management of non-cavity-deforming intramural myomas remains controversial. Although myomectomy is an effective method for reducing the burden of myomas while preserving fertility, it cannot be considered a preventive measure before conception and should be individualized, as it is unclear whether and how myomectomy affects uterine and foetus blood flow and pregnancy outcomes. Thus, pregnant women with uterine myoma and those with a history of myomectomy should be considered a high-risk group. To date, evidence-based treatment data are contradictory, and further research is needed to optimize its management plans.