Prevention of gestational complications in women with uterine leiomyoma

Authors

DOI:

https://doi.org/10.18370/2309-4117.2025.80.21-28

Keywords:

uterine leiomyoma, gestational complications, prevention, preconceptional preparation

Abstract

Background. Uterine leiomyoma (UL) in a pregnant woman is a risk of complications associated with the implantation process, progesterone transformation of the endometrium, insufficient invasion of the villous chorion, impaired metabolism of decidual tissue, incomplete transformation along the entire line of spiral arteries, etc.
Objective of the study: to determine a set of preventive measures for the occurrence of gestational complications in women with UL.
Materials and methods. 27 women who were under the supervision of a doctor before and during pregnancy according to the algorithm we developed (the main group), and 27 women who came under the supervision of a doctor at different stages of pregnancy without prior preconceptional preparation (the comparison group) were examined. The age of the participants was 29 ± 1.5 years.
Women underwent clinical, laboratory-clinical, biochemical, and instrumental examinations (ultrasound, including Doppler) before and during pregnancy according to the current orders of the Ministry of Health of Ukraine.
A comprehensive staged algorithm for the management of women with UL before and during pregnancy by trimester of gestation was developed and proposed, which included a psycho-emotional regimen, a balanced diet, the use of micronized progesterone, vitamin D, magnesium preparations, and vitamin-macro-microelement complexes.
Results. Pregnant women with UL had a complicated somatic, gynecological, and obstetric history. The frequency of gestational complications significantly prevailed in women of the comparison group in the I, II and III trimesters. In the group of women whose management was carried out according to the proposed algorithm, which included preconceptional preparation, the frequency of threatened abortion, premature birth, anemia, isthmic-cervical insufficiency was significantly lower compared to the comparison group.
Conclusions. Women with LM are recommended pregnancy planning, personalized staged, combined, etiopathogenetically based prevention of gestational complications. Preconceptional preparation for pregnancy for women with UL is recommended to be carried out for 3–4 months before fertilization in order to regulate the menstrual cycle, hormonal homeostasis, prevent hypovitaminosis, microelementosis, normalize the ecosystem of the gastrointestinal tract, urinary system, and genitourinary tract.

Author Biography

V.P. Mishchenko, Odessa National Medical University, Odessa

MD, professor, Department of Obstetrics and Gynecology

References

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Published

2025-11-28

How to Cite

Mishchenko, V., & Mishchenko, V. (2025). Prevention of gestational complications in women with uterine leiomyoma. REPRODUCTIVE ENDOCRINOLOGY, (80), 21–28. https://doi.org/10.18370/2309-4117.2025.80.21-28

Issue

No. 80 (2025)

Section

Pregnancy and childbirth

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