Predictors of uterine fibroids development in women outside and during pregnancy

• Tatiana A. Anikina
• Lyudmila Yu. Karakhalis

Abstract

Background. The search for factors in the development of uterine fibroids continues. At the same time, no works that comparing patients complains and risk factors for occurrence of myomas nodes outside pregnancy and in pregnant women have been identified.

The purpose of the study: to compare the risk factors for the development of uterine fibroids in patients operated on the background and outside pregnancy, as well as their complaints.

Material and methods. A cohort observational study of medical data was carried out in 72 operated patients with uterine fibroids, of which 13.9% had surgery during pregnancy. The study was conducted at the basis of the perinatal center of Regional Clinical Hospital No. 2, Ministry of Health of Krasnodar Territory. The patients were divided into two groups: group 1 (n=62) – patients who were operated on beyond the pregnancy, and group 2 (n=10) – pregnant women who were operated on during the pregnancy. Somatic, reproductive history was studied, the presence of known risk factors for development of uterine fibroids in both groups was assessed. The statistical analysis was carried out using the Statistica 13.3 program (Tibco, USA). The accepted level of statistical significance p=0.05 was used, at p<0.05 the difference in the obtained values was considered statistically significant.

Results. The main complaints in group 1 were abundant menstruation in 61.29%; in group 2 – the pain in 100%. A significant difference in the age of uterine fibroid verification was revealed: in the group 1 – 40.35±14.0 years and in group 2 – 29.9±4.63 years, as well as in the age of the surgery: in group 1 – 43.32±8.7 years, and in group 2 – 32.5±4.53 years. The number of nodes in the group 1 reached eight, and in group 2 there were maximum three. The volumes of the largest nodes differed: in the group 1 it was 72.2 cm³ and in the group 2 – 121.03 cm³. In the group 1 46.77% of patients had type 6, in the group 2 40.0% had type 4 and 40.0% – type 5. The active blood flow in myomas nodes was in group 1 – 66.13%, and group 2 – in 60.0%. There were 30.65% patients in group 1 had anemia, but in group 2 – 80.0%. In the group 1, the results of the histological assessment were leiomyoma, in group 2 – 30.0% patients had leiomyoma with secondary changes (edema, necrosis, hemorrhages) and “red degeneration”.

Keywords: uterine fibroids; pregnancy; complaints; anamnesis

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