• The assessment of uterine contractility in women with uterine leiomyoma as a necessary stage of preconception preparation 
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The assessment of uterine contractility in women with uterine leiomyoma as a necessary stage of preconception preparation 

PERINATOLOGIYA I PEDIATRIYA. 2016.3(67):49-52; doi 10.15574/PP.2016.67.49 
 

The assessment of uterine contractility in women with uterine leiomyoma as a necessary stage of preconception preparation 
 

Aleksenko O. O., Medvedev M. V.

Municipal Institution «I.I. Mechnikov Dnipropetrovsk Regional Clinical Hospital», Dnipro, Ukraine

State Institution «Dnipropetrovsk Medical Academy of Health Ministry of Ukraine», Dnipro


Objective — to study the effect of intramural uterine leiomyoma on fertility by analyzing tumor effects on quantitative and qualitative indicators of uterine activity.


Patients and methods. The study was conducted on the basis of Municipal Institution «I.I. Mechnikov Dnipropetrovsk Regional Clinical Hospital» for the period 2013-2015 years. It is included 64 somatically healthy women of reproductive age with desire for pregnancy. The 1st (control) group consisted of 32 healthy women, the 2nd group — 32 patients with uterine leiomyoma with infertility and with intramural or intramural-subserous location of sites, preverified by ultrasound examination. The adopted level of statistical significance in the study is p<0.05. After the checking of normality of distribution the parametric or non-parametric tests (Student's t-test, chi-square and Fisher's exact test) were used. The relationship between the two variables was evaluated by the use of the nonparametric Spearman correlation analysis. The data is processed on a PC using the statistical package Statistica 6 (Statsoft, USA).


Results. It is found that the implementation of human reproductive function largely depends on peristalsis (contractile function) of not pregnant uterus. It is believed that one of the mechanisms of the negative impact on the fertility of uterine fibroids may be a change in the amplitude and direction of a normal contractive activity of the uterine in the periovulation period and during the «window of implantation». One of the mechanisms for the recovery of reproductive function may be a timely correction of contractive uterine activity. And one of these methods may be conservative myomectomy.


Conclusions. The study of the contractive uterine function in women with uterine leiomyoma may be one of the criteria that can be used for choice of myomectomy in women with intramural uterine leiomyoma without deforming its cavity.


Key words: uterine leiomyoma, uterine motility, infertility.


REFERENCES

1. Aleksenko OO, MedvedEva LE, MedvedEv MV. 2015. Intramuralna leyomIma tIla matki I fertilnIst (oglyad lIteraturi). MedichnI perspektivi. 4: 10—15.

2. Vikhliaieva EM. 2004. Kerivnytstvo po diahnostytsi ta likuvanniu leiomiomy matky. Moskva, Medpres-Inform: 400.

3. Hladchuk IZ, Nazarenko OIa. 2005. Reproduktyvni naslidky u zhinok, yaki perenesly konservatyvnu miomektomiiu. Reproduktyvnoe zdorove zhenshchynы. 3(23): 104—106.

4. Medvediev M. 2011. Mozhlyvosti orhanozberihaiuchoho likuvannia miomy matky. Z turbotoiu pro zhinku. 4(25): 3—5.

5. Aleksenko OO, Medvedieva LIe, Medvediev MV. 2015. Pat. 98911 Ukraina, MKY v/15. Sposib otsinky vplyvu intramuralnoi leiomiomy matky na mozhlyvist zaplidnennia. Zaiavka u201412985; zaiavl. 14.12.2014; opubl. 12.05.2015, biul. №9, patent na korysnu model №98911; 12.05.2015, biul. № 9.

6. Petrenko E. 2011. Mioma matky ta vahitnist. Z turbotoiu pro zhinku. 4: 14—17.

7. Potapov VA, Stepanova DIu. 2011. Suchasni aspekty diahnostyky ta likuvannia leiomiomy matky. Medychni perspektyvy. 4: 10—15.

8. Tatarchuk TF, Kosey NV, Tutchenko TN. 2011. Mioma matki i reproduktivnaya funktsiya zhenschinyi: kriticheskaya otsenka terapevticheskih podhodov. Reproduktivnaya endokrinologiya. 1: 56—63.

9. Yoshino O, Hayashi T, Osuga Y et al. 2010. Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. Hum Reprod. 25: 2475—2479. http://dx.doi.org/10.1093/humrep/deq222; PMid:20719814

10. Klatsky PC, Tran ND, Caughey AB et al. 2008. Fibroids and reproductive outcomes: a systematic literature review from conception to delivery. Am J Obstetrics & Gynecology. 198(4): 357—366. http://dx.doi.org/10.1016/j.ajog.2007.12.039; PMid:18395031

11. Meirzon D, Jaffa AJ, Gordon Z, Elad D. 2011. A new method for analysis of non-pregnant uterine peristalsis using transvaginal ultrasound. Ultrasound Obstet Gynecol. 38: 217—224. http://dx.doi.org/10.1002/uog.8950; PMid:21308836

12. Bulletti C, de Ziegler D, Polli V et al. 2000. Uterine contractility during the menstrual cycle. Hum Reprod. 15; Suppl 1: 81—89. http://dx.doi.org/10.1093/humrep/15.suppl_1.81; PMid:10928421