- Evaluation of the effectiveness of a modified algorithm for managing the third stage of labor and the early postpartum period in women with uterine leiomyoma
Evaluation of the effectiveness of a modified algorithm for managing the third stage of labor and the early postpartum period in women with uterine leiomyoma
Journal Health of Woman. 2026. 2(183): 39-45. doi: 10.15574/HW.2026.2(183).3945
Morokhovets I. M.1,2, Govsieiev D. O.1,2
1Bogomolets National Medical University, Kyiv, Ukraine
2Kyiv Perinatal Center, Ukraine
For citation: Morokhovets IM, Govsieiev DO. (2026). Evaluation of the effectiveness of a modified algorithm for managing the third stage of labor and the early postpartum period in women with uterine leiomyoma. Ukrainian Journal Health of Woman. 2(183): 39-45. doi: 10.15574/HW.2026.2(183).3945
Article received: Dec 24, 2025. Accepted for publication: Mar 22, 2026.
Aim – to evaluate the effectiveness of a modified algorithm for the prevention of obstetric bleeding in women with uterine leiomyoma.
Materials and methods. A prospective study was conducted with the participation of 120 women with term pregnancy and uterine leiomyoma (types 3-5 nodules larger than 5 cm), who gave natural childbirth. The patients were divided into two groups of 60 women each: Group I (n=60) – patients with standard management of the third stage of labor and the postpartum; Group II (n=60) – patients who were applied the proposed algorithm (administration of 1 g of tranexamic acid intravenously in the third stage of labor and remodeling of the lower uterine segment in the early postpartum period). A comprehensive assessment of the effectiveness of the algorithm was carried out by the frequency of achieving a favorable clinical outcome. A favorable outcome was considered to be the achievement of the blood loss ≤500 ml. The frequency of favorable and unfavorable outcomes in each group, absolute risk reduction, relative risk reduction and the number of patients needed to treat to prevent one adverse event were determined.
Results. The proposed algorithm ensured a favorable clinical outcome in 76.7% of parturient women, which was significantly higher compared to the standard management tactics (45.0%). The relative increase in the frequency of favorable early postpartum period was 70.4%.
Conclusions. The use of a modified algorithm for managing the third stage of labor and the early postpartum period in women with uterine leiomyoma is associated with reduced blood loss, better hematological parameters, and faster rates of postpartum uterine involution. The results obtained indicate the effectiveness of the proposed algorithm for the prevention of obstetric hemorrhage in this category of patients.
The study was carried out in accordance with the accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee. Written informed consent was obtained from all participants.
The authors declare no conflict of interest.
Keywords: uterine leiomyoma, labor, third stage of labor, postpartum period, blood loss, uterine involution.
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