Title Miomi uterusa u trudnoći
Title (english) The uterine fibroids in pregnancy
Author Magdalena Kujundžić
Mentor Vito Starčević (mentor)
Committee member Mato Pavić (predsjednik povjerenstva)
Committee member Željko Duić (član povjerenstva)
Committee member Vito Starčević (član povjerenstva)
Granter University of Zagreb School of Medicine (Department of Gynecology and Obstetrics) Zagreb
Defense date and country 2022-10-29, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Miomi maternice su najčešći benigni tumori u žena generativne dobi. Mogu se nalaziti na različitim mjestima te dovesti do povećanja i deformacije maternice. Najčešće su multipli. Razlikujemo subserozne, intramuralne i submukozne miome. Javljaju se u 3-12 % trudnica. Uglavnom su asimptomatski te većina trudnica ima normalan ishod trudnoće. U 10 % slučajeva dovode do komplikacija, a simptomi ovise o broju, veličini i lokalizaciji. Većina mioma maternice tijekom trudnoće ne pokazuje značajne promjene u veličini. Ako se povećavaju, to čine uglavnom u prvom tromjesečju. Nakon trudnoće se uglavnom smanjuju. Prisutnost mioma maternice povezuje se s povećanim rizikom od nastanka mnogih opstetričkih komplikacija, no rezultati istraživanja su i dalje suprotstavljeni te se točan mehanizam njihova nastanka još uvijek ne zna. Najčešća komplikacija je bolna degeneracija mioma. Ostale komplikacije uključuju spontani pobačaj, prijevremeni porod, abrupciju posteljice, antenatalno i perinatalno krvarenje, ograničenje rasta fetusa, fetalnu malprezentaciju, povećani rizik za carski rez uslijed otežanog poroda i druge. Lijeĉenje mioma tijekom trudnoće je uglavnom konzervativno. Zbog povećane vaskularizacije maternice tijekom trudnoće, žene su izložene većem riziku od krvarenja, histerektomije, prijevremenog poroda ili pobačaja. S obzirom na moguće štetne posljedice, potrebno je pažljivo odlučiti o potrebi za operacijom. Miomektomija može biti dobar izbor liječenja u iskusnim rukama i u probranih pacijentica dok se porod carskim rezom najčešće bira kada normalan vaginalni porod nije moguć. Prema rezultatima dosadašnjih istraživanja, miomi maternice su jedan od čimbenika rizika za nastajanje opstetričkih komplikacija, no stavovi o njihovom utjecaju na ishod trudnoće su i dalje suprotstavljeni zbog manjkavosti studija koji opisuju njihov odnos. Kako bi se ujednačila stajališta o međusobnom utjecaju mioma maternice i trudnoće, potrebna su daljnja istraživanja.
Abstract (english) Uterine fibroids are the most common benign tumours in women of reproductive age. Usually, they are multiple and can be found in different places of the uterus, leading to its deformation. We distinguish subserosal, intramural and submucosal fibroids. Uterine fibroids occur in about 3-12 % of pregnancies and the majority of fibroids are asymptomatic requesting no intervention leading to normal pregnancy outcomes. Complications may occur in 1 out of 10 cases and symptoms depend on the number, size and localization of fibroids. Most of them don’t show significant changes in size during pregnancy and if they increase, it seems to occur in the first trimester. During postpartum a decrease in fibroid size can be found. The presence of uterine fibroids is associated with a higher risk of many obstetric complications, but the research results are still contradictory and the exact mechanism of action of influence on the course of pregnancy and labour is still unknown. The most common complication is the painful degeneration of fibroids. Other complications include miscarriage, premature birth, placental abruption, antenatal and perinatal bleeding, fetal growth restriction, fetal malpresentation, increased risk of the cesarean section due to difficult labour and others. Treatment of fibroids during pregnancy is usually conservative. Due to increased uterine vascularization during pregnancy, women are at higher risk of haemorrhage, hysterectomy, preterm birth or miscarriage. Therefore, it is necessary to cautiously decide about the indication for surgery having in mind possible adverse consequences. Myomectomy can be a good choice of treatment in experienced hands and carefully selected patients while cesarean delivery should be a treatment of choice if a normal vaginal delivery is impossible. According to current evidence, the presence of uterine fibroids could be the risk factor for obstetric complications. However, opinions about their influence on the outcome of pregnancy are still contradictory because there are few studies describing their relationship. Further research is needed to unify standpoints and clarify the association between uterine fibroids and adverse pregnancy outcomes.
Keywords
ishodi trudnoće
miomi maternice
opstetriĉke komplikacije
spontani pobaĉaj
trudnoća
Keywords (english)
pregnancy outcome
uterine fibroids
obstetric complications
miscarriage
pregnancy
Language croatian
URN:NBN urn:nbn:hr:105:027433
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2023-10-25 12:36:50