Chajka K. Pathogenesis of uterine leiomyoma. Pregravid preparation and obstetric tactics.

In the thesis is gaved a new solution of the urgent problems of modern obstetrics and gynecology - improve recovery of reproductive function and reduce gestational and perinatal complications in women with uterine leiomyomas. In this work is proposed a new approach to the differential diagnosis and treatment of uterine leiomyoma in reproductive age women, based on the diameter of the dominant nodus and intratumoral blood flow parameters (diffuse or peripheral) using three-dimensional power Doppler. Scientifically justified and proven that the drugs of choice during the preoperative and postoperative therapy of uterine leiomyoma are progesterone receptor blockers. Were developed an surgical technique of conservative myomectomy using synthetic polymers suture materials, which allow to reduce the intensity of adhesions formation, enhance postoperative scar, give possibility to control the process of tissue repair and its completeness in terms of subsequent pregnancy. Based on a comprehensive assessment of parameters of intratumoral and intraplacental blood flow, as well as their relationship were developed prediction criteria and prevention methods of gestational and perinatal complications in pregnant women with uterine leiomyoma. Were shown high effectiveness of the proposed treatment from the standpoint of evidence based medicine.