CLINICAL AND MORPHOLOGICAL RATIONALE FOR THE ULIPRISTAL ACETATE PRE-OPERATION TREATMENT BEFORE ORGANPRESERVING OPERATIONS IN MYOMAS UTERUS PATIENTS WITH THE INTRAUTERINE BLEEDING AND ANAEMIA
https://doi.org/10.21518/2079-701X-2017-13-8-14
Abstract
Objective: assessment of the feasibility and safety of the use of ulipristal acetate on the basis of the clinical and morphological study.
Materials and methods: the study involved 78 women with leiomyoma, abundant menstruation and anemia. Group I – 43 patients who underwent ulipristal acetate therapy for three months and then laparoscopic myomectomy. Group II – 35 patients who were myomectomyed without presurgical preparation. A comparative analysis was made of the clinic-laboratory data, operational parameters, pathomorphological changes in the nodes and endometrium. According to the original clinical laboratory study groups I and II were almost homogeneous.
Results: in the case of ulipristal acetate therapy in all group I patients uterine bleeding ceased, the size of the myomatous nodules decreased by an average of 25 per cent according to the ultrasound and the MRI (p < 0.05), the haemoglobin and the ferritin levels reached normal values (p < 0.01). In group I there was a decline in the duration of the operation and blood loss compared to group II. Some leiomyoma reduction mechanisms have been identified. In endometrium of group I patients drug pathomorphosis after therapy was diagnosed. However, the immunohistochemical study made it possible to establish that these changes were benign and reversible.
Conclusions: presurgical treatment by ulipristal acetate of reproductive age patients with myomas, uterine bleeding and anaemia is appropriate, safe and pathogenetically justified. The possibility to use repeated courses of the drug, which may eventually postpone or cancel the need for surgical treatment is promising.
About the Authors
A. V. Kozachenko
Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia
Russian Federation
Russian Federation
MD,
Moscow
Z. V. Revazova
Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia
Russian Federation
Moscow
Russian Federation
Moscow
L. V. Adamyan
Kulakov Scientific Center for Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia
Russian Federation
Russian Federation
Academician of RAS, MD, Prof.,
Moscow
T. A. Demura
Sechenov First Moscow State University of the Ministry of Health of Russia
Russian Federation
Russian Federation
MD, Prof,
Moscow
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For citations:
Kozachenko AV, Revazova ZV, Adamyan LV, Demura TA. CLINICAL AND MORPHOLOGICAL RATIONALE FOR THE ULIPRISTAL ACETATE PRE-OPERATION TREATMENT BEFORE ORGANPRESERVING OPERATIONS IN MYOMAS UTERUS PATIENTS WITH THE INTRAUTERINE BLEEDING AND ANAEMIA. Meditsinskiy sovet = Medical Council. 2017;(13):8-14. (In Russ.) https://doi.org/10.21518/2079-701X-2017-13-8-14
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