Most of the women of childbearing age, who diagnosed or suspected Misa uterus, ask doctors about the same questions: which represents this disease? Does the Mioma makes conception, can the cause of infertility?
Content
Pregnant women, of course, are interested in how dangerous Mioma is in their position, what is the definition for mom and for a child.
It should be recognized: we are not at all these issues now with one-to-one replies, and the purpose of our article — Not so much «issuance» ready recommendations, how much grant readers «Information to think».
What is the uterine myoma and how it arises
Greek root MoO- indicates… Mouse, A «at the same time» — muscle. Mioma (Fibromyoma) — This is a benign muscle tumor (connecting) fabric. Myoma uterus arises as a result of the fact that the cages of the uterus spontaneously begin to actively share. The reasons for this phenomenon are not fully found, but it has been established that it is stimulated hormonally and is primarily due to the increased secretion of estrogen. Roughly speaking, estrogens stimulate the growth of myoma, and progesterone, on the contrary, causes its reverse development. This, however, does not mean that the normal balance of estrogen content and progesterone in the blood unequivocally testifies to the absence of myoma. The fact is that the local change in the level of estrogen in the uterus is most often not reflected or very slightly reflected on the content of the hormones of this group in the blood.
From said it follows that the fact of the occurrence of pregnancy (by itself confirming the normal content of estrogen and progesterone in the blood) does not exclude the presence of the uterine misa — There are cases when myomas are combined with pregnancy. Moreover, recently, the frequency of detection of the uterine misa during pregnancy has increased: firstly, the average fever «Aged» (and hormonal disorders are more common after 30 years), and secondly, methods of diagnosis are rapidly improved — In particular, ultrasound is increasingly used.
As mimoma affects pregnancy and childbirth
Conception. Difficulties in conception caused by the Misa are explained by the most different factors, among which squeezing the uterine pipes, impeding the movement of sperm, disruption of ovulation. Mioma itself does not consider the cause of infertility, however, if all the established causes of infertility are eliminated, the removal of Moma significantly increases the probability of conception. True, this applies to MIOM, the size of which is less than 12 weeks pregnancy. If myomas are large and deforming the uterine cavity, keep the ability to childbear when it is difficult to remove it, especially since such an operation may be accompanied by bleeding, sometimes requiring the removal of the uterus.
First trimester of pregnancy. Serious complications arise in the event that there is contact of the world with a placenta (t.E. When placentating in the field of myomatous nodes). In addition, the size of the nodes (most women with small myomatous nodes during pregnancy is not observed, no complications are observed and the disease proceeds asymptomatic).
Patients with the Mioma uterus often occur spontaneous abortions. This is associated with an increase in the contraction of the uterus (the fact is that prostaglandins are released during the destruction of myoma — Physiologically active substances causing a reduction in the smooth muscles, including musculatures of the uterus) and circulatory disorders in the uterus, as well as with neuroendocrine disorders, chronic infectious diseases, processes manifested by the growth of the uterus mucous membrane (hyperplasia, etometrial polyposis).
The second and third trimesters of pregnancy. It is believed that in the presence of Moma increases the risk of spontaneous abortion and premature genera. It is associated with a decrease in free space for a child in the uterus due to myomatous nodes, as well as with an increase in the contractile activity of the uterus. As a rule, the larger the size of the Mioma, the higher the probability of premature labor. Again, the location of the Mioma and the presence of its contact with the placenta.
Mioma of large sizes has a certain impact on the growth and development of the fetus. So, there are cases of birth of children with deformation of the skull and krivoshea, apparently due to the pressure of myoma. Pregnant women with big myomas are more often born children with low weight.
Roda. There is an opinion that myoma affects labor. Indeed, approximately half of pregnant women with Miomaries there are protracted labor. In addition, in the presence of Moma, it becomes more often a need for a delivery by cesarean section. Although myoma itself, as a rule, does not represent a true fruit obstacle, myomatous nodes (especially large) are often combined with the anomalies of the situation and the prelation of the fetus (cross position, pelvic and facial preview), in which the natural delivery is not possible. In some cases — For example, if the area of the cut with a cesarean section falls on Mioma, the doctor can remove the tumor.
In patients with Mioma, the placenta detachment is more often (especially if myoma is located behind the placenta — retroplated). Doctors necessarily take into account this when conducting labor.
Postpartum period. With the presence of myoma, both early and late postpartum complications may be associated with. Early include postpartum bleeding associated with low tone of the uterus, the dense attachment and increment of the placenta; To Late — incomplete involution of the uterus (when the uterus does not decrease to «source» Sizes), infectious diseases.
How pregnancy and childbirth affect Mioma
For the development of pregnancy, elevated education is needed as estrogen and (even more) progesterone — both, as explained above, significantly affects the state of myoma. In addition, in addition to hormonal, in pregnancy, purely mechanical changes occur — Increase and stretching of the muscle membrane of the uterus (myometrium), the intensification of blood flow in the uterus wall. The impact of these changes to the already existing Mioma depends on where exactly and how it is located to what extent «Captured» Makeup.
It is believed that Momoma is growing during pregnancy, but there is an opinion that this is not true, and the apparent growth associated with the increasing uterus in general. Mostly a minor increase in the size of Moma is observed in the first and second trimesters, and in the third, there are fewer misers. In general, the substantial growth of Moma during pregnancy is rarely observed and practically does not complicate the course of pregnancy.
More often during pregnancy, another phenomenon is observed — so-called degeneration (t.E. Destruction) Moma. Forced to disappoint those who consider this phenomenon with a positive change: the destruction of Moma is associated with very unpleasant processes — necrosis (samples) of mioma tissues, the formation of edema, cyst, bleeding and t.D. Degeneration can occur on any gestation period, as well as in the postpartum period — It depends on the location of the Mioma.
The causes of degeneration are not completely clear — Apparently, they matter both hormonal (increased progesterone content), and vascular and mechanical (violation of blood supply to the tumor due to thrombosis of the power of blood vessels) changes. Signs of violation of the blood supply to Moma are as follows: pain in the location of myomatous node, increase the tone of the uterus, temperature increase. In the blood, the number of leukocytes increases, elaborates. The diagnosis is confirmed by ultrasound. Such a state, as a rule, lasts one or two weeks. At this time, doctors usually adhere to conservative tactics, appointed patient analgesics and bedding. If the abdominal pain appears, the increased tone of the uterus is preserved, the patient is hospitalized and further treatment is carried out in the hospital.
Surgical treatment is carried out very rarely and only in absolute indications (high fever, leukocytosis, deterioration of the state, acute abdominal pain, severe uterine bleeding). Sometimes enough minimal surgical intervention — and pregnancy can save. To abortion and premature childbirth, the operation leads only in the most difficult cases.
As for the changes undergoing Moma in the first months after delivery, — they are diverse and unpredictable. Mioma, which delivered a lot of trouble during pregnancy, may not appear after childbirth and do not cause any symptoms. As the uterus after childbirth undergoes the reverse development, the location of the Moma is often changing.
How to diagnose Mioma
Classical manifestations of Moma uterus are protracted cyclic (t.E. Regular, corresponding to the menstrual cycle) bleeding (menorrhagia), against which are often acyclic (irregular) uterine bleeding (metrragia). If such symptoms appear, it is necessary to go to the gynecologist. The diagnosis of the uterine misa is not difficult if there is an increase in the size of the uterus, the uterine bleeding, the deformation of the uterine by myomatous nodes. Mioma can be detected by tacking the uterus through the front abdominal wall. Finally confirmation of the diagnosis gives ultrasound. Not all methods of diagnosing misa are permissible during pregnancy — So, hysterography (radiographic examination of the uterus after administration to its cavity of the X-ray infertime) and hysteroscopy (inspection of the uterine cavity using a special device, a hysteroscope introduced into the uterine cavity) apply only in the absence of pregnancy.
How to treat Mioma
Conservative (non-surgical) Moma treatment consists in braking tumor growth. Specific methods depend on the cause of myoma and its individual properties. In pregnancy, anemia often contributes to the development of myoma — This is one of the many arguments in favor of the urgent need for a systematic blood test during pregnancy: timely emergency treatment can prevent or stop the development of myoma. Preparations of iron, protein diet, vitamins, ascorbic and folic acids are usually prescribed as medical and preventive measures. Vitamins E and A are also important, which have a regulating effect on the neuroendocrine system as a whole and reduce the sensitivity of the genital organs to estrogen.
In patients with uterine, there is often a violation of fat (lipid) exchange, which is expressed in high body weight. In such cases, food correction is necessary: restriction of carbohydrate consumption, replacing animal fat vegetable, inclusion in the diet of fruit and vegetable juices.
In the future, hormonal drugs are used outside pregnancy — Assign funds containing progesterone (it, as we have already spoken, reduces the ability of cells to divide, thus keeping the tumor growth).
If the growth of Moma uterus fails, they decide on surgical treatment methods.
At the beginning of the article, we said that we want to provide readers with information, resicor from the Soviets. And yet, one recommendation here is not only appropriate, but also necessary: prevention is always better than treatment, and the treatment of any disease at an early stage is always more effective than the struggle against a failed ailment, so when any alarming symptoms appear to consult a doctor as soon as possible!
