Modern approaches to managing the patients with uterine myoma
Selikhova M.S., Vdovin S.V.

Volgograd State Medical University

Introduction: the most significant problem of gynecology is the uterine myoma. The frequency of occurrence of the uterine myoma ranges from 20-25% among the patients of the reproductive age up to 50% in the perimenopausal period. 
The aim of the research was to study the efficacy of conservative therapy of the uterine myoma in patients in the perimenopausal period, suffering from the bleedings leading to anemia.
Patients and methods: 29 women aged 45-52 years with uterine myoma, complicated by uterine bleeding, leading to anemia, participated in the study. Each woman received mifepristone at a dose of 50 mg / day for 3 months, starting from the 3rd-5th day of the menstrual cycle. To assess the size of myomatous nodules ultrasound examination was performed, the state of the endometrium was monitored by ultrasound and endometrial pipelle biopsy. The examination of the patients was carried out at the beginning the study, after 3 months of receiving Ginestril and 3 months after the drug was discontinued.
Results: the examination of patients 3 months after the end of Ginestril therapy showed a statistically significant (p <0.05) improvement in all evaluated parameters: in all patients with amenorrhea it persisted during the treatment, the level of hemoglobin increased by 3.2 g / l from the initial, the volumes of myomatous nodules tended to decrease in 86.2% of patients. Three months after the withdrawal of the drug, in four patients (13.8%) amenorrhea persisted; in 18 patients, menstruations recurred. Three patients (10.3%) had recurrent bleedings and underwent a hysterectomy because of the ineffectiveness of the therapy.
Conclusion: in 89.7% of cases the use of Ginestril allowed to stop the bleeding and avoid organ-resecting operations. Control of the intensity of uterine bleeding is the most important and useful effect of mifepristone, which leads to the restoration of hemoglobin and the improvement of the general condition of the patient.

Key words: uterine myoma, bleeding symptom, perimenopause, conservative therapy, mifepristone.
For citation: Selikhova M.S., Vdovin S.V. Modern approaches to managing the patients with uterine myoma // RMJ. 2017. № 26. P. 1938–1940.