The specific features of uterine hemodynamics and hemostatic system in myoma complicated by hemorrhagic syndrome


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Abstract

Objective. To study the specific features of uterine hemodynamics and hemostatic system in uterine myoma complicated by hemorrhagic system. Subjects and methods. The paper provides a detailed comparative analysis of the results of examination of 76 women with uterine myoma; out of them 43 patients with clinical presentation of hemorrhagic syndrome during hormone therapy formed a study group; a comparison group comprised 33 patients who were observed to have no complications due to hormone treatment for uterine myoma. A control group included 27 apparently healthy women. A complex Doppler ultrasound scanning was carried out using a HITACHI-5500 apparatus. The hemostatic system (platelet component, coagulation hemostasis, and fibrinolysis) was investigated by conventional procedures. An enzyme immunoassay was used to identify IgG and IgM antibodies to the pathogens of urogenital infections. Results. It was found that there was a preponderance of a hypervascular tumor (90.7%; n = 39) in uterine myoma complicated by hemorrhagic syndrome during hormone therapy with increases in systolic blood flow in the uterine arteries (by 1.8 times) and resistance index (by 1.6 times) and a decrease in diastolic blood flow (by 2.5 times). The occurrence of hemorrhagic syndrome during hormone therapy for uterine myoma is associated with the exacerbation of chronic urogenital infections, which gives rise to the impaired blood hemostatic potential (hypercoagulation, decreased platelet number and their aggregability, suppressed fibrinolysis, and increased paracoagulation products. Conclusion. The findings necessitate a more detailed examination of women in order to improve medical treatments for uterine myoma and to reduce the frequency of complications due to hormone therapy.

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About the authors

Natalia F. Khvorostukhina

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: Khvorostukhina-NF@yandex.ru
Ph.D., Associate Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Pediatrics

Anna E. Ostrovskaya

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: anna7@inbox.ru
post-graduate student of the Department of Obstetrics and Gynecology, Faculty of Pediatrics

Irina E. Rogozhina

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: itg.r@yandex.ru
MD, Professor, Head of the Department of Obstetrics and Gynecology, Faculty of Pediatrics

Denis A. Novichkov

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: dnovichkov@mail.ru
MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Faculty of Pediatrics

Natalia N. Stepanova

V.I. Razumovsky Saratov State Medical University, Ministry of Health of Russia

Email: natalil063@mail.ru
Assistant of the Department of Obstetrics and Gynecology, Faculty of Pediatrics

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