Features of the third stage of labor and postpartum period in women with uterine leiomyoma: a comparative analysis with somatically healthy parturients
DOI:
https://doi.org/10.15574/HW.2025.4(179).3943Keywords:
uterine leiomyoma, labor, postpartum period, third stage of labor, blood loss, uterine involutionAbstract
Aim - to compare the characteristics of labor and the early postpartum period in women with uterine leiomyoma with similar indicators in somatically healthy parturients, taking into account the anatomical features of myomatous nodules, in order to understand the impact of uterine leiomyoma on the labor, to identify a group at increased obstetric risk, and to develop an individualize management strategy for parturients in this group aimed at reducting hypotonic uterine hemorrhage and improving the quality of obstetric care.
Materials and methods. A prospective study was conducted involving 220 women in term pregnancy, divided into two groups: the main group - 120 women with uterine leiomyomas of types 3-5 according to the International Federation of Gynecology and Obstetrics (FIGO) classification larger than 5 cm, and the control group - 100 somatically healthy women without uterine pathology. All participants underwent clinical examination, ultrasound evaluation of the number, location, and size of fibroid nodules, monitoring of labor progression (duration of labor stages, uterine contractility, and blood loss), and assessment of uterine involution during the first five days postpartum.
Results. Women of the main group had significantly longer durations of all three stages of labor compared to the control group. Abnormal labor patterns occurred much more frequently in the main group. The mean intrapartum hemorrhage in women of the main group was approximately 60% higher than in healthy parturients. Uterine involution during the postpartum period was markedly slower among women of the main group.
Conclusions. Parturients with uterine leiomyoma experience prolonged labor and have an increased risk of abnormal uterine contractility. These women more often exhibit excessive blood loss and delayed uterine involution, which underscores the need for an individualized approach to labor management and targeted prevention of hypotonic postpartum hemorrhage.
The study was conducted in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the local ethics committee. Informed consent was obtained from the patients for the study.
The authors declare no conflict of interest.
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