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Aim: to summarize results of up-to-date world researches on the current trends of symptomatic myoma treatment.Materials and Мethods. A search of publications was carried out in the main international databases in Russian and English languages: PubMed/MEDLINE, The Cochrane Library, Embase, eLibrary. The analysis included studies published over the past 10 years examining the clinical efficacy and safety of various groups of pharmacological agents for the treatment of uterine myoma combined with heavy menstrual bleeding in women of reproductive age.Results. Currently, the treatment of uterine fibroids is divided into three main methods: surgical, minimally invasive organ-preserving methods, and pharmacotherapy. Until now, surgical intervention remains the main method of treatment, and, unfortunately, is often carried out in the volume of hysterectomy. However, today it is important to have a personalized approach to the management of a patient with symptomatic uterine myoma, taking into account her desire to preserve reproductive function. The development of the possibilities of drug therapy made a great contribution to the optimization of managing such patients.Conclusion. The global trend is to decrease the number of radical interventions, as well as the development and improvement of new methods of treating symptomatic uterine fibroids. Currently, pharmacotherapy of leiomyoma can significantly improve the quality of life of patients, reduce radical surgical interventions, optimize surgical treatment, and in certain situations, completely eliminate the need for surgery.
Aim: to summarize results of up-to-date world researches on the current trends of symptomatic myoma treatment.Materials and Мethods. A search of publications was carried out in the main international databases in Russian and English languages: PubMed/MEDLINE, The Cochrane Library, Embase, eLibrary. The analysis included studies published over the past 10 years examining the clinical efficacy and safety of various groups of pharmacological agents for the treatment of uterine myoma combined with heavy menstrual bleeding in women of reproductive age.Results. Currently, the treatment of uterine fibroids is divided into three main methods: surgical, minimally invasive organ-preserving methods, and pharmacotherapy. Until now, surgical intervention remains the main method of treatment, and, unfortunately, is often carried out in the volume of hysterectomy. However, today it is important to have a personalized approach to the management of a patient with symptomatic uterine myoma, taking into account her desire to preserve reproductive function. The development of the possibilities of drug therapy made a great contribution to the optimization of managing such patients.Conclusion. The global trend is to decrease the number of radical interventions, as well as the development and improvement of new methods of treating symptomatic uterine fibroids. Currently, pharmacotherapy of leiomyoma can significantly improve the quality of life of patients, reduce radical surgical interventions, optimize surgical treatment, and in certain situations, completely eliminate the need for surgery.
The article presents modern data on the etiology, pathogenesis, diagnosis, prevention and treatment of iron deficiency anemia (IDA) and anemia of chronic disease, as well as their combination on the eve of and during pregnancy. The emphasis is made on the role of iron deficiency of any etiology in the development of obstetric and perinatal complications, especially its impact on the central nervous system formation and further psychophysical child development. Need for prevention of iron deficiency states in risk groups which includes all women of reproductive age who have menstruation is shown based on evidence-based medicine data. Effectiveness and safety of modern drugs containing iron in oral and parenteral forms has analyzed. The paper presents data on the safety and effectiveness of an innovative form of ferric iron in the form of liposomal iron, which differs in the mechanism of action, digestibility and the absence of side effects typical for this group of drugs.According to various authors the frequency of IDA in pregnant women ranges up to 80%, in puerperas up to 40%. It is unimpossible to stop IDA without iron supplementation only with an iron-rich diet. Two main groups of iron preparations are used to correct iron deficiency differing in the valence of iron atoms – bivalent iron salts and trivalent complexes. These drugs differ in the tolerability and bioavailability of atomic iron. Liposomal iron is a new drug for treatment of iron deficiency and IDA today; it has an innovative way of iron delivery to the body. Liposomal iron has advantages for the prevention of anemia in patients with anemia of chronic disease or its combination with IDA (inflammatory bowel diseases, obesity, after resection of the stomach and intestines, etc.). An innovative form of liposomal iron in Ukraine is represented by a dietary supplement Ferroview containing 30 mg of elemental iron, that is corresponds to the average prophylactic dose recommended in WHO documents
The article contains modern data of the characteristics, course and impact on pregnant women, postpartum women, fetus and newborn of the SARS-CoV-2. The opinions of experts from different countries of the world on the consequences of coronavirus disease depending on racial, ethnic, age differences and delivery time. Immunological and hormonal protection during pregnancy against viral influences is noted. In the context of a pandemic, the number of premature births (for various reasons) and the birth of children with low birth weight significantly increased, but their relationship with COVID-19 infection has not been proven. Risk factors for the hospitalization of pregnant woman infected with COVID-19 are high body mass index, obesity and concomitant diseases (diabetes mellitus, hypertension. Women in older reproductive age also need hospitalization more often. During pregnancy, innate and adaptive immune responses shift from an inflammatory to an anti-inflammatory phenotype to prevent affection of the fetus and promote passive transmission of maternal antibodies to the fetus. These COVID-19 protection effects are largely mediated by estradiol and progesterone. New data on the impact of COVID-19 on erythropoiesis, hemoglobin and ferritin levels are presented, and risk groups of a more severe course of the disease are identified: elderly adults, patients, patients with arterial hypertension, obesity and diabetes mellitus, pregnant women, patients with primary and acquired immunodeficiency, with oppression of the hematopoiesis, HIV-infected and with cancer. The algorithm of outpatient monitoring of pregnant women during a pandemic (self-assessment of the state, online control, etc.) is given.Some current world protocols for the COVID-19 prevention and treatment have been analyzed and a modification adapted for Ukrainian pregnant women has been proposed. A method is proposed for the prevention miscarriage and nutritional deficits – one of the frequent and dangerous COVID-19 complications in pregnant women.
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