Uterine leiomyoma occurs in women over 35 years of age in 25–30% and in pregnant women in about 3–12%. However, in 10% of pregnant women, it turns out to be an accidental finding and is detected by ultrasound examination in the first trimester of pregnancy Approximately 10–30% of pregnant women with uterine leiomyoma have complications during pregnancy, childbirth and the postpartum period. The article demonstrates a case of successful delivery in a patient with uterine myoma at full-term pregnancy with preservation of reproductive function in a maternity hospital of the 3rd level. In the period of 38–39 weeks, the patient was hospitalized in the maternity hospital. By the decision of the council, the pregnant woman was prepared for a planned operative delivery. A lower median laparotomy was performed for adequate access. Performed caesarean section in the lower segment according to Defler. During the operation, a live, full-term girl weighing 3600 g and height 53 cm, 7/8 points on the Apgar scale was extracted. On the left, along the anterior surface of the uterus in the bottom area, a subserous myomatous node on a pedicle is determined, measuring 300*220*150 mm. Blunt and sharp dissection of adhesions was performed, followed by removal of a myomatous node weighing more than 1 kg. The postoperative period was uneventful. The patient was discharged on the 5th day. In our clinical case, a successful myomectomy was performed during a planned caesarean section. This type of surgery can be considered a safe option in carefully selected cases and a cost-effective method. However, this method should be performed by experienced surgeons who are skilled in the technique and take into account the size and location of the myomatous node.

Aim: to study the factors leading to adverse perinatal outcomes allowing, on this basis, to predict degree of perinatal risk.Materials and Methods. The medical records of 155 patients who performed delivery in 2019–2021 were retrospectively analyzed. The following groups were formed: main group included 56 patients with adverse perinatal outcomes (9 fetuses died antenatally, 36 fetuses born below Apgar score 5, 9 newborns died within the first 168 hours of extrauterine life, 2 infant deaths). The control group included 99 patients with favorable perinatal outcomes. While assessing the data retrieved from medical records, sociobiological and laboratory-instrumental indicators, obstetric-gynecological and somatic anamnesis, the presence of extragenital pathology, the delivery process, information related to child condition at the time of birth and in early neonatal period were analyzed.Results. In patients of the main group, significant differences were revealed compared to control group, respectively: high parity (3 or more deliveries) – 11 (19.6 %) and 15 (15.1 %) (p = 0.001); vomiting of pregnant women in early gestation – 27 (48.2 %) and 14 (14.1 %) (p = 0.005); the presence of uterine scar after two or more caesarean sections – 7 (12.5 %) and 2 (2.1 %) (p = 0.009); former abortions – 24 (42.8 %) and 16 (16.1 %) (p = 0.0017); acute respiratory viral infection in the first trimester – 21 (37.5 %) and 13 (13.1 %) (p = 0.005); threatened abortion in the second trimester – 23 (41.0 %) and 15 (15.1 %) (p = 0.0005); Doppler-based blood flow disorders in the second trimester – 17 (30.3 %) and 11 (11.1 %) (p = 0.008) and in the third trimester – 9 (16.0 %) and 3 (3.0 %) (p = 0.006); altered amniotic fluid index according to ultrasound data in the second trimester – 6 (10.7 %) and 1 (1.0 %) (p = 0.011); intrauterine growth retardation in the third trimester – 15 (26.7 %) and 4 (4.0 %) (p = 0.012); severe preeclampsia – 6 (10.7 %) and 1 (1.0 %) (p = 0.04). In patients of the main group, pregnancy was finished prematurely in 41.1 % of cases compared to 100% term delivery in control group.Conclusion. The risk factors identified, which were manifested in the first and second trimesters of pregnancy may be predictors for adverse perinatal outcomes. Based on the study results for patients of the main and control groups, it was convinced that the topic of predicting favorable and unfavorable perinatal outcome is currently far from being disclosed, which is a long meticulous path of search, analysis and comparison.