The article highlights modern approaches to the surgical treatment of uterine fibroids in patients of reproductive age, depending on the size and type of localization of the node in the uterus in accordance with the FIGO classification. It has been established that submucosal uterine fibroids of types 0, 1, 2 are subject to hysteroscopic removal, since their effect on the onset, prolongation of pregnancy and reproductive outcomes has been proven. Intramural uterine leiomyomas are subject to removal if the node size is more than 5 cm or other unidentified causes of infertility in patients with reproductive plans. Subserous uterine leiomyomas do not affect fertility and do not require removal.
The article provides data from epidemiological studies on the correlation between hypertensive disorders in pregnant women and the risk of cardiovascular diseases in later life, describes possible pathophysiological determinants for the occurrence of arterial hypertension after complicated pregnancy. The most informative predictors of the development of arterial hypertension in women with abdominal obesity are described, which were indicators of waist circumference, uterine artery resistance index, N-terminal fragment of the brain natriuretic peptide and highly sensitive C-reactive protein; a mathematical model was calculated to predict the probability of developing arterial hypertension in women with abdominal obesity and hypertensive disorders of pregnancy one year after delivery.
Age-related aspects of women's health have been in the focus of attention of cardiologists, gynecologists, and endocrinologists for many years. The physiological features of the course of the peri- and postmenopausal periods and the possible consequences of estrogen deficiency are already well-studied. For nearly 20 years, there has been a debate about the benefit-risk ratio of menopausal hormone therapy. The evidence for its protective effect on age-related cases is overwhelming: prevention of osteoporosis development, cardiovascular diseases, cognitive decline, and improvement of the overall quality of life. The article presents current data on the association of menopausal hormone therapy with venous thromboembolic complications, depending on the type of estrogen and progestogen components, dose, regimen and methods of application. The feasibility and safety of menopausal hormone therapy in the context of the COVID-19 coronavirus pandemic is considered. The probability of increased risk of thromboembolic complications in case of COVID-19 infection during menopausal hormone therapy has not been proven in clinical practice. The data from the latest publications are presented, indicating the likely positive effect of female sex hormones on the course of SARS-CoV-2 and the recommendations of the leading international communities on menopause measurement regarding the admissibility of menopausal hormone therapy during the pandemic and limited ability to counsel patients.
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