The cohort prospective comparative study investigated the efficacy of mifepristone use in patients after surgical treatment of uterine myoma. It was shown that the use of mifepristone at a dose of 50 mg/day in a continuous mode for 3 months after surgical treatment for proliferating uterine myoma led to the absence of recurrences of the disease for 2 years after the drug withdrawal. The use of mifepristone after embolization of uterine arteries allowed to significantly reduce the size of the node by 25% during 12 months and by 50% (p<0.05) after 24 months. Complex treatment of uterine myoma, including myomectomy and drug therapy with mifepristone, allowed to realize reproductive function in 46% of patients, and delivery through the natural birth canal occurred in 24% of patients.

The study demonstrated the need for topical use of Ovestin® in preoperative preparation of postmenopausal women with varying degrees of genital prolapse and stress urinary incontinence, as well as early start of administration in women during perimenopause to prevent estrogen-dependent complications and reduce the progression of the disease with minimum clinical manifestations.

The cohort prospective comparative study showed improvement of the management of patients with various forms of purulentseptic diseases (PSD). The study included 276 women with PSD admitted to the gynecological hospital from January 1, 2014 to December 31, 2016. The patients were divided into two cohorts depending on the clinical course, management, and outcomes, which corresponded to the clinical forms of PSD: uncomplicated and complicated. The parameters that were evaluated in patients in both groups included complaints, pregnancy course and childbirth, duration of manifestations of the disease, the clinical picture, laboratory parameters. The study resulted in the development of an algorithm for management of patients with PSD including lavage of the site of infection, adequate antibiotic therapy depending on the type of pathogen, infusion and anticoagulant therapy, and treatment of vaginitis. The developed algorithm for management of patients with various forms of postpartum PSD allowed all 276 (100%) participants to preserve reproductive function and avoid early postoperative complications.

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Introduction. The efficacy of preoperative therapy with Gynestril in the treatment of symptomatic uterine fibroids and anaemia of various degrees of severity was studied in the prospective, comparative cohort study.Aim. To evaluate the efficacy of preoperative therapy with mifepristone in patients with uterine fibroids and chronic iron deficiency anaemia of various degrees of severity.Materials and methods. The study included 70 women who were scheduled to undergo the organ-preserving surgical treatment due to symptomatic uterine fibroids from January 1, 2017 to December 31, 2022. 50 patients received Gynestril at a dose of 50 mg/day (1 tablet) from day 1 of the menstrual cycle for 3 consecutive months. Due to contraindications to its use, 20 patients refused to administer the drug in the preoperative period and received symptomatic haemostatic therapy, and were included in the control groups. The patients of both groups received anti-anaemic therapy with iron(III)-hydroxide polymaltose tablets, 250– 300 mg/ day orally. 40 patients underwent the organ-preserving surgery depending on the size, number, type and localization of uterine fibroids according to the FIGO 2011 classification and patients’ motivation to preserve their reproductive function.Results. The analysis of changes in the laboratory test results revealed that hemoglobin levels in the groups after Gynestril therapy reached reference ranges in all women, averaging 123.4 ± 8.2 g/l as compared to the baseline value 84.3 ± 6.7 g/l, p < 0.05. It was also noted that ferritin levels increased significantly, averaging 12.2 ± 1.9 µg/l compared to the pre-treatment level 8.8 ±  0.8 µg/l, serum iron levels reached 12.8 ± 1.0 compared to the pre-treatment level 8.0 ± 0.8, and TIBC level reduced to 72.1 ± 3.5 compared to the pre-treatment level 96.7 ± 4.8 (p < 0.05).Conclusions. A comprehensive multidisciplinary approach to the treatment of uterine fibroids, including preoperative therapy with Gynestril, myomectomy using occlusive and X-ray endovascular techniques preserved the reproductive function in 50 patients with symptomatic uterine fibroids and anaemia of various degrees of severity.