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Objective@#To compare the nature of pregnancy and deliveryin women with leiomyoma who were treated with uterine artery embolization to the outcomes in women who were treated with abdominal myomectomy. @*Material and Methods@#A prospective, clinical study was conducted in 2010-2013 at “Urguu” Maternity Hospital, Ulaanbaatar. 94 women meeting the criteria were selected for the study. Post-treatment, the patients were reviewed for a period of two years. Uterine artery embolization was performed using polyvinyl alcohol particles (300-500 µm in diameter).@*Results@#The percentage of conception in UAE group was 25.5% and 31.9% in myomectomy group (p=0.494); complication of pregnancy was 50.0% and 57.1% respectively (p=0.729); complication of delivery was 33.3% and 0.0% respectively (p=0.047). 88.9% and 90.0% (p=0.596) had Caesarean delivery. 16 (84.2%) women had uncomplicated and 3 (15.8%) women had complicated delivery due to placenta praevia, placenta acreta and uterine hypotonia. These cases all belonged to UAE group. @*Conclusion@#Pregnancy rates in women with leiomyoma who were treated by uterine artery embolization, compared with pregnancies after abdominal myomectomy, were similar.(p=0.494) In this study, there was the rate of Cesarean delivery above 80 percent in both group. There were no differences in newborn weights and Apgar scores.
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@#BACKGROUND OF STUDY: According to WHO report estimation, 76.3 million people have been diagnosed with disorder related to alcohol use which has been root cause for over 60 types of disease in the world.1 Smoking causes death to4 million people every year, 11 people every day and 6 every minute. This number is estimated to double reaching 10 million by 2030.2 The study conducted by the ‘World Vision Mongolia’ international organization and the Anti-alcoholism and Drug Association of the Ministry of Justice show 76% of all teenagers has drunk alcohol to some extent. AIMS: To determine alcohol, tobacco and psychoactive drug use by school teenagers of Sukhbaatar district in Ulaanbaatar MATERIAL AND METHODOLOGY: The survey on inquiry of alcohol, tobacco and psychoactive drug use (ASSIST) was conducted among a total of randomly selected 800 (374 boys, 426 girls) students of 8-12th grade from 7 secondary schools of Sukhbaatar district. Statistical data was put into Microsoft office applications (excel, word) and processed by SPSS application with 95% of probability of information and 5.0% of trust level. RESULT OF STUDY: Out of all respondents 32% (256) use tobacco, 43.8% (350)alcoholic drinks, 2.6% (21)cannabis,1.1% (9) cocaine, 1.5% (12) amphetamine, 3%(24)volatile substance, 4.3% (34)sedative and tranquilizer drug, 0.6% (5)hallucinogenic drug, 0.5% (4) opioid, and 0.1% (1) uses other types of drug. Among the survey participants, there are a total of 214 teenagers (in duplicated number) who need short-term action and 2 teenagers who are smoker and need intensive treatment. CONCLUSION: Among total teenagers, the survey participants, 1 in 3 used tobacco, 1 in 2 alcoholic drinks and 1 in 7 used psychoactive drug. Male students smoke twice more than female students and there is no difference in use of alcoholic drink in both sexes. The alcohol and tobacco use among teenagers at the age of 12-18 who participated in the survey showed that they use more when they grow older. 1 in 4 students of all participants belongs to a group with average risk and needs intensive treatment.
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Uterine leiomyomas are common (20-50%) in women of reproductive age. It is a benign tumor and it ranks second place among genital organ disorders in women.To date, abdominal laparotomy and laparoscopic surgical treatment (myomectomy and hysterectomy) are widely used to manage symptomatic leiomyomas.Although, hysterectomy is considered to be a radical method to manage uterine leiomyomas, women who have had hysterectomy are left totally infertile and they also are at risk to develop post-surgical and post-anesthetic complications. The advantage of myomectomy is to preserve women’s fertility and menstrual function but, the probability of recurrence of leiomyoma is 15-30% [1, 2]. Furthermore, depending on the location, size and number of fibroids, duration of surgery lingers, volume of blood loss is high and the risk to develop post surgical adhesions are high too.In recent, more than a decade period, effective and minimally invasive new, non-surgical methods to manage uterine leiomyomas have been introduced in many countries around the world. These methods have short recovery period and are advantageous to women to preserve their reproductive organ and fertility. They include: uterine artery embolization, uterine artery occlusion via transvaginal route and MRI– guided focused ultrasound surgery of uterine fibroids. Antiprogesterone-low-dose mifepristone for uterine leiomyomas are being introduced as well.In our country, managing leiomyomas surgically is still occupying high rate among surgical treatments. Further, to prevent and reduce complications of surgical treatment and to preserve organ, it is essential and imperative to introduce some of the above- mentioned contemporary non-surgical methods.
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INTRODUCTION:Uterine leiomyoma occurs with broad range of 20-50% among reproductive aged women. It takessecond place of all women’s genital diseases that cause abnormal menstrual bleeding. Leiomyomadependent surgical frequency such as hysterectomy is around up to 80, 6%. Lately uterine fibroidembolization treatment is highly effective, less painful, and more rapid recovery, most importantlykeeping organ while maintaining the reproductivity, is successfully entered in practice. We successfullyperformed 40 cases first time in Mongolia and 8 of them conceived naturally after treatment.GOAL:To determine if arterial embolization in women with uterine fibroids (leiomyomata) is an effectivemethod to keep their reproductive organ intact.OBJECTIVES:• To study pregnancy cases in women who had uterine fibroid embolization• To monitor and determine the features of course of pregnancy and childbirth.• To evaluate uterine fibroids.MATERIALS AND METHODS:The study was conducted in 2009-2012. A total of forty women between 23-50 years of age,diagnosed with symptomatic uterine fibroid that received embolization treatment of dominatingarterial blood vessel feeding the uterine fibroids were involved in the study. Eight of the forty womenwho conceived naturally were selected for the study. The study focused on monitoring the course oftheir pregnancy and delivery and its outcome.RESULTS:Among 40 women who underwent bilateral uterine artery embolization, 31 (75.5%) were seeking tobecome pregnant, and 8 of the 31 (25, 8%) became pregnant, four having been nulliparous. Onepatient had two pregnancies. All 8 pregnancies were spontaneous. The mean time from embolizationto conception was 12±3, 5 months (range, 6-27 months). Three medical terminations occurred. Theother 5 pregnancies went to term; one pregnancy had to be terminated pre-term due to placentapraevia. 60% experienced threatened abortion and 1 case with advanced age mother complicatedwith mild preeclampsia. 62,5% of the women’s pregnancy ended with childbirth, of which one woman(20%) had vaginal delivery and the remaining four pregnancies (80%) ended with C-section. On anaverage, post-treated uterine fibroids decreased in volume by 94% in comparison to pre-treateduterine fibroids in the patients who became pregnant. All of the neonates were healthy with Apgarscores greater than8. The mean weight of the neonates was 3,189± 200 g (range, 2,100–3,800 g). One neonate waspreterm due to placenta praevia (2,100 g).CONCLUSION:1. Of the forty women that received arterial embolization treatment with uterine fibroid, thirty one(75, 5%) women desired to keep their uterine for further reproduction, of which eight women (25,8% of the patients) between the ages of 23-42 years (mean age=35) conceived naturally. Arterialembolization to treat women with uterine fibroids is an effective method for women who wish to keeptheir reproductive organ intact to conceive and reproduce.2. 60 percent of the women who conceived experienced threatened abortion and 20 percent of thewomen’s pregnancy had to be terminated pre-term due to placenta praevia. 62,5 percent of thewomen’s pregnancy ended with childbirth, of which one woman (20%) had vaginal delivery and theremaining four pregnancies (80%) ended with C-section.3. On an average, post-treated uterine fibroids decreased in volume by 94% in comparison to pretreateduterine fibroids.