OPTIMIZATION OF MANAGEMENT TACTICS FOR CONGENITAL HEART DISEASE, ENDOMETRIOSIS AND UTERINE FIBROID

Abstract. Congenital heart defect tetrad Fallot is one of the most pressing problems of modern cardiac surgery. The tactics of managing such patients is also a problem, the solution of which is relevant not only for cardiologists and cardiac surgeons, but also for doctors of other specialties. The presence of concomitant gynecological pathology in patients with TF requires close attention to this category of patients of obstetricians and gynecologists. The study of this clinical situation made it possible to optimize the management tactics of a patient with CHD, OMC caused by uterine fibroids, endometriosis and anemia with the use of Buserelin- Long (an agonist of Hh-RG) for 6 months (3 months before surgery and 3 months after it) for the purpose of preoperative preparation and postoperative management. Relief of severe pelvic pain was noted already in the first month of treatment with Buserelin - Long. During the examination of the patient 3 months after the operation, no recurrence of endometriosis was detected. The patient noted good tolerability of the drug. Buserelin – Long, due to its pharmacodynamics, has no negative effect on lipid and carbohydrate metabolism, as well as the blood clotting system, which was its important advantage among all hormonal drugs that cannot be prescribed in this clinical case. Buserelin-Long can be recommended in a similar clinical situation to patients with CHD and OMC caused by uterine fibroids and endometriosis, when the metabolic neutrality of the drug is of paramount importance and allows optimizing the management tactics of patients with CHD, OMC caused by uterine fibroids, endometriosis and anemia.