ВПЛИВ ГІПЕРПРОЛІФЕРАТИВНИХ ЗАХВОРЮВАНЬ МАТКИ НА ПЕРЕБІГ ПЕРШОГО ТРИМЕСТРУ ВАГІТНОСТІ У ЖІНОК

The impact of hyperproliferative uterine diseases (HPD), including uterine leiomyoma (LM), uterine endometriosis (adenomyosis) (A), and endometrial hyperplastic processes (such as polyps and/or endometrial hyperplasia (PE and/or GE)) present prior to pregnancy, particularly their combination, on pregnancy outcomes remains a pressing issue in modern medicine. Over the past decade, there has been a significant increase in the number of pregnant women with endometriosis, LM, and a history of PE and/or GE. Aim of the study: To investigate the characteristics of pregnancy course in women with hyperproliferative uterine diseases. Materials and methods. A prospective cohort randomized study was conducted among 680 women treated at the Department of Purulent-Inflammatory Diseases in Obstetrics and the Department of Rehabilitation of Women's Reproductive Function at the State Institution "All-Ukrainian Center for Motherhood and Childhood of the National Academy of Medical Sciences of Ukraine" from January 2018 to December 2024. Group 1 included 517 pregnant women with HPD and their combinations (LM, A, PE and/or GE). Group 2 (comparison group) consisted of 82 pregnant women without HPD but with pregnancy complications. Group 3 (control group) included 81 pregnant women without HPD and without pregnancy complications. Results. Early pregnancy loss was observed in 68.2% of pregnant women with HPD, while 36.6% of patients had a history of induced or medical abortions, and 27.2% exhibited a combination of complications from previous pregnancies. A high frequency of uterine wall curettage was also noted in the medical history of pregnant women with HPD (88.6%). During the first trimester, the threat of early miscarriage was present in 90% of pregnant women with HPD (OR = 3.922; 95% CI: 2.261–6.802). Retrochorial hematoma was detected twice as often in Group 1 compared to the comparison group (OR = 2.519; 95% CI: 1.418–4.473), and low placentation was observed in 18.9% of women in Group 1 (OR = 2.163; 95% CI: 1.010–4.635). These complications were more prevalent in pregnant women with a combination of adenomyosis and other uterine fibroids. Conclusions. Pregnancy in women with hyperproliferative uterine diseases (LM, A, PE and/or GE present prior to pregnancy) is frequently complicated during the first trimester by the threat of early miscarriage, retrochorial hematoma, and low placentation.