Mikronizovaný progesteron v léčbě hrozícínekrózy myomu v graviditě. Ultrazvukovézměny v průběhu léčby
Z. Hájek; M. Uhlíř
Gynek. -porod. klinika 1. LF UK a VFN, Praha, přednosta prof. MUDr. J. Živný, DrSc.
Ceska Gynekol 1999; (3): 189-192
In two pregnant primigravidae with signs of imminent necrosis of a myoma treatmentwith micronized progesterone, preparation Utrogestan R , was successful. After oral and vaginaltreatment with a dose of 300 - 600 mg/day the symptoms receded within several days. Completeregression of symptoms was recorded within one to two weeks. Both women terminated theirpregnancy during the 37th - 38th week and were delivered of healthy infants. One women gavebirth to the infant by Caesarean section, the other one per forcipem Shutte. During surgery onthe myoma no signs of degeneration were found and it was left in situ. Progesterone treatmentprevented in both women surgery on account of an acute abdomen. Treatment was monitored byultrasonographic assessment of the flow in afferent vessels of the myoma. This measurementrevealed marked changes, i.e. an increased flow. At the onset of treatment there was a smalldifference between the indices of pulsatility (PI) and resistance (RI). This difference increasedgradually, and also the difference between systole and diastole in the investigated vessels increa-sed. This led to an increased flow and blood supply of the myoma. Thus evidence can be providedthat large doses of natural progesterone have a favourable effect on the blood vessels and increa-se the blood flow in the vascular wall at the site of the myoma.
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Gynaecology and obstetrics