MYOMAS AND MIDWIFERY ACTIVITIES IN THE CARE OF WOMEN DIAGNOSED WITH UTERINE MYOMAS

Miomi su najčešće dobroćudni tumori maternice građeni u prvom redu od glatkih mišića. Ne pojavljuju se prije puberteta, rastu pod utjecajem hormona (estrogena) u reproduktivnoj dobi, a s pojavom menopauze im učestalost opada. Rijetko ih pronalazimo pojedinačno, već se obično pojavljuju kao multipli (više mioma istovremeno). Uzrok nastanka mioma nije poznat, no estrogen pospješuje njegov rast. Mogu biti karakterizirani cijelim rasponom simptoma, a najčešći simptom koji se javlja je metroragija i zbog njega je najčešće potreban kirurški zahvat. Najčešći indikacija za histerektomiju je obilno i nepravilno krvarenje iz maternice uzrokovano miomima. Kako simptomi mogu biti bolni i nelagodni te remete kvalitetu života, potrebno je što prije postaviti točnu dijagnozu pacijentice. Najprije uzimamo osobnu i obiteljsku anamnezu te svakoj ženi pristupamo individualno. Liječenje mioma ovisi o više faktora, a to su: dob pacijentice, paritet, sadašnjoj trudnoći, želji za trudnoćom, općem zdravlju pacijentice, simptomima te veličini i smještaju mioma. Postoje tri vrste liječenja, a najčešći izbor liječenja kirurški je pristup. Danas primalja ima važnu ulogu u pripremi pacijentice za operaciju, ali i nakon nje. Educira ju, savjetuje i skrbi za nju tijekom boravka u bolnici, pregleda u privatnim ordinacijama ili u bilo kojoj drugoj zdravstvenoj ustanovi te ima velik utjecaj na psihološko stanje pacijentice. Fibroids are the most common benign tumours of the uterus primarily composed of smooth/slick muscles. They do not occur before puberty as they grow influenced by the oestrogen hormone in the reproductive age and with the beginning of menopause, their frequency diminishes. They are rarely seen individually but rather occur as multiples (more fibroids at the same time). The cause of the creation of the fibroid is not known, but what is known is that the oestrogen helps its growth. They can be characterised by a wide range of symptoms, the most common being metrorraghia which requires a surgery. The most common indication for hysterectomy is abundant and irregular bleeding of the uterus caused by fibroids. As the symptoms can be painful and uncomfortable as well as disruptive of the quality of life, the correct diagnosis of the patient is necessary. Primarily, there is a need to gather personal and familial anamnesis and approach each patient individually. Fibroid treatment depends on several factors, and these are: the age of the patient, symptoms as well as the size and position of the fibroid. Today, the midwife has an important role in the preparation of the patient for the operation and afterwards. They educate the patient, advise her and take care of her during her stay in the hospital, during the check-ups in the private hospital or other health institution and has a huge impact on the psychological state of the patient.