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Introduction. Uterine artery embolization (UAE) is an effective minimally invasive manipulation that has been widely applied in obstetric and gynecological practice. The expediency of using this method of surgical treatment in patients with reproductive plans is still controversial. The main clinicians' concerns are the risk of developing local endometrial ischemia able to lead to habitual miscarriage, premature birth and pathological placentation as well as decreased ovarian reserve due to impaired adequate ovarian blood supply.Aim: to analyze the literature data regarding UAE effect on reproductive function.Materials and Methods. The search for literature was carried out in databases Web of Science, eLibrary, Scopus, PubMed/MEDLINE. We selected articles for the years 1995–2023 devoted to assessing UAE influence on reproductive function. The articles were searched by the keywords "embolization", "uterine arteries", "reproductive function", "prognosis", "assessment". No methodological filter was used to exclude the omission of suitable articles. The study included full-text sources and literary reviews on the subject under study. Articles that are not directly related to the subject UAE were excluded from the review. In order to avoid the inclusion of duplicate publications if two same author studies were found, the study period of each author was assessed, and if publication dates coincided, the most recent publication was selected.Results. Based on the review of domestic and foreign literature sources over recent years, it can be concluded that there are restrictions on the frequency and outcomes of pregnancy in such cohort of patients who underwent UAE. Many patients included in existing studies and case reports have variable factors complicating direct analysis or comparison such as age of patients, previous spontaneous abortions, previous uterine surgery, different techniques and professional training of X-ray endovascular surgeons, uncertainty of a woman regarding further reproductive plans and other forms of infertility, which can also distort research results. In addition, the most well-controlled studies often have small patients sample sizes not allowing to obtain meaningful clinical information from thereof.Conclusion. Pregnancy is possible in women after UAE, and many of these pregnancies proceed without complications and lead to successful childbirth. The actual fertility rate after UAE remains uncertain, but is approaching 38.3 % based on the available published results.

Choosing a treatment option for uterine fibroids is today one of the most relevant problems in gynecological practice. Thanks to the success of modern medicine and the increased level of the population’s culture, female patients seek medical help without waiting for the tumor to acquire significant sizes. However, in practice, there are cases when fibroids reach gigantic sizes. Hysterectomy is a traditional approach to treating uterine fibroids of these sizes according to the current clinical guidelines. The introduction of new high-tech treatments, such as uterine artery embolization, has led to a revision of radical surgery, by giving preference to alternative approaches especially in cases where the patient desires to preserve the reproductive organ. The paper describes a clinical case that confirms an individual approach to choosing a treatment option towards organ-sparing surgery for giant uterine fibroids. The use of endovascular embolization of the uterine arteries as a treatment for giant uterine fibroids is shown to be justified as an organ-sparing surgery if the patient desires to preserve reproductive function.

The article presents the results of long-term prospective clinical research on uteroplacental and fetal blood flow of pregnant women. In the research they made a special in-depth analysis of single disturbance of blood flow in uterine artery basin according to Doppler measure data after 18-week gestation. They connect uteroplacental perfusion disturbance with chronic infection nidi (focus) of different location in the organism of pregnant woman. They made comparative analysis of correcting therapy, when there is an uteroplacental perfusion disturbance, including detection and elimination of persistent infection nidi (asymptomatic forms as well), and also application of medicaments that influence vascular tone and rheological properties of blood. They showed efficiency of Diripidamol when used for idiopathic disturbances of uteroplacental perfusion.

Objective: to make analysis of isolated deterioration of blood flow in the pool of uterine arteries in low-risk pregnancy after 18-week gestation, to detect connection of blood flow deterioration with infection processes of different location in the organism of pregnant women.Methods. Doppler screening research was made as well as analysis of spectrograms of uteroplacental and fetal blood flow of 357 pregnant women.Results. Low-risk pregnancy was accompanied by high frequency of hyperdynamic deterioration in the system of "mother-placenta-fetus" (14%), most frequently was detected the reduction of perfusion data of uteroplacental blood flow (67,9%) with almost absolute dominance (prevalence) of one-sided deterioration; high correlation dependence was revealed between reduction of uteroplacental blood flow and existence of extragenital chronic infection foci (71,4%); asymptomatic bacteriuria and infection-and-inflammatory disease of laryngological organs; causal treatment improved hemodynamic rates, with idiopathic forms of uteroplacental perfusion deterioration, pathogenic treatment is recommended, dipyridamol – 75 mg daily (25 mg three times a day) is a chosen medicine.Conclusion. Isolated one-sided deterioration of uteroplacental blood flow during low-risk pregnancy may be considered as the mark of chronic infection foci in the body of a pregnant woman; well-timed diagnostics and causal treatment allow to avoid progressive deterioration of hemodynamic rate.

Purpose: to study relation between middle rectal and uterine arteries in norm and with uterine fibroids.Materials and methods: the analysis of angiograms of 63 patients with the uterine fibroids and without pathology (n=29 and n=34 respectively) was performed. Localization of orifices of middle rectal arteries, their diameter, existence anastomosis with uterine arteries are estimated.Results: the right middle rectal artery generally departed at level or earlier than uterine artery (26,3% and 21,1% respectively), and left was more often above the orifice of a uterine artery (42,1%). Diameter of rectal vessels didn’t differ in both groups (р>0,05). Anastomosis between middle rectal arteries and uterine vessels were better developed in the I group (52,4% of upervision).Conclusion: the network of anastomosis between middle rectal arteries and uterine arteries was more developed in I group (patients with uterus myoma), that caused higher risk of inappropriate embolism. Knowing features of orifices relation helps to reduce time of endovascular intervention and lower radiation influence.

Objective: to make analysis of isolated deterioration of blood flow in the pool of uterine arteries in low-risk pregnancy after 18-week gestation, to detect connection of blood flow deterioration with infection processes of different location in the organism of pregnant women.Methods. Doppler screening research was made as well as analysis of spectrograms of uteroplacental and fetal blood flow of 357 pregnant women. Results. Low-risk pregnancy was accompanied by high frequency of hyperdynamic deterioration in the system of "mother-placenta-fetus" (14%), most frequently was detected the reduction of perfusion data of uteroplacental blood flow (67.9%) with almost absolute dominance (prevalence) of one-sided deterioration; high correlation dependence was revealed between reduction of uteroplacental blood flow and existence of extragenital chronic infection foci (71.4%); asymptomatic bacteriuria and infection-and-inflammatory disease of laryngological organs; causal treatment improved hemodynamic rates, with idiopathic forms of uteroplacental perfusion deterioration, pathogenic treatment is recommended, dipiridamol - 75 mg daily (1/3 three times a day) is a chosen medicine.Conclusion. Isolated one-sided deterioration of uteroplacental blood flow during low-risk pregnancy may be considered as the mark of chronic infection foci in the body of a pregnant woman; well-timed diagnostics and causal treatment allow to avoid progressive deterioration of hemodynamic rates.