To define clinical and morphological criteria for uterine scar competence after pregravid myomectomy, the authors examined 115 women, including 40 patients who had undergone laparotomic myomectomy, by sewing the nodal bed with double-row synthetic sutures, 40 women with a uterine scar from laparoscopic myomectomy, by sewing the nodal bed with double-row synthetic sutures, and 35 patients with a uterine scar from laparoscopic myomectomy, by coagulating the myoma nodal bed. Their examination revealed the ultrasound, hysteroscopic, and X-ray signs of scar incompetence in 47 women who underwent cesarean section later on. A delivery plan was worked out for the remaining 68 women during pregnancy and labor. The expediency of hormonal rehabilitation with midiana, a combined oral contraceptive containing drospirenone, was studied in 30 women in the postoperative period after myomectomy. A control group included 30 post-myomectomy patients who received conventional postoperative care. It has been established that in reproductive-aged women with uterine myoma, laparotomic or laparoscopic myomectomy should be carried out, by necessarily sewing the myomatous nodal bed with double-row sutures. Nodal bed coagulation is impermissible as the risk of histopathic hysterorrhexis is high during pregnancy. It has been found that it is reasonable to use midiane, a combined oral contraceptive, in reproductive-aged women in the postoperative period after myomectomy, which promotes the high-grade involution of the uterus and the creation of favorable conditions for adequate scar healing.