- Features of endocrinological status and fetoplacental complex in pregnant women with adenomyosis
Features of endocrinological status and fetoplacental complex in pregnant women with adenomyosis
HEALTH OF WOMAN. 2018.3(129):104–107; doi 10.15574/HW.2018.129.104
Skripchenko N. Y., Pavlova O. M., Mazur T. M.
SI «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine», Kiev
The objective: to study the features of the endocrinological status and the fetoplacental complex in pregnant women with adenomyosis, the course of pregnancy and childbirth in these women, to develop new, systematize and improve the existing methods of diagnosis, treatment and prevention of complications and reproductive losses.
Materials and methods. We examined 90 pregnant women who were divided into groups: 30 healthy women – control group, a comparison group of 30 women with adenomyosis receiving classic progesterone therapy and the main group of 30 women with adenomatosis who received advanced preserving, metabolic therapy and diet therapy. The condition of the feto-placental complex, the frequency of IUGR, hemodynamic disturbances on the part of the fetus, and the level of estriol, progesterone, cortisol, chronic gonadotropin (CGL), placental lactogen were evaluated.
Results. The main complication in pregnant women with adenomyosis was placental dysfunction (the comparison group was 60.0% and the main group was 33.3%), whose structure was performed by compensated (58.2%) and subcompensated forms (35.8%). The frequency of preterm labor threat was 20.0% in comparison group and 13.3% in main one, while in the control group – 1 case, which is 3.3%. Frequency of SCR was in the comparison group – 20.0% and in the main – 3.3%. Low levels of estriol, progesterone, HHG, placental lactogen, increased cortisol levels in comparison and main groups were determined, and after treatment the indicators of the main group significantly improved.
Conclusions. With timely correction of violations, prevention of fetoplacental insufficiency and complex treatment with the use of advanced classical progesterone therapy in combination with metabolic and diet therapy we can significantly reduce the frequency of various complications in pregnant women with adenomyosis.
Key words: adenomyosis, pregnancy, non-pregnancy, diet therapy, metabolic therapy, preservation therapy, preventive care.
1. Bashmakova NV, Vinokurova EA, Krayeva OA. 2012. Premature birth prediction in women with primary and secondary recurrent miscarriages in an anamnesis. Obstetrics and Gynecology 5:29–33.
2. Bila V, Nіkіtіna Yu, Sazonenko L. 2014. The system of the family planing and reproductive health in Ukraine. Management of the health care institution 6:30-39.
3. Blokh ME, Dobryakov IV. 2013. Psychological assistance in the integrated approach to solve reproductive health problems. Journal of Obstetrics and Women's Diseases 62;3:16-19.
4. Vereina NK, Chulkov VS. 2010. The course of pregnancy and childbirth, the state of the endothelium in patients who smoked before pregnancy. Text. Journal of Obstetrics and Women's Diseases. LIX;3:110-112.
5. Greshchyshyn M, Precis V. 2000. Newest achievements in obstetrics and gynecology. Buffalo-Lviv.
6. Grishchenko NG. 2011. Pathogenetic bases of auxiliary reproductive technologies improvement in women who suffered chronic inflammatory diseases of the pelvic organs. Kharkiv:363.
7. Dankovich NA, Vorobei-Vikhovskaya VN. 2013. Causes and kinds of infertility. Modern possibilities of diagnosis and treatment. Women's Health 3:192-197.
8. Karpenko VG. 2001. Study of adrenocorticotropic hormone and melatonin in pregnant women with preeclampsia and anemia. Problems of Medicine 3/4:16-17.
9. Quinan DT, Hobbins DS, Spong KU. 2009. Protocols for high-risk pregnancies. Kyiv, Phoenix:792.
10. Chubei GV. 2008. Influence of the inflammatory process of genitals on the course of adenomyosis in women of reproductive age. Pediatrics, obstetrics and gynecology 1:88-91.
11. Benagiano G, Brosens I, Carrara S. 2009. Adenomyosis: new knowledge is generating new treatment strategies. Women’s Health 5(3):297-311. https://doi.org/10.2217/WHE.09.7; PMid:19392615
12. Bonocher CM, Montenegro ML, Rosa e Silva JC, Ferriani RA, Meola J. 2014. Endometriosis and physical exercises: a systematic review. Reproductive Biology and Endocrinology 12(4):112-117. https://doi.org/10.1186/1477-7827-12-4
13. Iams JD, Paraskos J, Landon MB. 2014. Cervical sonography in preterm labor. Obstet. Gynecol. 84:40.
14. Jain K, Radhakrishnan G, Agrawal P. 2014. Infertility and psychosexual disorders: relationship in infertile couples. Indian. J. Med. Sci. 54;1:1–7.
15. Juang CM, Chou P, Yen MS. 2017. Adenomyosis and risk of preterm delivery. BJOG. 114;2:165–169.
16. Koppan A, Hamori J, Vranics I, Garai J, Kriszbacher I, Bodis J, Rebek-Nagy G, Koppan M. 2010. Pelvic pain in endometriosis: painkillers or sport to alleviate symptoms? Acta Physiol Hung. 97(2):234-239.
17. Meis PJ, Michielutte R, Peters TJ. 2016. Factors associated with preterm birth in Cardiff, Wales. II. Indicated and spontaneous preterm birth. Amer. J. Obstet. Gynecol. 173(2):597–602.
18. Mendez Lozano DH, Fanchin R, Basille C. 2011. Taktika vedeniya zhenschin s plohim otvetom yaichnikov na stimulyatsiyu ovulyatsii v programmah VRT. Problemy reproduktsii 14;1:37-42
19. Mercer BM, Miodovnik M, Thunau GR. 2015. Antibiotic therapy for reduction of infant morbidity after preterm premature rupture of the membranes. A randomized controlled trial. JAMA. 278:989–95.