Корекція способу життя як допоміжна прегравідарна підготовка та профілактика акушерських ускладнень у жінок з аденоміозом

Abstract

The objective: to evaluate the effectiveness of the proposed method of lifestyle correction as an auxiliary pregravid preparation and prevention of obstetric complications in women with adenomyosis. Patients and methods. 65 patients of reproductive age (29–32 years) with adenomyosis in 1–2 stage. Control group – 38 healthy women. Differences between the groups: pregravid preparation (group 1 received dietary recommendations and metered physical exercises, group 2 – combined oral contraceptives) and pregnancy (group І received progesterone therapy and diet therapy, group ІІ received exclusively progesterne therapy). Levels of progesterone, placental lactogen, tumor necrosis factor, interleukin-6, percentage of pregnancy, early miscarriage risks and reproductive loss were studied. Results. In 87% of women with adenomyosis there were manifestations of inflammation of different localization in pelvis, infertility – in 94% of women. The level of IL-6 in women with adenomyosis before treatment was increased by almost 2.6 times. The increase in tumor necrosis factor- is associated with dysfunction of the inner organs, as possible development factor of septic complications. The reduction of progesterone in patients with adenomyosis confirms the pathogenetic mechanism of the disease. In group I, 80% (28) had pregnancy, 42.8% (12) had risk of miscarriage, 14.3% (4) cases of reproductive loss. Pregnancy in group II was detected in 80% (24) cases, of which 50% (12) had a risk of miscarriage and 6 (25%) reproductive losses. Conclusions. Pregravidal preparation, which includes physical activity and dietary nutrition, contributed to improve reproductive function, normalized of the cytokine and hormonal profile in the progression of pregnancy, and contributed to the reduction in obstetric and perinatal losses in women with adenomyosis. Key words: adenomyosis, pregravidder training, lifestyle correction, pregnancy, obstetric complications.