Характеристика перебігу пубертатного періоду у дівчаток-підлітків Прикарпатського регіону та основні чинники зниження репродуктивного потенціалу

Abstract

Reproductive capacity significantly depends on the period of puberty of a woman-to-be, as well as on the so-called «intrauterine childhood». The objective: to determine the peculiarities of the development of a girl during her puberty, to evaluate the causes of the menstrual function disturbances and to identify the main factors of the reproductive potential decline. Patients and methods. The medical and social audit was conducted by interviewing, questioning and studying the medical documentation (clinical symptoms of extragenital pathology, duration of the disease, state of menstrual function, heredity, lifestyle and bad habits) in 264 girls in order to evaluate the probable factors of the development of menstrual function disturbance and ovarian-menstrual cycle disorders. Results. The period of «intrauterine childhood» was in the context of a complicated gestation period: the threat of abortion, preeclampsia of varying degrees of severity, perinatal infections, preterm labour, fetal hypotrophy, harmful parenting habits, fetal distress during childbirth. More than two thirds of girls have chronic diseases of the internal organs, 24.2% of patients have the comorbidity of gynaecological pathology and extragenital diseases. Menstrual disorders predominate by type of algodismenorrhea, premenstrual syndrome and juvenile uterine bleeding. In sexually active adolescents the inflammatory processes of the genitals have been revealed in 46.2% of cases, undoubtedly the number of girls with absolute or relative risk of infertility is increasing. Dyshormonal diseases of the mammary glands were noted in 16.7% of cases, in girls with gynaecological pathology – twice as often, and in patients with menstrual function disturbances – 53.4%. The comparative analysis indicated the most obvious negative effect on the reproductive capacity, ovarian reserve of ovarian operations and hereditary predisposition to the disturbed reproductive function (OR=19.3; 95%: 3.1–92.6). Conclusion. The obtained results help in classifying the risk factors of reduced reproductive potential for female adolescents and girls, which allows to optimize the formation of risk groups, to predict and monitor the reduction of the ovarian reserve and to develop preventive measures for improvement of the reproductive capacity. The most significant causes that reduce the reproductive potential of girls in the period of «intrauterine childhood» are: complicated pregnancy (severe gestosis, complicated childbirth), maternal perinatal infections (especially in the early stages), and in the adolescence – ovarian surgery, childhood infections, hypothyroidism and bad habits (smoking). Key words: puberty, main causes of menstrual disturbances, reproductive potential.