Clinical and diagnostic aspects of abnormal uterine bleeding in reproductive aged women with extragenital pathology

I.A Tuchkina,E.V Blagoveshchensky,R.E Blagoveshchensky,L.A Vygivska

doi:10.18370/2309-4117.2021.59.101-104

I.A Tuchkina, E.V Blagoveshchensky + Show 2 more

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https://doi.org/10.18370/2309-4117.2021.59.101-104

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Abstract

Study objective: to determine the clinical and diagnostic features of the abnormal uterine bleeding (AUB) in women of reproductive age with extragenital pathology.Materials and methods. The study involved a retrospective assessment of 400 case histories of reproductive aged women with AUB who underwent inpatient treatment.The main clinical group (I) consisted of 300 case histories of women with AUB and concomitant extragenital disorders, control group (II) consisted of 100 case histories of somatically healthy women with AUB. An ultrasound scan with Doppler mapping was performed to assess the pelvic organs. All women underwent hysteroscopy and/or separate diagnostic curettage with further morphological assessment of the endometrium.Results. The most common extragenital disorder was diseases of the circulatory system and endocrine system, diseases of the digestive system. 123 patients (41%) had concomitant hypertension and obesity, 76 (25.3%) – obesity and varicose veins, 53 (17.6%) – somatoform autonomic dysfunction and chronic gastritis, 39 (13%) – obesity and diabetes mellitus, 24 (8%) – chronic gastritis and obesity. AUB was complicated by anemia of varying severity in 176 (58.6%) women. According to ultrasound data the most common endometrial disorder in women of group I was glandular hyperplasia of the endometrium.Conclusion. A retrospective analysis of case histories showed a high prevalence of AUB among women with extragenital pathology, which is a clinical indicator of major menstrual disorders in this category of patients and can be a serious problem for women's health in general. The need to study the prevalence and identify the main risk factors for the AUB development will make it possible to provide a general strategy for its prevention, improve the reproductive potential of women and avoid serious abnormal changes in the process of fulfilment of the reproductive function in young women.

Highlights

Abnormal uterine bleeding (AUB) occupies one of the central places among gynecological problems [1]
MATERIALS AND METHODS The study involved a retrospective assessment of 400 case histories of reproductive aged women with AUB who underwent inpatient treatment at the communal non-profit enterprise “City Maternity Hospital No 1” of Kharkiv City Council for the period 2015–2019
AUB was complicated by anemia of varying severity in 176 (58.6%) women

Summary

Introduction

Abnormal uterine bleeding (AUB) occupies one of the central places among gynecological problems [1]. Long-term AUB associated with asthenic syndrome, anemia, fatigue, depression development, a significant decrease in labor productivity, disrupt normal daily life, resulting in a significant deterioration in the life quality of women with a simultaneous increase in the burden on the health care system [6, 7]. Both gynecological and extragenital pathology are of great importance in the etiopathogenesis of AUB. Secondary to metabolic endocrine disorders, in particular obesity, dyslipidemia causes atherosclerotic damage of the vascular wall; an increase in leptin leads to hyperinsulinemia and insulin resistance, hyperglycemia as a result of various hormonal and metabolic disorders has a vasospastic, damaging effect on the vascular wall and an increase in the thrombogenic potential of the endothelium, aggravating bleeding [10–15]

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Conclusion