Prevention and treatment of obstetric and perinatal complications in women with adenomyosis

and methods. Clinical, laboratory and functional analysis of observations on 60 pregnant patients with adenomyosis was conducted, who were divided into two groups: the comparison – 30 patients who received the commonly used treatment and prophylactic measures and the main – 30 women who received our advanced algorithm for pregravid preparation and pregnancy (hormonal therapy, control and correction of the vaginal biota state, correction of metabolic processes and disorders of the blood coagulation system, diet therapy according to the method proposed by us, correction of psycho-emotional disorders, physical activity dose). 30 healthy pregnant women formed a control group. Results. The use of advanced treatment and prophylactic measures algorithm can reduce the frequency of placental dysfunction, preeclampsia, premature births, abnormalities in labor, intrauterine infection and fetal distress, as well as normalize the psycho-emotional state of pregnant women, which in aggregate can improve obstetric and perinatal consequences of childbirth. Conclusion. The requested algorithm for diagnostic and therapeutic and prophylactic measures can reduce the incidence of reproductive health in women with adenomyosis and can be widely used in practical health care. Key words: adenomyosis, pregnancy, obstetric and perinatal complications, prevention, treatment.

1. Adamyan LB, Kulakov VI, Andreeva EN. (2016). Endometriozyi: Rukovodstvo dlya vrachey. M, Meditsina: 411. 2. Aylamazyan EK, Potin VV, Tarasova MA. (2017). Genitalnyiy endometrioz. Ginekologiya ot pubertata do postmenopauzyi. M, MEDpress-inform: 284–302. 3. Hnatko OP, Samoilova MV. (2014). Otsinka yakosti zhyttia u zhinok z endometriozom yaiechnykiv. Tavrycheskyi medyko-byolohycheskyi vestnyk 15;2;1 (58): 60–63. 4. Kogan EA, Agokova EO, Unanyan AL. (2017). Besplodie pri endometrioze: kratkiy ocherk sovremennyih predstavleniy. Prostranstvo i vremya 1 (27): 251–259. 5. Korchynska OO, Mashtepa AM, Voloshyna UV ta in. (2015). Endometrioz yak odna iz suchasnykh problem u ginekologii ta akusherstvi (analitychnyi ohliad naukovoi literatury). Ukraina. Zdorovia natsii 2 (34): 104–115. 6. Nakaz MOZ Ukrainy vid 06.04.2016 r. No. 319 «Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry henitalnomu endometriozi (Unifikovanyi klinichnyi protokol pervynnoi, vtorynnoi (spetsializovanoi) medychnoi dopomohy «Taktyka vedennia patsiientok z henitalnym endometriozom». 7. Prudnikov PM. (2017). Porivnialni aspekty vplyvu riznykh metodiv likuvannia henitalnoho endometriozu na yakist zhyttia. Zdorove zhenshchynу 9: 97–100. 8. Unanyan AL. (2017). Endometrioz i reproduktivnoe zdorove zhenschin. Akusherstvo, ginekologiya i reproduktsiya 4; 3: 6–11. 9. Chervak NM. (2017). EndometrIoz: stan problemi. Meditsinskie aspektyi zdorovya zhenschiny 8 (83): 2–7. 10. Barañao RI. (2015). Thinking about Endometriosis. SAEGRE Magazine XXII;1: 6–9. 11. Johnson N, Hummelshoj L. (2013). Consensus on current management of endometriosis. Hum Reprod. 28: 1552–1568. https://doi.org/10.1093/humrep/det347; PMid:24014602 12. Huhtinen K, Perheentupa A, Poutanen M et al. (2017). Pathogenesis of endometriosis. Duodecim. 127;17: 1827–1835. 13. Nezhat C, Nezhat F, Nezhat C. (2016). Endometriosis: ancient disease, ancient treatments. Fertility and Sterility 98;6; Supplement: S1-S62. https://doi.org/10.1016/j.fertnstert.2012.08.001; PMid:23084567