Features of endocrinological status and fetoplacental complex in pregnant women with adenomyosis

N.Y. Skripchenko, O.M. Pavlova, T.M. Mazur
In: HEALTH OF WOMAN · 2018 · pp. 104 · doi:10.15574/hw.2018.129.104 · W3140172380
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This study found pregnant women with adenomyosis experience placental dysfunction, preterm labor, and altered hormone levels, which improved with advanced metabolic and diet therapy.

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This study examined 90 pregnant women with adenomyosis, comparing outcomes and endocrinologic and fetoplacental markers between a control group of 30 healthy women, a group receiving classic progesterone therapy (n=30), and a main group receiving advanced preserving, metabolic, and diet therapy (n=30). The authors assessed fetoplacental complex status, IUGR frequency, fetal hemodynamic disturbances, and hormone levels including estriol, progesterone, cortisol, chronic gonadotropin, and placental lactogen. Placental dysfunction was reported as the main complication (60.0% with classic progesterone vs 33.3% with the advanced regimen), with lower levels of estriol, progesterone, HHG, and placental lactogen and higher cortisol in the comparison and main groups; after treatment, the main group’s hormone and related indicators improved. The paper directly focuses on adenomyosis pregnancy outcomes and endocrinological/fetoplacental features, with relevance to endometriosis and adenomyosis because it is centrally about adenomyosis-associated pregnancy complications and their endocrine and placental correlates.

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Abstract

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.
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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.

References

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