Особливості перебігу гестаційних процесів у жінок з аденоміозом

Background. The relevance of the topic of the features of gestational processes in women with adenomyosis lies in the high frequency of occurrence in practical medicine of infertility, miscarriage, gestational complications by trimesters of gestation, obstetric bleeding in childbirth, etc. Adenomyosis in the vast majority of women clinically occurs in parallel with concomitant gynecological, somatic diseases, negatively affects the psycho-emotional state of women. Objective of the study: determination of the features of the course of gestational processes in women with adenomyosis of I–II degree. Materials and methods. We observed 51 women of reproductive age. Of these, 34 had adenomyosis of the I-II degree of severity, who were divided into subgroups depending on the management algorithm. The remaining 17 pregnant women without gynecological pathology were included in the control group.Results. The average duration of the adenomyosis was 5–7 years. More than 80% of the participants with adenomyosis underwent treatment within the last three years. These patients had a high frequency of somatic and gynecological pathology, a high level of gestational complications, including chorionic/placental abruption, hypotonic bleeding during childbirth. The indicators were significantly better in the group of women who received preconception preparation.Conclusions. Women with adenomyosis and reproductive plans are subject to systematic dispensary supervision, including the use of etiopathogenetic therapy and timely complex stage-by-stage personalized preconception preparation for pregnancy. The algorithm for managing pregnant women with adenomyosis should be exclusively personalized depending on the clinical general condition of the mother and fetus, data from instrumental and laboratory examinations in the dynamics of observation. Delivery must take place under obstetric supervision due to the risk of bleeding.Women with adenomyosis should undergo preconception preparation 4–6 months before pregnancy, which includes hormone therapy (micronized progesterone), vitamin D in combination with the trace element magnesium, folate in physiological doses, macro- and microelement complexes for pregnant women, nutritional support, and measures to maintain mental health.