Peculiarities of echography of pelvic organs disorders of menstrual function during puberty

Background. Pelvic ultrasonography is the method of choice for evaluating genitalia in children as an accurate, painless, non-invasive method that does not require sedation or ionizing radiation. Purpose – to determine the characteristics of ultrasound parameters of the pelvic organs, the level of steroid hormones and insulin in teenage girls with various disorders of the menstrual cycle (oligomenorrhea and abnormal uterine bleeding). Materials and methods. 393 girls with various disorders of the menstrual cycle were examined. 192 adolescents with abnormal uterine bleeding (AUB) and 201 patients with oligomenorrhea (OM). All patients underwent ultrasound examination of the pelvic organs. Serum levels of estradiol, testosterone, cortisol, DHEA-S and insulin were determined. Results. Peculiarities of echosonographic parameters of the uterus and ovaries in girls with various pathologies of the menstrual cycle-AUB and OM have been established. It was found that the increase in the size of the uterus and ovaries with age was characteristic of adolescents with OM, as it also happens during the physiological course of puberty. Such dynamics are not observed in patients with AUB. Phenomena of endometrial hyperplasia were 2.3 times more frequent in AUB (p ˂ 0.0001). Moreover, the thickness of the endometrium depended on the duration of bleeding, and decreased with prolonged uterine bleeding. In girls with OM, the thickness of the endometrium decreased with the increase in the period of existence of the violation of menstrual function. The location of ovarian cysts was observed in every 8–9 girls with disorders of menstrual function and did not differ significantly depending on the type of menstrual disorder. Multifollicular ovaries were detected twice as often. Morphometric and hormonal indicators had different effects on the parameters of the uterus and ovaries in girls with the opposite pathology of menstruation. The size of the uterus and ovaries during bleeding was influenced by BMI, cortisol, and testosterone, and in OM, primarily by age, estradiol, and insulin. Conclusions. The high diagnostic value and safety of ultrasound examinations make them the method of choice for pathology of the pelvic organs in teenage girls, which make it possible to reliably assess the anatomical features and hormonal status of children, to speed up the final diagnosis, which will contribute to the timely and differentiated appointment of treatment to girls with menstrual disorders.