Features of the management of reproductive aged women with adenomyosis in the post-COVID period

development of an algorithm for managing women of reproductive age with adenomyosis of I–IV degrees of severity after COVID-19 by studying anamnestic, clinical, laboratory indicators, results of instrumental and hardware research and determining personalized therapy and prevention.

and methods. We monitored 120 reproductive aged women with adenomyosis after COVID-19, who were divided into group B (60 women with adenomyosis of the I–II degree of severity) and group C (60 women with adenomyosis of the III–IV degree of severity). Groups B and C were divided into 2 subgroups: subgroups B1 and C1 received the proposed therapy; subgroups B2 and C2 received standard therapy. All women underwent a clinical and laboratory examination, which included the study of the general condition, clinical and biochemical parameters, examination of biological fluids (blood, urine, vaginal contents), histomorphological study of the tissues of uterus, ovaries, hardware and instrumental methods of examination. The results were evaluated before treatment, after 3, 6 and 12 months of therapy, comparing between groups B and C. Results. The effectiveness of the proposed algorithm is confirmed by a significant difference (p < 0.05) in the reduction of the frequency of complaints, symptoms of exacerbation of extragenital and gynecological pathology, stabilization of indicators of general blood test, functional liver tests, lipid and cholesterol metabolism, reduction of indicators of hypercoagulation, activity of biological markers of inflammatory processes, increase the vitamin D and magnesium values, positive changes in the vaginal biocenosis, a decrease in the frequency of herpes simplex virus types 1 and 2 detection, an increase in the number of Lactobacillus sp., positive dynamics of uterine ultrasound parameters, including the state of blood flow in a. uterus in the observation dynamics after 3, 6 and 12 months. Conclusions. Women of reproductive age with adenomyosis of various degrees of severity after suffering from the COVID-19 disease are subject to personalized dispensary supervision, which includes diagnostic, therapeutic, preventive measures in the dynamics of observation. The definition of the measures of such algorithm should be based on the results of proven pathological changes in the body, namely: exacerbation of extragenital diseases, combined gynecological pathology, blood hypercoagulation and microcirculation disorders, activity of biological markers of inflammation, levels of sex hormones, vitamin D, magnesium, state of vaginal biocenosis.

- Bakun, O.V., Tkachuk, A.I. “Influence of genital endometriosis and concomitant diseases on infertility under the data of the retrospective analysis of case histories.” Bukovinian Medical Herald 4.92 (2019): 9–15. - Bulavenko, O.V., Bodnarchuk, O.V., Honcharenko, O.M., et al. “Dynamics of markers of lipid metabolism during combined preventive therapy of pregnant women with obesity and reduced vitamin D status.” Reproductive Endocrinology 4.66 (2022): 54–60. DOI: 10.18370/2309-4117.2022.66.54-60 - Goncharenko, G.Y. “The role of estrogen and progesterone receptors in postmenopausal women with adenomyosis.” Bulletin of the Vinnytsia National Medical University 1.23 (2019): 148–52. DOI: 10.31393/reports-vnmedical-2019-23(1)-26 - Medvedіev, M.V., Pokrovenko, D.A. “A modern view of the etiology, pathogenesis and diagnostic possibilities of external genital endometriosis (literature review).” Medical perspectives 24.1 (2019): 21–30. DOI: 10.26641/2307-0404.2019.1.162173 - Potapov, V.O. “Adenomyosis: problematic issues of treatment.” Obstetrics Gynecology Reproduction 2.43 (2021): Available from: [health-ua.com/article/65800-adenomioz-problemn-pitanny-likuvannya]. - Pryputnevich, T.V., Gordeev, A.B., Lyubasovskaya, L.A., et al. “The new coronavirus SARS-COV-2 and pregnancy: a literature review.” Obstetrics and gynecology 5 (2020): 6–12. DOI: 10.18565/aig.2020.5.6-12 - Senchuk, A.Y., Ventskivskyi, B.M., Tytov, A.V., et al. “Hereditary and acquired thrombophilias in obstetrics and gynecology practice.” Kyiv (2003): 84 p. - Tatarchuk, T.F., Zakharenko, N.F., Reheda, S.I., et al. “Algorithms for prescribing menopausal hormone therapy in different periods of menopause.” Reproductive Endocrinology 4.66 (2022): 68–70. DOI: 10.18370/2309-4117.2022.66.68-70 - Andreev, T.S., Kleimenova, A.O., Drobintseva, V.O., et al. “Signal molecules in volvedin the fermatio of new nerve endingsin endometriosis (literature review).” Swing scientific results of biomedical research 5 (2019): 94–107. - Chen, G., Wu, D., Guo, W., et al. “Clinical and immunological features of severe and moderate coronavirus disease 2019.” J Clin Inverst 13.5 (2020): 2620–9. DOI: 10.1172/JCI137244 - Ding, T., Zhang, J., Wang, T., et al. “Potential influence of menstrual status and sex hormones on female SARS-CoV-2 infection: a cross-sectional study from multicentre in Wuhan, China.” Clin Infect Dis 72.9 (2021): e240–8. DOI: 10.1093/cid/ciaa1022 - Gebhard, C., Regitz-Zagrosek, V., Neuhauser, H.K., et al. “Impact of sex and gender on COVID-19 outcomes in Europe.” Biology of Sex Differences 11.1 (2020): 29. DOI: 10.1186/s13293-020-00304-9 - Ghandehari, S., Matusov, Y., Pepkowitz, S., et al. “Progesterone in Addition to Standard of Care vs Standard of Care Alone in the Treatment of Men Hospitalized with Moderate to Severe COVID-19: A Randomized, Controlled Pilot Trial.” Chest 160.1 (2021): 74–84. DOI: 10.1016/j.chest.2021.02.024 - Guerriero, S., Condous, G., van den Bosch, T., et al. “Systematic approach to sonographic evaluation of the pelvis in women with suspected endometriosis, including terms, definitions and measurements: a consensus opinion from the International Deep Endometriosis Analysis (IDEA) group.” Ultrasound Obstet Gynecol 48.3 (2016): 318–32. - Harada, T., Kline, Y.M., Kaponis, A., et al. “The Impact of Adenjmyosis on Women’s Fertility.” Obstet Gynecol Surv 71.9 (2016): 557–68. DOI: 10.1097/OGX.0000000000000346 - Johnson, N.P., Hummelshoj, L., Adamson, G.D., et al. “World Endometriosis Society consensus on the classification of endometriosis.” Hum Reprod 32.2 (2017): 315–24. - Lippi, G., Plebani, M., Henry, B.M. “Thrombocytopenia is associated with severe coronavirus disease 2019 (COVID-19) infections: A meta-analysis.” Clin Chim Acta 506 (2020): 145–8. DOI: 10.1016/j.cca.2020.03.022 - Martire, F.G., Lazzeri, L., Conway, F., et al. “Adolescence and endometriosis: symptoms, ultrasound signs and early diagnosis.” Fertil Steril 114.5 (2020): 1049–57. - Richardson, S., Hirsch, J.S., Narasimhan, M., et al. “Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area.” JAMA 323.20 (2020): 2052–9. - Rolla, E. “Endometriosis: advances and controversies in classification, pathogenesis, diagnosis, and treatment.” F1000Research 8 (2019): F1000 Faculty Rev-529. DOI: 10.12688/f1000research.14817.1 - Rozhkovskaya, N.M., Sitnikova, V.O., Sivyi, S.M., Lomakina, I.S. “Clinical and morphological features of combined hyperplastic diseases of the uterus against the background of adenomyosis.” Journal of education health and sport 10.4 (2020): 226–33. DOI: 10.12775/JEHS.2020.10.04.025 - Singh, S.S., Suen, M.W. “Surgery for endometriosis: beyond medical therapies.” Fertil Steril 107.3 (2017): 549–54. DOI: 10.1016/j.fertnstert.2017.01.001 - Tang, N., Bai, H., Chen, X., et al. “Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy” J Thromb Haemost 18.5 (2020): 1094–9. DOI: 10.1111/jth.14817 - Tang, N., Li, D., Wang, X., Sun, Z. “Abnormal coagulation parameters are associated with poor prognosis in patients with novel coronavirus pneumonia.” J Thromb Haemost 18.4 (2020): 844–7. DOI: 10.1111/jth.14768 - Varga, Z., Flammer, A.J., Steiger, P., et al. “Endothelial cell infection and endotheliitis in COVID-19.” The Lancet 395.10234 (2020): 1417–8. DOI: 10.1016/S0140-6736(20)30937-5 - World Health Organization. WHO Coronavirus (COVID-19) Dashboard (2020). Available from: [https://covid19.who.int/]. Downloads Published How to Cite Issue Section License Copyright (c) 2023 А.В. Булгар, М.Б. Запорожченко This work is licensed under a Creative Commons Attribution 4.0 International License. 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