Kosiuha O. Prevention and treatment of early gestational complications in women with adenomyosis

In the presented dissertation the new solution of the actual problem of modern obstetrics and gynecology is presented - to reduce the number and severity of early gestational complications in women with adenomyosis. The dissertation work presents a new solution to the the actual task problem of modern obstetrics and gynecology - to reduce the number and severity of early gestational complications in women with adenomyosis. Based on a retrospective analysis of the reproductive results of cycles of assisted reproductive technologies in women of good responders with a radiologically established diagnosis of adenomyosis and evidence of its direct influence on the course and results of pregnancy, determination of possible morphofunctional uterine factors of reproductive disorders in adenomyosis, studies of the effect of various methods of preconception training in infertile women of good responders with adenomyosis to myometrial vascularization, hormonal status, proteomic profile, endometrial immunoreactivity and reproductive results, an optimal method of preconception training in women with adenomyosis was proposed. Based on the analysis of the features of sonographic, Doppler and biochemical markers of placentation, nitrosative status in women with adenomyosis at 7-8 weeks of pregnancy, a pathogenetically substantiated prophylactic therapeutic and prophylactic method of managing women with adenomyosis in the first half of pregnancy has been developed, its advantages have been presented. Conducting the proposed pathogenetically grounded prophylactic treatment method for the management of women with adenomyosis leads to a statistically significant reduce the number of complications in the first half of pregnancy, including the threat of abortion 2.56 times (OR 0.22, 95% CI 0,09-0,55), retrochoric hematomas - 2,13 times (OR 0.36; 95% CI 0.13-0.99), early miscarriages - 3.07 times (OR 0.26, 95% CI 0,08-0.88), late miscarriages - 2.05 times (OR 0.47, 95% CI 0.08-2.68), all miscarriages – 2.73 times (OR 0.27, 95% CI 0,09-0.77).