Novikova Anastasiia Artemivna A. Optimization of diagnosis and prognosis of abnormal uterine bleeding during puberty

The study is devoted to the optimization of diagnosis, treatment, prognosis and prevention of abnormal uterine bleeding during puberty (AUDP). The study identified provoking factors as possible causes that preceded the development of bleeding. Most often there was a stressful situation, acute or exacerbation of chronic diseases of the respiratory system. It is established that menstrual dysfunction in the form of uterine bleeding leads to serious pathological changes in the endocrine and immunological state of the adolescents, accompanied by severe hemostasis shifts, anemia in 66.6% of patients, psycho-emotional abnormalities and thus, complicates not only puberty period, but also increases the risk of complications in the process of normal realization of reproductive potential in the future. Significant changes in the platelet-vascular link of the hemostasis system with subsequent involvement in the process of coagulation potential due to a decrease in the anticoagulant system of the blood have been identified. The study showed serious disorders of the hypothalamic-pituitary-ovarian system, characterized by a decrease in the LH / FSH index (62.3%), hypoprogesteronemia (69.6%), hyperestrogenemia (40.3%), hyperprolactinemia (24%), increased cortisol levels in every third patient. There was high increased level of special anxiety as the main reason of stress, as it was superfluous to decreased level of dopamine, norepinephrine and increased level of adrenaline and cortisol; the value of the adjustment in place of IL-1α, IL-8, FNP-α in blood, against the background of pathological changes in biocenosis in control group patients. The investigation allowed to identify complex dopplerometric characteristic of hemodynamic disturbances of pelvic organs in AUBDP depending on features of a clinical course of puberty taking into account hormonal profile and the condition of endometrium. The authors developed an algorithm for predicting the occurrence and recurrence of AUBDP in adolescent girls. Complex treatment with inclusion of non-hormonal (with efficiency of 87%) and hormonal techniques, adequate physiotherapy and psychoprophylaxis has been developed and tested