CHARACTERISTICS OF REPRODUCTIVE POTENTIAL IN WOMEN WITH A DISORDER OF MENASTRAULAL FUNCTION REGULARIZATION IN ANAMNESIS TAKING INTO ACCOUNT BODY MASS INDEX
DOI:
https://doi.org/10.11603/24116-4944.2017.2.8046Keywords:
disorder of menstrual function regularization, deficit of body weight, obesity, reproductive potential, pregnancy course.Abstract
The aim of the study – to assess the reproductive potential and peculiarities of the pregnancy and childbirth in women with a variation of body mass index and a disorder of menstrual function regularization.
Materials and Methods. An examination of 110 women with a disorder of menstrual function regularization in anamnesis (the main study group), starting from the preconception preparation stage, using clinical, laboratory, microbiological, sonographic (ultrasound and doplerometric), hormonal and statistical research methods have been carried out. Three groups have been formed: comparison group, which included 24 patients with normal mass-and-height index (BMI = 18.5–24.9), the first study group – 41 women with excess body weight and the second study group – 45 patients with deficit of body weight (BMI <18.5 kg / м2). The control group included 20 practically healthy women.
Results and Discussion. In most women with a deficit of body weight, a delayed puberty, sexual infantilism, a disorder of menstrual function regularization by type of algodismenorrhea and dysfunctional uterine bleeding have been diagnosed, while women with overweight suffered from polycystic ovary syndrome or menstrual disturbances by type of oligoopsomenorrhea with episodes of secondary amenorrhea. The assessment of a “family portrait” and analysis of abstract of outpatient medical records of a child’s development made it possible to mark the preterm births in 12.72 % of cases, and newborns with low birth weight – in 35.45 % of observations. Also, the heterogeneity in physical development of women of the main group was found: macrosomatic harmonious development (28.18 %), disharmonious development (14.54 %), microsomatic harmonious development (23.63 %), mesosomatic harmonious development (33.63 %). In the group of patients with overweight, primiparas who were pregnant again, accounted for two-thirds of all examined patients. Pelvic surgeries, medical abortions and instrumental interventions were noted in 29.26 % of cases, premature spontaneous miscarriages – in 8.76 %, preterm labor – in 21. 95 %, primary infertility – in 12.19 %. A more pronounced decline in reproductive capacity was commonly found in women of the second group with a deficit of body weight. Primary or secondary infertility was diagnosed in 35.55 % of patients; pregnancy in women of the second group occurred during the first year of regular sexual life (17.77 %), during the second year – in 24.44 %, 28.88 % of women became pregnant after hormonal correction or after applying the assisted reproductive technologies.
Conclusions. The analysis of reproductive potential demonstrated a high percentage of primary infertility, hormonal induction of ovulation, the use of assisted reproductive technologies, and a large number of obstetric complications and pathological childbirths without a significant difference in the groups. However, differences in the structure of gestational and delivery complications with predominance of habitual noncarrying of pregnancy and surgical delivery in women with a deficit of body mass and increasing preeclampsia, placental dysfunction and postpartum complications in patients with overweight should be noted
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