Female Diseases
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Adenomyosis uterus and pregnancy

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Adenomyosis and pregnancy - in most cases inconsistent state. After endometriosis in more than 50% of the cause of infertility. And in some women with this disease arises various pathologies of pregnancy, in particular - miscarriage.

GENERAL

Adenomyosis, endometriosis, or uterine - this is the most frequent localization of endometrioid heterotopias (about 80% of all cases). It occurs mainly in women of childbearing age - 25-40 years.

Adenomyosis in pregnancy is characterized by the proliferation of functioning cells of the endometrium outside the uterine cavity, particularly in the muscular and serous layers of it. The appearance of such endometrioid heterotopias accompanied by the development of inflammation, as well as disruption of the structure and function of affected tissue.

CAUSES

Obvious causes of endometriosis, uterus during pregnancy has not yet been fully elucidated. Currently, however, reliably established hormone-genesis of the disease.

Contributing factors to the development of this pathology may be different medical intrauterine manipulations, genetic predisposition, hormonal imbalance, some gynecological and somatic diseases, and so on. d.

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The reasons causing infertility and are often unable to make pregnancy uterine adenomyosis is also not well understood. Most likely in this case are expressed hormonal disorders with the lack of ovulation, the structural changes in the endometrium and myometrium with impaired uterine capacity.

CLASSIFICATION

There are four stages of the flow of adenomyosis, which proved the depth of the uterus column. At the first stage the disease process is limited to the basal layer of the endometrium and myometrium approximately 30% of the thickness. And the fourth step is diagnosed defeat all segments of the uterine body with frequent involvement of the peritoneum and the adjacent organs.

Endometriosis uterine thicker may be located diffusely in the form foci or sites. Sometimes there is a mixed type of distribution of endometrioid heterotopias.

SYMPTOMS

Adenomyosis major manifestations are heavy and prolonged menstruation in combination with pain localized in the lower abdomen and / or back. Characteristic appearance of "smearing" spotting for two or three days before and after menstruation.

In some cases, the disease is asymptomatic. And some women are considered "normal" painful, heavy and prolonged menstruation and do not go to the doctor.

During pregnancy adenomyosis symptoms markedly reduced.

DIAGNOSTICS

Manifestations of adenomyosis are quite typical, and suspect the disease is already possible at the stage of clinical examination.

To confirm the diagnosis using a variety of additional methods of research. Chief among them are: an ultrasound scan of the pelvic organs, hysteroscopy and laparoscopy. Sometimes used hysterosalpingography and magnetic nuclear imaging.

TREATMENT

Adenomyosis treatment involves a comprehensive approach and includes conservative and surgical measures.

The main method of medical treatment of adenomyosis is the use of hormonal agents of various pharmacological groups. Selection of a particular drug is determined by the degree of incidence of the pathological process, severity of symptoms, and the presence of concomitant diseases.

Also in the treatment of endometriosis, uterine used anti-inflammatory and immunomodulatory agents, resolution therapy, physiotherapy and so on. D.

Surgical treatment in young patients is conducted as much as possible sparing. If possible, run an ablative surgery, allowing a woman to plan pregnancy in the future. After 40 years with adenomyosis in most cases made radical surgery in which the uterus is removed, often - with appendages. This is due to the frequent combination of adenomyosis with endometrial hyperplasia and tumors of the ovaries, which increases the risk of malignancies of female genital mutilation.

Independently quite difficult to conceive of the uterus endometriosis, and even more difficult - to bear and give birth to a healthy child in a timely manner. Because quite often in this disease have to resort to assisted reproductive technologies.

COMPLICATIONS

Long-term and progressive course of adenomyosis in pregnancy negatively affects the female reproductive function, with the result that often form the primary or secondary infertility.

If conception does occur the pathological changes in the uterus caused by adenomyosis, pregnancy is of paramount importance.

Adenomyosis is common in miscarriages and various complications of its flow.

Possible pathology during pregnancy adenomyosis:

  • Miscarriage or premature birth.
  • uterine rupture.
  • Premature detachment of the placenta.
  • Placental insufficiency.
  • Wrong position of the fetus at the time of delivery.

PREVENTION

The main preventive measure uterine endometriosis is the early detection of disease. Do not ignore the unpleasant symptoms that occur during menstruation or pregnancy.

Timely treatment to the gynecologist with adenomyosis in pregnancy will significantly improve the quality of life, prevent disease progression and the development of infertility.

FORECAST

Pregnancy after uterine adenomyosis in the case of its successful complex treatment occurs on average at 30-55% of women during the first year.

Complete cure uterine endometriosis is only possible in the case of radical surgical procedures.

Many women during pregnancy adenomyosis symptoms significantly reduced or even disappear, especially in the early stages of the disease. Further for this disease are difficult to predict, given a tendency to recurrence of endometriosis.

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