Features of the course of gestational processes in women with adenomyosis

Authors

DOI:

https://doi.org/10.18370/2309-4117.2025.81.18-26

Keywords:

рregnancy, adenomyosis, gestational process, complications

Abstract

Background. The relevance of the topic of the features of gestational processes in women with adenomyosis lies in the high frequency of occurrence in practical medicine of infertility, miscarriage, gestational complications by trimesters of gestation, obstetric bleeding in childbirth, etc. Adenomyosis in the vast majority of women clinically occurs in parallel with concomitant gynecological, somatic diseases, negatively affects the psycho-emotional state of women.
Objective of the study: determination of the features of the course of gestational processes in women with adenomyosis of I–II degree.
Materials and methods. We observed 51 women of reproductive age. Of these, 34 had adenomyosis of the I-II degree of severity, who were divided into subgroups depending on the management algorithm. The remaining 17 pregnant women without gynecological pathology were included in the control group.
Results. The average duration of the adenomyosis was 5–7 years. More than 80% of the participants with adenomyosis underwent treatment within the last three years. These patients had a high frequency of somatic and gynecological pathology, a high level of gestational complications, including chorionic/placental abruption, hypotonic bleeding during childbirth. The indicators were significantly better in the group of women who received preconception preparation.
Conclusions. Women with adenomyosis and reproductive plans are subject to systematic dispensary supervision, including the use of etiopathogenetic therapy and timely complex stage-by-stage personalized preconception preparation for pregnancy. The algorithm for managing pregnant women with adenomyosis should be exclusively personalized depending on the clinical general condition of the mother and fetus, data from instrumental and laboratory examinations in the dynamics of observation. Delivery must take place under obstetric supervision due to the risk of bleeding.
Women with adenomyosis should undergo preconception preparation 4–6 months before pregnancy, which includes hormone therapy (micronized progesterone), vitamin D in combination with the trace element magnesium, folate in physiological doses, macro- and microelement complexes for pregnant women, nutritional support, and measures to maintain mental health.

Author Biographies

V.P. Mishchenko, Odessa National Medical University, Odessa

MD, professor, Department of Obstetrics and Gynecology

V.V. Mishchenko, Odessa National Medical University, Odessa

MD, professor, Department of Surgery, Radiodiagnosis, Radiation Medicine, Therapy and Oncology

References

  1. Babienko VV, Mokienko AV. Substantiation of the definition and correction of magnesium deficiency as an essential macronutrient and stress-limiting factor (review of the literature and results of our own research). Public Health Journal. 2023;3:23–32. DOI: 10.32782/pub. health.2023.3.3
  2. Bulgar AV. Clinical assessment of the condition of women of reproductive age with adenomyosis after COVID–19. Bulletin of the Vinnytsia National Medical University. 2023; 1(27):69–73. DOI: 10.31393/reports-vnmedical-2023-27(1)-13
  3. Bulgar AV, Zaporozhchenko MB. Peculiarities of management of patients with adenomyosis in women of reproductive age, patients with adenomyosis, in the post-covid period. Reproductive Endocrinology. 2023;1(67):68–73. DOI: 10.18370/2309-4117.2023.67.68-73
  4. Goncharenko GY. The role of estrogen and progesterone receptors in women with adenomyosis in postmenopause. Bulletin of the Vinnytsia National Medical University. 2019;1(23):148–52. DOI: 10/31393/reports-vnmedical-2019-23(1)-26.
  5. Bulavenko OV, Bodnarchuk OV, Goncharenko OM, et al. Dynamics of lipid metabolism markers during combined preventive therapy of pregnant women with obesity and reduced vitamin D status. Reproductive endocrinology. 2022;4(66):54–60. DOI:10.18370/2309-4117.2022.66.54-60
  6. Kravchenko OV, Solovey VM. Peculiarities of the course of the gestational period, childbirth and condition of newborns in patients with the threat of early termination of pregnancy. Neonatology, surgery and perinatal medicine. 2022;12;3(45):22–28. https://doi.org/10.24061/2413-4260.XII.3.45.2022.
  7. Рotapov VO, Ivakh VI. Strategy for preventing recurrence of uterine leiomyoma in combination with adenomyosis after organ-preserving operations in women of reproductive age. Reproductive endocrinology. 2019;5(49):16-21. DOI: 10.18370/2309-4117.2018.49.12-16
  8. Devall AJ, Coomarasamy A. Sporadic pregnancy loss and recurrent miscarriage.” Best Practice & Research: Clinical Obstetrics & Gynaecology. 2020;69:30–39. DOI: 10.1016/j.bpobgyn.2020.09.002
  9. Tatarchuk TF, Zakharenko NF, Regeda SI, et al. Algorithms for prescribing menopausal hormone therapy in different periods of menopause. Reproductive endocrinology. 2022;4(66);68–70. http://dx.doi.org/10.18370/2309-4117.2022.66.68-70
  10. Prescott J, Farland LV, Tobias DK, et al. A prospective cohort study of endometriosis and subseguent risk of intertility. Hum.Reprod. 2016;31.7:1475–82. DOI: 10.1093/humrep/dew085
  11. Abbott JA. Adenomyosis and abnormal uterinebleeding (AUB–A) – pathogenesis, diagnosis, and management. Best Pract. Res. Clin. Obstet.Genaecol. 2017;40:68–81. DOI: 10.1016/j.bpobgyn.2016.09.006.
  12. Ahn SH, Singh V, Tayade C. Biomarkers in endometriosis: challenges and opportunities. Fertil.Steril. 2017:107:523–32. DOI: 10.1016/j.fertnstert.2017.01.009
  13. Magnesium deficiency. [Internet]. DUODECIM Medical Publications, Ltd, 2018. Available from: http://guidelines.moz.gov.ua/documents/2918?id=ebm00503&Fo rmat=pdf.
  14. Pontis A, D’Alterio MN, Pirarba S, et al. Adenomiosis : a systematic review of medical treatment. Gynecol. Endocrinol. 2016;32:696–700. DOI : 10.1080/09513590.2016.1197200
  15. Andreev TS, Kleimenova AO, Drobintseva VO, et al. Signal molecules in volvedin the fermatio of new nerve endingsin endometriosis (literature review). Swing scientific results of biomedical research. 2019;5(1):94–107. DOI: 10.18413/2313-8955-2019-5-1-0-7
  16. Vanden Bosch T, de Bruijn AM, de Leuw RA, et al. A sonographic classification and reporting system for diagnosing adenomyosis. Ultrasound Obstet. Gynecol. 2019 May 5(53):576–582. DOI: 10.1002/uog.19096.
  17. Voitenko OV, Tkachuk TL. Psychological impact of combat stress on military personnel. Medical Affairs. 2017;7:141–6. DOI: 10.31640/LS-2017(7)27.
  18. Zlivkov VL, Lukomska SO, Fedan OV. Psychodiagnostics of personality in crisis life situations. К: Pedagogical thought, 2016; 219 p.
  19. Kokun OM, Agayev NA, Pishko IO, et al. Psychological work with military personnel - participants of the ATO at the recovery stage. Methodological manual. K: Research and Development Center of the Armed Forces of Ukraine, 2017;282 p.
  20. Psychological assistance in conditions of military operations. Psychological bulletin. 2023:3 [Internet]. Kyiv: Scientific and methodological center of the VFPO, 2023. Available from: https://uu.edu.ua/upload/universitet/normativni_documenti/Osnovni_oficiyni_doc_UU/Psihologichna_dopomoga/Psiholog_dopomoga_v_umovah_voennih_diy.pdf
  21. Tarasova V. Methodology for studying behavioral features in stressful situations of adolescents with an unreliable attachment style. Young Scientist. 2023;5:73-8. DOI: 10.32839/2304-5809/2023-5-117-14.
  22. Beery AK, Kaufer D. Stress, social behavior, and resilience: Insights from rodents. Neurobiology of Stress. Stress Resilience. 1 (2015): 116-127. DOI: 10.1016/j.ynstr.2014.10.004. ISSN 2352-2895. PMC 4281833. PMID 25562050
  23. Lovejoy DA, Barsyte D. Index. Sex, Stress and Reproductive Success. Chichester, UK: John Wiley & Sons, Ltd, 2011. DOI:10.1002/9780470979600.index
  24. Bie L. The Status and Research Progres on Vitamin D . Deficiency and Atrial Fibrillation. Braz J Cardiovasc Surg. 2019 Dec 1;34(5): 605-609. DOI:10.21470/1678-9741-2018-0322
  25. Carberg C. Vitamin D in the Cotext of Evolution. Nutrients 2022 Jul 22;15(15):3018. DOI: 10.3390/nul4153018
  26. Kusuma AAN, Widiyanti ES, Putra IGM, et al. Serum Magnesium Levels in Preeclampsia and Eclampsia Patients During Magnesium Sulfate Therapy. Journal of Obstetrics, Gynecology and Cancer Research. 2024;10(1):40–50. DOI: 10.30699/jogcr.10.1.40
  27. Thacher TD. Evaluating the Evidence in Clinical studies of Vitamin D in Covid-19. Nutrients 2022 Jan 21; 14(3):464. DOI:10.3390/nu 14030464
  28. Wang Z, Hassan MU, Nadeem F, et al. Magnesium Fertilization Improves Crop Yield in Most Production Systems: A Meta-Analysis. Front Plant Sci Jan. 2020;24(10):1727. DOI: 10.3389/fpls.2019.01727. PMID: 32038691; PMCID: PMC6992656.
  29. Zmijewski MA. Vitamin D and Human Health. Int J Mol Sci. 2019 Jan 3;20(1):145. DOI:10.3390/ijms 20010145

Published

2025-12-30

How to Cite

Mishchenko, V., & Mishchenko, V. (2025). Features of the course of gestational processes in women with adenomyosis. REPRODUCTIVE ENDOCRINOLOGY, (81), 18–26. https://doi.org/10.18370/2309-4117.2025.81.18-26

Issue

Section

Gynecology