Organ-preserving operations are on the organs of small pelvis for proceeding in a reproductive health

Abstract

DOI: 10.52705/2788-6190-2023-02-12
УДК 618.17/.5-036.1-02:618.13-089

The objective: increase of efficiency of treatment of infertility and prophylaxis of perinatal pathologyfor women with violation of reproductive function as a result of disfunction of ovaries on abackground different genital morbidity on the basis of improvement and introduction of algorithmof diagnostic, treatment-and-prophylactic and rehabilitation measures with the use of modernendoscopic and reproductive technologies.

Materials and methods. Researches were conducted in two stages. On the first stage the functionalstate of the reproductive system was studied in 316 patients with female infertility (1thgroup), which carried organ-preserving operations on the organs of small pelvis. These patientswere up-diffused on 4 sub-groups taking into account the variant of present pathology. On thesecond stage the evaluation of clinical motion of pregnancy and births is conducted in 129 (40,8%)from 316 patients, operated on the first stage, which were also up-diffused on 4 sub-groups.In the complex of the conducted researches were included clinical, endoscopic, echographic, doppler,endocrinology, morphological and statistical.

Results. The patients of reproductive age have organ-preserving surgical interferences on theorgans of small pelvis, regardless of nosology, during a 6 miss cause the considerable diminishingof volume of uterus and both ovaries, and also bring to the increase of vascular resistanceviolation over of collateral network on periphery of ovaries with diminishing of volume of peripheralfabric in 1,5 times.During comparison of different variants of operative interferences the state of follicle pool(anymore after laparoscopic operative interference by comparison to laparotomy – on33,7%; after the use of bipolar electrosurgery by comparison to monoarctic – on 25,3%).Efficiency of the conducted operative interference with the subsequent rehabilitation of reproductivefunction is 33,0%, here frequency of the use of assisted reproductive technologiesarrives at 53,6%.At different pathology it is got the followings results: for women with pathology of ovaries pregnancycame in 31,4%, and a level of the use of assisted reproductive technologies was 56,3%;at pathology of uterus – 32,3% and 48,4%; at pipe peritoneal to the factor – 35,4% and 55,9%; atpresence of adhesive process on a background the united pathology – 29,3% and 81,8%.

Conclusion. Women, operated concerning different genital pathology in the volume of organpreservingoperations, are included in the group of high risk in relation to efficiency of proceedingin a reproductive function, and in future and considerable frequency of perinatal pathology. It isnecessary to develop stage-by-stage going near the conduct of such women, beginning fromquality of operative interference and concluding tactic of conduct of pregnancy and births. Justthe same approach will allow to reduce frequency of reproductive and perinatal pathology for thewomen of group of high risk.