Background To analyze the allelic variants of genes of enzymes involved in estrogen metabolism: CYP1A1, CYP1A2, CYP19 and SULT1A1 using polymerase chain reaction-restriction fragment length polymorphism-restriction fragment length polymorphism (PCR-RFLP) analysis of women with histologically confirmed adenomyosis and women without proliferative diseases of pelvic organs was performed. We studied the following polymorphisms: CYP1A1 M1, T264 → C transition in the 3′-noncoding region; CYP1A2*1F, C734 → A transversion in CYP1A2 gene; C → T transition (Arg264Cys) in exon 7 of CYP19; SULT1A1*2, G638 → A transition (Arg213His) in the SULT1A1 gene. Materials and methods The study included 804 patients. Group I (experimental group) consisted of 268 women with adenomyosis. Inclusion criteria were: histological verification of adenomyosis, consent of patients to participate in the study. Group II (control group) – 536 women without proliferative diseases of the uterus. Inclusion criteria were: lack of proliferative processes of the uterus histologically confirmed by ultrasound examination, patient’s consent to participate in the study. Results We found the significant association of C allele, T/C and C/C genotypes of the CYP1A1 gene (CYP1A1 M1 polymorphism), A allele, C/A and A/A genotypes of the CYP1A2 gene (CYP1A2*1F polymorphism) and the T allele, C/T and C/C genotypes of the CYP19 (Arg264Cys polymorphism) gene with the risk for adenomyosis. Conclusions Patients with adenomyosis had increased frequency of C allele, T/C and C/C genotypes of the CYP1A1 gene, A allele, C/A and A/A genotypes of the CYP1A2 gene and T allele and C/T and C/C genotypes of the CYP19 gene and, on the contrary, decreased frequency of the mutant allele and heterozygous and mutant homozygous genotype of the CYP1A2 gene compared to women without proliferative diseases of the uterus.

Цель. Определение овариального резерва у недоношенных девочек при рождении и в пубертатный период. Материалы и методы. Обследованы 100 недоношенных и доношенных новорожденных девочек, а также 200 девушек-подростков 15-16 лет, рожденных недоношенными и доношенными, проведены лабораторные, ультразвуковые исследования, статистическая обработка материала. Результаты. Определены показатели овариального резерва у недоношенных девочек и девушек-подростков, рожденных недоношенными. Установлены статистически значимые различия всех показателей, характеризующих овариальный резерв у недоношенных новорожденных девочек и девушек-подростков, рожденных недоношенными, по отношению к доношенным. Гипофизарные гормоны у недоношенных новорожденных девочек и девочек-подростков, рожденных недоношенными, были выше, а яичниковые гормоны-ниже. По данным ультразвукового исследования, средний объем яичников и среднее количество антральных фолликулов в яичнике у недоношенных новорожденных девочек и девочек-подростков, рожденных недоношенными, были меньшими. Заключение. Невынашивание беременности вносит изменение в формирование овариального резерва в антенатальный период. Выявленная функциональная незрелость овариального резерва у недоношенных девочек при рождении остается в постнатальном периоде. Ключевые слова: новорожденные девочки, девушки-подростки, рожденные доношенными и недоношенными, показатели овариального резерва.

Aim. To review the current publication highlighting the features of pregnancy and childbirth outcomes in patients with endometriosis. Materials and methods. The analysis of 45 foreign and domestic publications on this topic has been carried out. Results. Patients with endometriosis have fertility problems, and when pregnancy occurs, it was characterized by a higher risk of preeclampsia, placenta previa, gestational diabetes, miscarriage and preterm labor, as well as delivery by caesarean section. Newborns in women with endometriosis have an increased risk of prematurity and small for gestational age. Probably, in addition to the presence of endometriosis, the risk of obstetric and neonatal complications is influenced by the localization and severity of the disease, as well as the use of assisted reproductive technologies. Conclusion. The results obtained indicate that patients with endometriosis have a high risk of perinatal complications and require additional antenatal monitoring and care.

Here we analysed rare and acute complications of endometriosis in pregnant women by searching Cochrane, HINARY, and PubMed databases. Keywords were “rare”, “causes”, “acute”, “complications”, “endometriosis”, and “pregnancy”. The search depth was 10 years (2011−2021). In total, we found 126 publications, 41 of which met the selection criteria. The course of pregnancy and childbirth in patients with endometriosis is insufficiently studied. Yet, it is characterised by a higher risk of complications including those rarely occurring: haemoperitoneum, intestinal perforation, appendicitis, torsion and rupture of the endometrioid cyst, and thoracic endometriosis. Because of major hormonal changes occurring during the pregnancy, endometriosis undergoes a significant progression or decidualisation. As endometrioid tissue is characterised by a resistance to progesterone, its defciency during the pregnancy can lead to necrosis, perforation of decidualised foci, and severe bleeding. Progesterone deficiency provokes hypervascularisation of the endometrioid tissue, which is the most common cause of spontaneous haemoperitoneum and most frequently occurs in the third trimester of pregnancy and after in vitro fertilisation. Pregnancy increases the risk of endometriosis-related intestinal perforation of different localisation: small intestine, caecum, appendix, and rectosigmoid colon. Limited information about the pregnancy-related complications of endometriosis leads to their underestimation, albeit they can be life-threatening and significantly impact the health of the mother and fetus. The results of this review indicate the need for the further studies of the pregnancy course in patients with endometriosis, especially after the use of assisted reproductive technology. Development of specific clinical guidelines would contribute to the efficient prevention of obstetric and perinatal complications in patients with endometriosis.

No abstract