Reproductive health disorders in patients with female genital tract malformations

Abstract

Female genital tract malformations are often a challenge not only for obstetricians and gynecologists, but also for doctors of other specialties. This pathology often leads to negative obstetric and perinatal consequences, the emergence of gynecological complications that significantly impair the quality of life of patients at different ages. The incidence of female genital abnormalities in the general female population ranges from 5.5 to 6.7% and is on average three times higher among patients with reproductive health disorders. The objective: to assess the frequency of reproductive disorders and determine the sequence of use of clinical and instrumental methods of examination in patients with female genital tract malformations. Materials and methods. We conducted a retrospective assessment of the relationship between menstrual disorders and the presence of female genital tract malformations. We observed 124 patients with a confirmed diagnosis of female genital tract malformations. The age of women ranged from 22 to 42 years. The diagnosis was based on complaints, medical history and life, as well as data from clinical, laboratory and instrumental examinations. Results. The mean age of patients was 29.2±3.8 years. From the moment of the patient’s first visit to the gynecologist until the final verification of the diagnosis took from 6 months to 7 years. Dysmenorrhea occurred in 70.2% of patients with abnormalities in the development of the female genital organs, late menarche – in 12.1%, primary / secondary amenorrhea – in 11.3%, irregular menstrual cycle – in 9.7%, violation of the menstrual cycle – at 28.2%. The combination of female genital tract malformations with various defects of the urinary system occurred in 24 (19.4%) women. Conclusion. In 81.2% of patients from adolescence there were clinical manifestations associated with female genital tract malformations. Screening ultrasound examination of the pelvic organs and gynecological examination is shown to all girls aged 15 years. It is advisable to determine the karyotype in patients with primary / secondary amenorrhea. Renal ultrasound should be performed in all patients with suspected female genital tract malformations. In case of suspicion of ultrasound examination for abnormal development of the female genitals, patients before sexual intercourse are recommended to perform MRI examination; in the presence of sexual life with a preserved menstrual cycle, it is advisable in the second phase of the cycle to conduct transvaginal 3D ultrasound, which can be supplemented by MRI. Keywords: genital abnormalities, dysmenorrhea, menstrual function.