Ultrasound diagnostics of visceral obesity in women with obstetric and gynecological pathology

Background. Obesity is a metabolic disease that is spreading around the world, with one in four people in Ukraine suffering from obesity. Today, the prevalence of obesity among women of reproductive age in developed countries reaches 55–60%, while in Ukraine it is 15–27%. The usefulness of measuring both visceral and subcutaneous abdominal adipose tissue has been proven in relation to metabolic risk factors and heredity, but there are currently insufficient studies in pregnant women and gynecological patients. Purpose – is to determine the diagnostic role of ultrasound examination of abdominal and visceral adipose tissue in pregnant women and gynaecological patients with metabolic disorders and obesity for the prediction of severe obstetric and gynaecological complications and the development of effective treatment and prevention measures. Materials and Methods. We examined 105 women who were treated at the Regional Clinical Hospital, a municipal non-profit enterprise of the Kharkiv Regional Council, with various obstetric and gynecological pathologies, 85 of whom had signs of metabolic syndrome or obesity (main group). The control group consisted of 20 women of normal weight without signs of obesity. The women in the main group were divided into three groups: the first group consisted of 42 women with gynecological pathology (20 women with endometrial hyperplasia, abnormal uterine bleeding (AUB), and 22 women with ovarian cysts and cysts); the second group consisted of 32 pregnant women with obstetric pathology (20 pregnant women with gestational diabetes mellitus (GDM), 12 pregnant women with pre-eclampsia); the third group included 11 women who had undergone bariatric surgery to treat obesity. All women underwent clinical, laboratory, and instrumental examinations, and the degree of obesity was determined. The thickness of the visceral adipose tissue (VAT) and abdominal adipose tissue (AAT) layers was measured using a TOSHIBA (CANON) Xario 200 ultrasound system (Japan), C1-5 D convection probe. The study belongs to the category «description of a series of cases» – a type of research recognized by evidence-based medicine and does not claim statistical significance of the results. Results. The control parameters of BP, WHR, and their ratio were determined, and their peculiarities in obesity, metabolic syndrome, gestational diabetes, pre-eclampsia, ovarian tumors, and endometrial hyperplasia were revealed. The necessity of surgical treatment (bariatric surgery) has been proved in case of ineffectiveness of conservative therapy in women with obesity of the third degree (BMI over 40 kg/m2). Conclusions. Ultrasound examination of abdominal and visceral adipose tissue in pregnant and gynecological patients with metabolic disorders and obesity is an effective, fast, and cost-effective method that allows to determine the features and predict the further development of certain pathological conditions and can be used in a wide range of obstetric and gynecological practice.