PREDICTORS OF THE DEVELOPMENT OF BENIGN PROLIFERATIVE UTERINE DISEASES IN WOMEN OF REPRODUCTIVE AGE

Background. Among women of reproductive age, uterine leiomyoma is detected in 12-30%, endometrial hyperplastic processes in 10-18%, adenomyosis in 12-50%. The combination of uterine leiomyoma with endometrial hyperplastic processes occurs in 23-42% of cases, with internal genital endometriosis in 11-18%, in the case of genital endometriosis, pathological processes of the endometrium are diagnosed in 31.4% of patients. Aim: To determine predictors of the development of benign combined and solitary proliferative uterine diseases by examining the somatic health status and obstetric-gynecological history of women of reproductive age. Materials and methods. A questionnaire was conducted to study clinical and anamnestic indicators used to determine risk factors for the formation of combined and solitary proliferative processes of the uterus in 210 women of reproductive age, including 180 patients with proliferative diseases of the endo- and myometrium and 30 healthy women of the control group. The main group (Group I) included of 90 patients with combined proliferative processes and the comparison group (Group II) - 90 patients with isolated proliferative processes of the uterus. Results. Women with uterine leiomyoma in combination with endometrial hyperplastic processes and adenomyosis, as well as with solitary endometrial hyperplastic processes, are characterized by an older age than patients with solitary leiomyoma and adenomyosis (p<0.01). Analysis of anamnestic data of women with proliferative diseases of the uterus revealed a 1.4-fold higher frequency of childhood infectious diseases (p<0.01). In the case of combined proliferative diseases of the uterus, obesity was 1.6 times more common, diabetes mellitus and chronic pyelonephritis 1.3 times, varicose veins 2.3 times, atherosclerotic cardiosclerosis 2 times, neurocirculatory dystonia 1.8 times, irritable bowel syndrome 2.2 times, and cholelithiasis 1.6 times less common than in women with solitary proliferative diseases of the uterus (p<0.01). In women with combined and solitary proliferative diseases of the uterus, hyperpolymenorrhea occurred 6.5 and 6.2 times more often, as well as algodysmenorrhea 10 times more often (p<0.05). Women with combined and solitary proliferative diseases of the uterus gave birth 1.4 and 1.2 times less often, had a higher number of artificial abortions 3.1 and 2.6 times, spontaneous miscarriages 4.7 and 4.4 times (p<0.05), compared with healthy women. 11.1% of women with combined and 14.4% with solitary proliferative diseases of the uterus suffered from primary or secondary infertility (p<0.05). Conclusions. The conducted study shows that the premorbid background plays a significant role in the initiation and progression of proliferative processes of the endo- and myometrium, both in their solitary and combined development.