Reprodukcijski ishod kod bolesnica s adenomiozom

master's thesis

• Title (english): Reproductive outcome in patients with adenomyosis
• Author: Karla Mirčevski
• Mentor: Maja Banović (mentor)
• Committee member: Gordan Zlopaša (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Maja Banović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Adenomioza je bolest maternice kod koje se patohistološkom analizom tkiva maternice, unutar miometrija nalaze endometralne žlijezde i stroma. Ta invazija endometrija u miometrij rezultira morfološki promijenjenom maternicom te kliničkom slikom obilnih i bolnih menstruacijskih krvarenja, nepravilnih krvarenja, ali i neplodnosti kao posljedice ometanja procesa implantacije. Cilj ovog istraživanja bio je prikazati učestalost simptoma karakterističnih za adenomiozu i povezanost s drugim kliničkim i patohistološkim dijagnozama te prikazati reprodukcijske ishode kod bolesnica liječenih u Klinici za ženske bolesti i porode KBC-a Zagreb u razdoblju od 2011. do 2017. godine, kojima je patohistološkom analizom utvrđena adenomioza. Nađeno je da je medijan dobi u kojoj je dijagnosticirana adenomioza 55 godina. Bolesnicama je najčešće učinjena histerektomija (85,5%). Na adenomiozu se prije operacije posumnjalo u tek 5,5% bolesnica. Uputna dijagnoza je u 30% slučajeva bila sumnja na miom maternice, u 24,5% dokazan adenokarcinom endometrija. Kod 62,9% nađeni su simptomi karakteristični za adenomiozu. Čak 35% bolesnica imalo je jedan ili više spontanih pobačaja. Učestalost carskih rezova u ovoj skupini je bila 9,2%. Adenomioza je u našoj populaciji i dalje najčešće dijagnosticirana kod bolesnica kasne generativne ili postmenopauzalne dobi koje su histerektomirane. Često se, međutim, nalazi s drugim dijagnozama poput mioma ili adenokarcinoma endometrija. Sve su veći dokazi da je u skupini žena sa smanjenom plodnosti negativan utjecaj adenomioze značajan. Stoga je potrebno potaknuti sumnju na ovu bolest i kod mlađih bolesnica, pogotovo nakon čestih implantacijskih neuspjeha.

Abstract (english)

Adenomyosis is uterine disease in which endometrial glands and stroma can be found within myometrium using histopathological analysis. This endometrial invasion results in morphologically altered uterus and can be a cause of abnormal uterine bleeding and infertility by hindering the process of implantation. The aim of this study was to detect the frequency and correlation of various diagnoses and symptoms that are otherwise associated with adenomyosis and to present problematic reproductive outcomes in patients treated at Clinical Center for Female Diseases and Births UHC Zagreb in the period from 2011 to 2017. Data analysis has showed that median age in which adenomyosis is diagnosed at UHC Zagreb is 55 years. Most common surgery was hysterectomy in 85.5% of cases. Before the surgery adenomyosis was suspected in only 5.5% of patients. The main indication for the surgery was myoma in 30% and endometrial adenocarcinoma was found in 24.5% of patients. 62.9% of women had symptoms related to adenomyosis. In women with adenomyosis percentage of spontaneous abortions was 35% which is significantly higher than in general population. Cesarean section was performed in 9.2% of patients. In our terms, adenomyosis is still considered as the disease of elderly women and it is diagnosed mostly after hysterectomy. It is important to keep in mind that adenomyosis is frequently associated with other diagnosis such as myoma or endometrial adenocarcinoma. Also, there is more and more evidence that the negative influence of adenomyosis in subfertile women is significant. Therefore, it is advisable to suspect on adenomyosis in younger women, especially after frequent implantation failures.

• Keywords: adenomioza; neplodnost; reprodukcijski ishod
• Keywords (english): adenomyosis; infertility; reproductive outcome
• Language: croatian
• URN:NBN: urn:nbn:hr:105:311632
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2018-12-12 11:19:26