TIME COURSE OF CHANGES IN THE PHENOTYPIC SIGNS OF CONNECTIVE TISSUE DYSPLASIA AT DIFFERENT AGES: THE URGENCY OF THE PROBLEM IN OBSTETRICS AND GYNECOLOGY

Objective. To show the importance of physical identification of connective tissue dysplasia (CTD) by the phenotypic criteria in obstetrics and gynecology, their set and variability with regard to age. Subject and methods. 614 women with the classified and unclassified forms of CTD were examined. Group 1 consisted of 268 primigravidas (mean age 24.8±3.46 years); Group 2 included 346 women (mean age 44.5±10 years) with gynecological disorders. General clinical and laboratory studies, ECG, ultrasonography, EchoCG, radiological examination, comprehensive urodynamic study, and magnetic resonance imaging were used. Results. The manifestations of DST were absent in newborn infants. In the adults, the persistent and prognostically significant manifestations were the arm length being greater than stature (> 1.05), hand length, hand and foot length-to-stature ratios, middle finger length, upper-to-lower body segment ratio (< 0.86), a positive thumb test in 29.1-29.5% of the patients, joint hypermobility in 54.6-64.6%, talpes in 44- 65.3%, scoliosis, postural disorders in 49.8-76.8%, osteochondrosis in 34.1%, heart valve prolapse, involvement of a few valves in 25%, myxomatous degeneration in 15%, anterior abdominal wall hernias in 19.4%, visceral ptosis in 10.2%, cardiac rhythm and conduction disturbances in 33%, varicosity in 39.5%. Conclusion. The working diagnostic criteria for DCT are variable throughout an individual’s life and determined by the form of DCT, age, degree of involutional processes, and rate of manifestation. The diagnostic criteria for DCT in women over 40 years of age cannot be applied to young patients.

connective tissue dysplasia (CTD), unclassif ied forms of CTD, obstetrics, gynecology, mitral valve prolapse, phenotype, joint hypermobility, mitral regurgitation, musculoskeletal dysplasias, visceral manifestations of CTD, genital prolapse, labor