Pregnancy outcomes in patients with uterine junctional zone thickening
- Authors: Orekhova E.K.1,2, Zhandarova O.A.3, Kogan I.Y.1,4
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Affiliations:
- The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
- МС Ltd
- City Mariinskaya Hospital
- Saint Petersburg State University
- Issue: Vol 69, No 5 (2020)
- Pages: 69-75
- Section: Original Research
- Submitted: 26.06.2020
- Accepted: 29.09.2020
- Published: 23.12.2020
- URL: https://journals.eco-vector.com/jowd/article/view/34856
- DOI: https://doi.org/10.17816/JOWD69569-75
- ID: 34856
Cite item
Abstract
Hypothesis/aims of study. Overcoming infertility and miscarriage in adenomyosis is a complex practical problem in obstetrics and gynecology. It is likely that one of the signs of the disease is a thickening of the transitional zone between the endometrium and the myometrium (J-zone), which can be visualized using magnetic resonance imaging (MRI). The data on the influence of the biometric characteristics of the J-zone on the course and outcome of pregnancy in patients with adenomyosis is ambiguous. This study was aimed to assess the effect of J-zone thickness on pregnancy outcomes in patients with adenomyosis.
Study design, materials and methods. This is a prospective study, which included 102 patients aged 22-39 years with ultrasound signs of adenomyosis who were going to conceive. The patients were divided into two groups: Group 1 (n = 58) consisted of nulliparous patients with no history of previous intrauterine interventions; Group 2 (n = 58) comprised multiparous women with any of those, such as curettage of the uterine cavity for a non-developing or unwanted pregnancy and separate diagnostic curettage for a reason not related to pregnancy. Using MRI, J-zone maximum thickness was measured at the thickest part. We evaluated the relationship between J-zone thickness and pregnancy outcomes, while estimating J-zone thresholds for subfertility outcomes in the both groups.
Results. The average value of J-zone maximum thickness in Group 2 was significantly higher than that in Group 1 and amounted to 12.1 ± 4.2 mm and 10.3 ± 3.9 mm, respectively (p < 0.05). The pregnancy rate in the both groups did not differ significantly and amounted to 43.1% in Group 1 and 38.6% in Group 2 (p > 0.05). The frequency of retrochorial hematoma was diagnosed in 13.8% and 22.7% of cases, respectively, and did not differ significantly in the both groups (p > 0.05). The frequency of spontaneous miscarriage in Group 1 and Group 2 did not differ, either (6.9% and 6.8%, p > 0.05). The J-zone thresholds for unfavorable pregnancy outcomes were determined with a probability of 60% in Group 1 (9.1 mm) and Group 2 (10.0 mm).
Conclusion. J-zone thickness may be used as a prognostic marker of pregnancy outcome in patients with adenomyosis.
Keywords
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About the authors
Ekaterina K. Orekhova
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; МС Ltd
Author for correspondence.
Email: orekhovakatherine@gmail.com
MD, Post-Graduate Student (Applicant)
Russian Federation, Saint PetersburgOlga A. Zhandarova
City Mariinskaya Hospital
Email: olyazhandarova@bk.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450
MD
Russian Federation, Saint PetersburgIgor Yu. Kogan
The Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott; Saint Petersburg State University
Email: ikogan@mail.ru
ORCID iD: 0000-0002-7351-6900
SPIN-code: 6572-6450
MD, PhD, DSci (Medicine), Professor, Corresponding Member of RAS, Director; Professor. The Department of Obstetrics, Gynecology, and Reproductive Sciences, Medical Faculty
Russian Federation, Saint PetersburgReferences
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