RU2095817C1 - Method for prognosticating expectancy of formation of ovary cysts in girls during prepubertal and pubertal age of their life - Google Patents

Abstract

FIELD: medicine; gynecology. SUBSTANCE: ovaries of girls of prepubertal and pubertal age are subjected to ultrasound examination in order to measure predominant follicle. In case of detecting follicle having size 10 mm and more, girl is subjected to re- examination at 15th-16th day of menstrual cycle. If follicle size increases up to 25 mm and upwards, girl's whole blood is analyzed to determine prolactine and folitropine concentration levels therein. If these values are equal, respectively, to 15.0 mcg/l and more, and to 9.0 MU/l and more, cyst formation is to be expected. EFFECT: 1) method makes it possible to timely detect group of girls incurring high risk of developing ovaries cysts, and to subject these girls to adequate treatment to prevent cyst formation; 2) timely and accurate diagnosis permits to avoid unnecessary surgical intervention and to preserve children' health.

Description

 The invention relates to medicine, namely to gynecology.

 A known method of gynecological examination of girls by taking blood and determining the content of prolactin (N.V. Kobzeva, M.N. Kuznetsov, Yu.A. Gurkin, Gynecology of children and adolescents, M. 1981).

 It was found that on the 6th 7th day of the menstrual cycle, the first peak of prolactin 8.0 IU / l. On the remaining days, a low basal excretion of this hormone was noted. At the age of 15, the peak of prolactin on the 13th 14th day of the menstrual cycle was 6 8.0 IU / L.

 The known method is not diagnostic and does not allow the use of the data to predict ovarian cysts.

 A known method for diagnosing the development of the dominant (largest) follicle in the pubertal period, including assessing the size of the follicle using ultrasound, depending on the days of the menstrual cycle (MN Kuznetsova, NS Martysh "Obstetrics and gynecology", N 3, p. 9, 1987).

 A known method for assessing the development of a dominant follicle in girls with an ovulatory cycle allows you to track the growth and maturation of the follicle during ovulation. It was established that on the 8th 10th day of the cycle, a follicle of 0.8 1 cm appears in one of the ovaries. On average, the diameter of the follicle increases by 2 4 mm per day. On the 15th 16th day it reaches 1.8 2.2 cm. I.e. 2.0 ± 0.2 cm on average.

 However, the known method does not allow to predict the development of ovarian cysts in children.

 The objective of the invention is to provide an accurate method for predicting the development of ovarian cysts in children.

 The essence of the method is that in the method for predicting the formation of ovarian cysts in girls in the prepubertal and puberty periods, including ultrasound examination of the ovaries with measurement of the dominant follicle, ultrasound is performed on day 10 of the menstrual cycle, and if a follicle of 10 mm or more is detected a second study is carried out on the 15th 16th day of the cycle, while with an increase in follicle size to 25 mm or more, a study of whole blood is carried out, in which the level of prolactin is determined and folitropina, and a value of the level of these indicators respectively 15.0 g / l or more and 9.0 IU / l and more predict cyst formation.

 Using the invention allows to obtain the following technical result: the method has high accuracy and objectivity; is non-invasive; allows you to timely identify a group of girls with a high risk of developing ovarian cysts and provide them with adequate treatment to prevent their appearance. Timely and accurate diagnosis allows you to avoid unreasonable surgical interventions and preserve the health of children.

 The technical result is achieved due to the fact that the established scientific fact was used for forecasting: an increase in prolactin content, reducing steroidogenesis, leads to the formation of cysts.

 An increase in prolactin content and a decrease in steroidogenesis is indicated by an increase in the size of the largest follicle. Exact digital criteria for the size of the dominant follicle, which predict the development of cysts, are established on large statistical material.

 The method is as follows.

 On the 6th 10th day of the menstrual cycle, an ultrasound examination of a girl with a pre-filled bladder is performed in her supine position. The skin is lubricated with a special gel, after which the sensor is installed above the bosom. Changing the angle of its inclination, the ovaries are removed both in longitudinal and transverse scanning.

 If a dominant (largest) follicle is detected in one of the ovaries, it is measured on the screen from the external to the internal contour.

 If the size of the dominant follicle is equal to or greater than 10 mm, a second study is carried out on the 16th day of the 16th menstrual cycle, and when the dominant follicle is increased to 25 mm or more, a blood test is performed. To do this, for girls on an empty stomach, from the cubital vein, blood is taken in an amount of 4 ml and the content of prolactin and folitropin (FSH) is determined in it.

 With the value of these indicators of 15.0 μg / L or more and 9.0 IU / L or more, ovarian cysts are predicted.

 The method has passed clinical trials on the basis of the Moscow City Children's Clinical Hospital No. 7 at the Department of Pediatric Radiology, RMAPO.

 A total of 500 girls aged 6 to 15 years were examined. 32 girls revealed ovarian cysts. In 426 girls, dominant follicles were not found. In 42, dominant follicles were identified. A blood test was performed. The prognosis of the probability of cyst formation is made. All girls received appropriate treatment. Cysts did not form.

 Example 1. Patient M. 14 years. On the 6th day of the menstrual cycle, an ultrasound examination of the ovaries was performed. Dominant follicles 10 mm in diameter were identified in the left and right ovaries. On the 16th day of the menstrual cycle, a second ultrasound examination was performed. The size of the dominant follicles was 25 mm. The patient took a blood sampling. A study was conducted to determine the content of prolactin and folitropin. Their values were 15.0 μg / L and 20 IU / L, respectively. The forecast is made: a high probability of developing ovarian cysts. Conducted appropriate treatment. Cysts in the ovary did not form. The observation period is 2 years.

 Example 2. Patient I., 14 years old. Received in the gastroenterological department with complaints of abdominal pain. An ultrasound scan on the 10th day of the menstrual cycle revealed a follicle with a diameter of 20 mm in the right ovary. On the 15th day of the cycle, the study was repeated. The size of the follicle was 26 mm. A blood test was performed. The level of prolactin was 90 μg / L, and FSH 9.0 IU / L. After 2 days, a retention cyst 34x40 mm in size formed in the right ovary. After the treatment, the cyst disappeared.

Claims (1)

 A method for predicting the formation of ovarian cysts in girls in the prepubertal and puberty period, including ultrasound examination of the ovaries and measurement of the dominant follicle, characterized in that the ultrasound examination is performed on the 6-10 day of the menstrual cycle and, if a follicle size of 10 mm or more is detected, a repeated examination of 15 16 days of the cycle, while with an increase in follicle size of 25 mm or more, a study of whole blood is carried out, in which the level of prolactin and folitro ina, and a value of the level of these indicators respectively 15 g / l or more and 9 IU / L, and more predict cyst formation.