[Genital prolapse in women and articular hypermobility syndrome in connective tissue dysplasia].
OBJECTIVE
To examine relationships between genital prolapse and joint hypermobility (JHM), between GP severity and degree of JHM, to reveal causes of GP in JHM patients.


METHODS
A total of 208 females with GP (mean age 38.9 years) entered the trial. They were divided into three groups by severity of connective tissue dysplasia (CTD): with mild CTD--16.3%, moderate CTD--35.6% and severe CTD--48.1%. The following methods of investigation were used: podometric Freedland's technique, ultrasonic investigation of the gall bladder, kidneys, echocardiography, morphological study of platelets, morphological and immunohistochemical study of the ligaments.


RESULTS
In GP patients JHM occurred in 41.8% patients. Hypermobility of large joints reaches 38.9%, large--20.7%. Such associated manifestations of CTD as flatfoot, JHM, deformation of the spine, varicosity, predisposition to vegetovascular dysfunctions, mitral prolapse, arrhythmia, impaired conduction, refraction, gastroptosis, nephroptosis, hernias were observed in 69.2, 46.1, 38, 53.8, 49, 43.3, 38, 19.2, 12, 6.7, 14.4%, respectively. The morphological changes are explained by 40 +/- 15% type 1-3 collagen loss in the interstitial substance. Severe forms of GP in patients with JHM were observed in 84%. 52.4% females with JHM developed severe GP within 3 years after delivery of a child. Most of the examinees carried undifferentiated congenital dysplasias.


CONCLUSIONS
JHM is a criterion of CTD diagnosis.
Smol'nova
T Iu
TIu
Savel'ev
S V
SV
Grishin
V L
VL
Iakovleva
N I
NI
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D003094:Collagen / Q000172:deficiency; D003240:Connective Tissue Diseases / Q000150:complications* / Q000175:diagnosis / Q000235:genetics; D005260:Female; D006547:Hernia / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000175:diagnosis; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D012189:Retrospective Studies; D013577:Syndrome; D014549:Urinary Incontinence / Q000175:diagnosis / Q000209:etiology; D014596:Uterine Prolapse / Q000175:diagnosis / Q000209:etiology*
D003094:Collagen