{
  "abstract": "Introduction Systemic sclerosis (SSc) affects mostly women, between the ages of 30-50 but data regarding gynecological health in women with SSc are scarce. The aim of this study is to provide a comprehensive report on gynecological health in childbearing age SSc patients, from both clinical and ultrasonographic point of view.Material and Methods This is an observational, single-center study with a case-control part (SSc versus Health controls (HC)) and a second cross-sectional phase regarding pelvic and ultrasound evaluation performed only in patients. The inclusion criteria were diagnosis of SSc, fertile age, not pregnancy, not breastfeeding.Each enrolled patient underwent both rheumatological and gynecological evaluation with pelvic examination and transvaginal ultrasound with uterine resistance assessment (using the Pulsatility index (UtA-PI). The presence of sexual dysfunction was evaluated using the female sexual function index (FSFI). Menstrual distress through the menstrual distress questionnaire (MEDI-Q) and urinary health through the Urinary Symptom Profile (USP). Quality of life (QoL) was assessed with the Short-form-12-health-survey (SF -12).Results Twenty-nine SSc patients and 33 HC were enrolled. Patients had a limited subset of disease in 54% of cases, with Scl 70 positivity in 45% of cases, mean disease duration of 5.7 and mean age of 39.57.Compared to HC, patients had a higher number of recurrent urinary (p = 0.007) and vaginal (p = 0.049) infections. Menstrual disorders were more frequent in SSc patients and associated with greater discomfort (p = 0.048 for total MEDI-Q and p = 0.006 for symptoms). Dyspareunia was reported by 41% of patients (p=0.018), with a higher presence of sexual dysfunction (FSFI <26.5 p = 0.033). Patients with SSc had a lower QoL compared to controls both in the physical (p = 0.007) and psychological (p = 0.043) domains. At pelvic ultrasound, adenomyosis was found in 26% of patients and endometriosis in 18%, which is higher than those estimated in the general Italian population (~5-10%). Patients with endometriosis reported chronic pelvic pain more frequently (p=0.010) and had a higher incidence of pelvic adhesions (p=0.026). Increased uterine artery resistance (values >95th percentile) was observed in 14% of patients. These patients reported dyspareunia (p=0.006) and ovulatory pain (p=0.008) more frequently than those with normal resistance.Conclusions The results highlight a high prevalence of gynecological, menstrual and sexual dysfunctions in patients with SSc. For the first time, an increase in uterine artery resistance is documented in SSc patients, with possible implications on pelvic vascularization and gynecological symptoms.Abstract P.368 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Rheumatologic unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio, Modena, Italy"
      ],
      "name": "Martina Orlandi"
    },
    {
      "affiliations": [
        "Prenatal Medicine Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena an, Modena, Italy"
      ],
      "name": "Sofia Gambigliani Zoccoli"
    },
    {
      "affiliations": [
        "Rheumatologic unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio, Modena, Italy"
      ],
      "name": "Mariagrazia Nuara"
    },
    {
      "affiliations": [
        "Rheumatologic unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio, Modena, Italy"
      ],
      "name": "Amelia Spinella"
    },
    {
      "affiliations": [
        "Rheumatologic unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio, Modena, Italy"
      ],
      "name": "Marco De Pinto"
    },
    {
      "affiliations": [
        "Prenatal Medicine Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena an, Modena, Italy"
      ],
      "name": "Carlo Alboni"
    },
    {
      "affiliations": [
        "Prenatal Medicine Unit, Department of Medical and Surgical Sciences for Mother, Child and Adult, University of Modena an, Modena, Italy"
      ],
      "name": "Antonio La Marca"
    },
    {
      "affiliations": [
        "Rheumatologic unit, Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio, Modena, Italy"
      ],
      "name": "Dilia Giuggioli"
    }
  ],
  "title": "P.368 Gynecological health and ultrasound evaluation among fertile women affected by systemic sclerosis",
  "uid": "cef4ab44-5bd4-5e93-9d5e-98b66f8c47d1"
}