scholarly journals Chronic endometritis and endometriosis: is there an interrelationship?

2021 ◽  
Vol 10 (3) ◽  
pp. 83-91
Author(s):  
N.Y. Pedachenko ◽  
R.A. Tukhtarian ◽  
I.L. Avetis'yan ◽  
T.L. Shemelko
Keyword(s):  
Pelvic Pain ◽  
Medical Information ◽  
Clinical Symptoms ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Cochrane Library ◽  
Control Group ◽  
Chronic Endometritis ◽  
Timely Diagnosis ◽  
Inflammatory Processes

Background. Chronic endometritis and endometriosis have a lot in common. Both diseases are long-term inflammatory processes, with definitively unspecified etiological factors and pathogenetic mechanisms that negatively affect fertility and may cause pelvic pain or abnormal uterine bleeding. The issue of effective and timely diagnosis of chronic endometritis remains open due to the lack of specific clinical symptoms and clinical examination data. Assessment of current scientific evidence of the interrelationship between endometriosis and chronic endometritis. Materials and methods. A systematic search of scientific medical information has been conducted in English-language databases: MEDLINE, Scopus, Web of Science, Medline, The Cochrane Library, PubMed. Results. According to the review of various scientific studies that have recently been conducted, it has been found that patients with endometriosis statistically have a significantly higher risk of developing chronic endometritis by 1.3-2.5 times than women without endometriosis. Using a histological endometrial study and detection of CD138, chronic endometritis was found in 52.94 % of women in the endometriosis group and in 27.02 % of patients in the endometriosis-free group; the rate was significantly higher in the endometriosis group than in the control group (p = 0.0311). Moreover, 76% of women with endometriosis showed inflammatory processes of pelvic organs (compared to the control group, where inflammation was found in 38.4 % of women, p < 0.0001). Conclusions. Patients with endometritis demonstrate a positive correlation with development of endometriosis. Given the inability to establish a causal relationship between endometriosis and chronic endometritis, extended diagnosis is necessary to eliminate chronic endometritis, especially if women have abnormal uterine bleeding or chronic pelvic pain. The combination of histological and immunohistochemical endometrial examination methods has shown its effectiveness in timely diagnosis of chronic endometritis. Identifying and adequately treating this condition will help avoid unnecessary surgery.

Etiological structure and diagnosis of abnormal uterine bleeding

GYNECOLOGY ◽  
2018 ◽  
Vol 20 (2) ◽  
pp. 14-17
Author(s):  
G E Chernukha ◽  
I A Ivanov ◽  
Z N Efendieva ◽  
M R Dumanovskaya ◽  
A V Asaturova
Keyword(s):  
Diagnostic Accuracy ◽  
Endometrial Hyperplasia ◽  
Ultrasound Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Histological Diagnosis ◽  
Reproductive Age ◽  
Endometrial Polyps ◽  
Chronic Endometritis ◽  
Endometrial Pathology

Abnormal uterine bleeding (AUB) is one of the most common indications for hysteroscopy. Most of the AUB cases occur due to endometrial or myometrium pathology. Among it, endometrial polyps (EP) and chronic endometritis (CE) prevalent in reproductive age, while endometrial hyperplasia (EH) and EP dominate in perimenopause. It was determined that EP and CE are characterized with menorrhagia and metrorrhagia approximately equally, whereas EH reveals AUB with oligomenorrhoea. Verification of exact endometrial pathology by ultrasound examination is hindered, that results in deviations of ultrasound and histological diagnosis. The usage of ultrasound data and AUB’s characteristics may improve the diagnostic accuracy on preadmission period.

Routine Syndecan-1 Immunohistochemistry Aids in the Diagnosis of Chronic Endometritis

2004 ◽  
Vol 128 (9) ◽  
pp. 1000-1003 ◽  
Author(s):  
Ilene B. Bayer-Garner ◽  
Jennifer A. Nickell ◽  
Soheila Korourian
Keyword(s):  
Plasma Cells ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Endometrial Polyp ◽  
Chronic Endometritis ◽  
Underlying Malignancy ◽  
Proliferative Endometrium ◽  
Exogenous Progesterone ◽  
Secretory Endometrium

Abstract Context.—Chronic endometritis is reportedly observed in 3% to 10% of women undergoing endometrial biopsy for abnormal uterine bleeding. The diagnosis of chronic endometritis rests on the identification of the plasma cells. Their identification may be obscured by a mononuclear cell infiltrate, plasmacytoid stromal cells, abundant stromal mitoses, a pronounced predecidual reaction in late secretory endometrium, menstrual features, or secondary changes due to exogenous progesterone treatment prior to the biopsy. Syndecan-1 is a proteoglycan that is found on the cell surface of plasma cells and keratinocytes. Immunohistochemistry stains for this antibody may facilitate diagnosis of chronic endometritis. Objective.—To determine whether or not routine syndecan-1 immunohistochemistry will aid in the diagnosis of chronic endometritis. Design.—Immunohistochemistry stains for syndecan-1 were performed on 3 levels of 47 endometrial biopsies from patients with abnormal uterine bleeding. None of the patients had endometrial hyperplasia or an underlying malignancy. Clinical correlation and follow-up was attempted in 20 cases that showed evidence of plasma cells by syndecan-1 by immunohistochemistry. Results.—Plasma cells were identified in 20 cases, 7 of which were initially diagnosed as chronic endometritis. The remaining 13 positive cases were diagnosed as tubal metaplasia (1), secretory endometrium (4), proliferative endometrium (4), menstrual endometrium (1), endometrial polyp (1), secretory endometrium with endometrial polyp (1), and endometrial polyp with exogenous hormone effect (1) based on the original hematoxylin-eosin section. Conclusions.—Syndecan-1 may be a useful adjunct in the diagnosis of chronic endometritis. Approximately half of the cases of chronic endometritis responded to an antibiotic regime; thus, this diagnosis is important and may potentially obviate the need for surgical intervention.

scholarly journals The Role of Mean Platelet Volume on Distinction of Submucosal Myomas from Other Etiologies in Increased Endometrial Thickness

2016 ◽  
Vol 22 (1) ◽  
Author(s):  
Kerem Doğa Seçkin ◽  
Mehmet Fatih Karslı ◽  
Burak Yücel ◽  
Elif Akkaş Yılmaz ◽  
Murat Öz ◽  
...  
Keyword(s):  
Mean Platelet Volume ◽  
Blood Count ◽  
Complete Blood Count ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
White Blood Count ◽  
Control Group ◽  
Platelet Volume ◽  
Significant Difference

<p>OBJECTIVE: The aim of the study was to determine whether it is possible to differentiate submucosal fibroids before interventional procedures based on mean platelet volume (MPV), in reproductive-age patients presenting with endometrial thickening and abnormal uterine bleeding.<br />STUDY DESIGN: This study included 581 reproductive-age women who underwent diagnostic procedures (curettage or operative hysteroscopy) and were subsequently divided into two groups based on clinico-pathological findings. The first group included those with benign endometrial pathology (control group, n=438), and the second group consisted of those with submucosal leiomyomas (n=143). The demographic characteristics and complete blood count (CBC) data of these patients were collected retrospectively, and comparisons were made between groups.<br />RESULTS: No statistically significant difference was found between the groups according to demographic features and CBC parameters such as hemoglobin levels and white blood count (p&gt;0,05). Platelet counts were significantly higher and MPV values were significantly lower in submucosal leiomyoma patients compared with the control subjects (p&lt;0,05).<br />CONCLUSIONS: MPV may be a useful predictive marker when differentiating submucosal leiomyoma from other benign causes of abnormal uterine bleeding. The ability to predict the possibility of the presence of submucosal leiomyoma before surgery can assist in determining the most appropriate type of invasive procedure.</p>

scholarly journals Treatment of C-section diverticula with hysteroscopic resection in women without childbearing intention: a retrospective cohort study

2019 ◽  
Author(s):  
Hui Shi ◽  
Jingyan He ◽  
Yunhe Gao ◽  
Shuang Qin ◽  
Jiaying Fan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Pelvic Pain ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Timing Of Surgery ◽  
Hysteroscopic Resection

Abstract Background: Diverticulum, one of the long-term squelae of cesarean section, can cause abnormal uterine bleeding, dysmenorrhea and chronic pelvic pain. Hysteroscopic resection of diverticula is thought to reduce abnormal uterine bleeding and chronic pelvic pain. In this study, we aim to describe the improvement after hysteroscopic resection of cesarean section diverticula hysteroscopic resection of cesarean section diverticula (CSD) in women without childbearing intention, and to explore the variables associated with poor prognosis.Methods: A retrospective cohort study of women aged 25-48 with CSD diagnosis by transvaginal ultrasonography (TVS) and hysteroscopy that were enrolled at Guangzhou Women and Children’s Medical Center between June 2017 and December 2018. A total of 124 women met the inclusion criteria and all patients had undergone hysteroscopic resection and accepted a follow-up interview at the 3rd and 6th months postoperatively to record symptom improvement.Result: The mean of intraoperative blood loss and operative time of hysteroscopic resection were (12.94±12.63) ml and (33.63±6.87) min in 124 patients. Overall observed improvement rates of CSD symptom were 47.2% and 65.6% in the first 3 and 6 months, respectively. Multivariable logistic regression models revealed that timing of surgery <14 days was a good prognostic factor associated with both 3-month improvement (OR, 16.59; 95% CI, 2.62-104.90; P=0.003) and 6-month improvement (OR, 15.51; 95%CI, 1.63-148.00; P=0.02); Patients with numbers of cesarean section(CS) ≥2 had a lower rate of improvement after 6 months of CSD repair surgery compared with patients who underwent one CS(OR, 8.29; 95%CI, 1.05-65.75; P=0.04).Conclusions: A hysteroscopic repair might be an appropriate method for CSD in women who no childbearing intentions. The timing of surgery and the number of CS seems to be factors influencing the postoperative improvement of CSD.

scholarly journals Role of sVEGFR1 in the development of complications in pregnant women with antenatal fetal death anamnesis record

2014 ◽  
Author(s):  
Anna Nevolina ◽  
Natalia Safonova ◽  
Maria Proskura
Keyword(s):  
Serum Concentration ◽  
Pregnant Women ◽  
Fetal Death ◽  
Clinical Symptoms ◽  
Statistical Significance ◽  
Control Group ◽  
Study Group ◽  
Prevention Measures ◽  
Physiological Concentration ◽  
Timely Diagnosis

Background sVEGFR1 is a hypoxia influenced growth factor, involved in the endothelial dysfunction characterizing the pregnancy disorder of preeclampsia. Objective Determine correlation between dynamic pattern of sVEGFR1 serum concentration and complications in pregnant women with antenatal fetal death history for timely diagnosis. Materials and Methods A total of 35 women in the second and third trimester of pregnancy were enrolled in the study group and 30 women – in the control group. The study group was divided into 3 subgroups: subgroup #1: pregnant women, with no placental insufficiency (n=21), subgroup #2 - pregnant women with PI (n=8), subgroup #3 - pregnant women with PI resulting in preeclampsia(n=6). The control group comprised 30 pregnant women with uncomplicated childbirth. sVEGFR1 concentration was estimated in maternal serum by means of enzyme multiplied immune assay Quantikine (R and D systems, USA and Canada). Statistical data was assessed by SPSS statistics. Package was used to perform all the statistical analysis. The conventional p≤0,05 was used to assess statistical significance. Results Average age of women in the study group was 28,4±4,7 years, in the control group – 27,7±4,7 years. A physiological sVEGFR1 serum concentration was observed in the subgroup #1. As well as that, this group demonstrated concordant to the healthy pregnant women fluctuations of sVEGRF1 serum concentration. However, sVEGRF1 level was 1,2 fold less than in the control group during 29-32, 33-36 weeks of pregnancy. It was statistically proven, that fluctuations in sVEGRF1 serum concentration in the subgroup #2 were similar to the ones in the control group. No statistically significant changes of sVEGRF1 serum concentration compared to the control group were detected in the subgroup #3 up to the 28th week of pregnancy. However, a 1,5 fold increase of sVEGFR1 concentration was observed in the subgroup #3 (p<0,005) in comparison with the control group (1586±358 pg/ml, 2347±519 pg/ml, 3695±1547 pg/ml during 29-32, 33-36, >37 weeks of pregnancy, respectively). Control group demonstrated physiological concentration of sVEGRF1 throughout the pregnancy. Conclusion Changes in sVEGFR1 serum concentration were statistically significant in the group of pregnant women with PI, resulting in preeclampsia. Moreover, they were detected 3-4 weeks prior to clinical symptoms, providing opportunity for timely diagnosis and prevention measures.

Success of uterus-preserving treatments for abnormal uterine bleeding, chronic pelvic pain, and symptomatic fibroids: age and bridges to menopause

2011 ◽  
Vol 204 (3) ◽  
pp. 272.e1-272.e7 ◽  
Author(s):  
Lee A. Learman ◽  
Sanae Nakagawa ◽  
Steven E. Gregorich ◽  
Rebecca A. Jackson ◽  
Alison Jacoby ◽  
...  
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding

scholarly journals Clinical and diagnostic aspects of abnormal uterine bleeding in reproductive aged women with extragenital pathology

2021 ◽  
pp. 101-104
Author(s):  
I.A. Tuchkina ◽  
L.A. Vygivska ◽  
E.V. Blagoveshchensky ◽  
R.E. Blagoveshchensky
Keyword(s):  
Chronic Gastritis ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Control Group ◽  
Clinical Group ◽  
Case Histories ◽  
Study Objective ◽  
Group I ◽  
Obesity And Diabetes ◽  
Reproductive Aged Women

Study objective: to determine the clinical and diagnostic features of the abnormal uterine bleeding (AUB) in women of reproductive age with extragenital pathology.Materials and methods. The study involved a retrospective assessment of 400 case histories of reproductive aged women with AUB who underwent inpatient treatment.The main clinical group (I) consisted of 300 case histories of women with AUB and concomitant extragenital disorders, control group (II) consisted of 100 case histories of somatically healthy women with AUB. An ultrasound scan with Doppler mapping was performed to assess the pelvic organs. All women underwent hysteroscopy and/or separate diagnostic curettage with further morphological assessment of the endometrium.Results. The most common extragenital disorder was diseases of the circulatory system and endocrine system, diseases of the digestive system. 123 patients (41%) had concomitant hypertension and obesity, 76 (25.3%) – obesity and varicose veins, 53 (17.6%) – somatoform autonomic dysfunction and chronic gastritis, 39 (13%) – obesity and diabetes mellitus, 24 (8%) – chronic gastritis and obesity. AUB was complicated by anemia of varying severity in 176 (58.6%) women. According to ultrasound data the most common endometrial disorder in women of group I was glandular hyperplasia of the endometrium.Conclusion. A retrospective analysis of case histories showed a high prevalence of AUB among women with extragenital pathology, which is a clinical indicator of major menstrual disorders in this category of patients and can be a serious problem for women's health in general. The need to study the prevalence and identify the main risk factors for the AUB development will make it possible to provide a general strategy for its prevention, improve the reproductive potential of women and avoid serious abnormal changes in the process of fulfilment of the reproductive function in young women.

scholarly journals LEVONORGESTREL INTRAUTERINE DEVICE VERSUS MEDROXYPROGESTERONE ACETATE IN TREATMENT OF SYMPTOMATIC UTERINE FIBROIDS

2018 ◽  
Vol 6 (7) ◽  
pp. 341-347
Author(s):  
Uğurkan Erkayıran ◽  
Bülent Köstü ◽  
Alev Özer ◽  
Abdullah Tok ◽  
Selim Karaküçük
Keyword(s):  
Pelvic Pain ◽  
Medroxyprogesterone Acetate ◽  
Intrauterine Device ◽  
Uterine Fibroids ◽  
Abnormal Uterine Bleeding ◽  
Good Choice ◽  
Uterine Bleeding ◽  
Number Of Patients ◽  
One Year ◽  
The One

Background: Medroxyprogesterone acetate (MPA) and levonorgestrel intrauterine device (LNG-IUD) are two drugs used to treat abnormal uterine bleeding in women with myoma. We organized this study to compare the effectiveness of these two treatments. Methods: This was a retrospective one-year-long cohort study of 95 women with uterine leimyoma. Fifty three women who had received LNG-IUD formed the LNG-IUD group while 42 women who received regular intramuscular injections of 150 mg MPA at every 3 months for one-year period made up the MPA group. Both groups were compared in aspect of demographic, clinical and biochemical characteristics. Results: At the end of one year, the LNG-IUD group had significantly smaller fibroid size, lower visual analogus scale score for pelvic pain, for dysmenorrhea and dyspareunia than the MPA group. There were a significant reduction in the number of patients with menorrhagia and a significant increase in serum hemoglobine levels both in  LNG-IUD and MPA groups at the end of the one-year long study period. Conclusions: LNG-IUD appears as a good choice for the reduction in fibroid size and associated pelvic pain.

Hyperbaric Oxygen Therapy Is Beneficial for the Improvement of Clinical Symptoms of Cerebral Palsy: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-14
Author(s):  
Yingqian Zhang ◽  
Jing Wu ◽  
Nong Xiao ◽  
Bo Li
Keyword(s):  
Systematic Review ◽  
Cerebral Palsy ◽  
Motor Function ◽  
Hyperbaric Oxygen ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Gross Motor ◽  
Gross Motor Function

<b><i>Introduction:</i></b> Hyperbaric oxygen (HBO) has been used for the treatment of cerebral palsy for more than 20 years, but its efficacy and safety are still controversial. In this systematic review and meta-analysis, we evaluated the currently promulgated data related to the efficacy of HBO for patients with cerebral palsy. <b><i>Methods:</i></b> We searched the PubMed/Medline, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases (from their inception to April 2020) for randomized controlled trials published in English or Chinese. Two researchers used the Cochrane Collaboration tool for data extraction and an independent quality assessment. The extracted data were analyzed by Review Manager 5.3 software. <b><i>Results:</i></b> A total of 25 studies consistent with the inclusion criteria were included, with a total of 2,146 people, which included 1,185 participants in the HBO group and 961 in the control group. This meta-analysis showed that when compared with the controls, HBO therapy can improve the gross motor functions evaluated by the Gross Motor Function Measure (<i>n</i> = 696, SMD 0.29, 95% CI [0.07–0.51], Z = 2.62, <i>p</i> = 0.009) and Gross Motor Function Classification System (<i>n</i> = 248, MD –0.40, 95% CI [–0.52 to –0.27], Z = 6.28, <i>p</i> &#x3c; 0.00001), global developmental level evaluated by Gesell (<i>n</i> = 560, RR 1.30, 95% CI [1.19–1.42], Z = 6.03, <i>p</i> &#x3c; 0.00001) and developmental quotient (<i>n</i> = 374, MD 8.25, 95% CI [6.48–10.01], Z = 9.15, <i>p</i> &#x3c; 0.00001) and language expression (<i>n</i> = 270, MD 4.34, 95% CI [2.30–6.38], Z = 4.17, <i>p</i> &#x3c; 0.00001) and comprehension (<i>n</i> = 270, MD 4.87, 95% CI [2.87–6.88], Z = 4.76, <i>p</i> &#x3c; 0.00001). HBO therapy only caused mild ear pain. However, the quality of the data for all outcomes evaluated by the Grading of Recommendations Assessment, Development, and Evaluation analysis was very low. <b><i>Conclusions:</i></b> HBO therapy may produce a much more efficient clinical experiment result than the control group with cerebral palsy patients, and HBO therapy is well tolerated and relatively safe for the included participants.

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