chronic endometritis
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2022 ◽  
pp. 62-65
Author(s):  
Yuriy Aleksandrovich Sorokin ◽  

Chronic endometritis is a clinical and morphological syndrome with a complex of morphological and functional changes in the endometrium, leading to a violation of the physiological cyclic transformation and receptivity of endometrial tissues. The treatment of chronic endometritis requires special consideration. Despite the progress of pharmacotherapy, there are significant methodological and practical difficulties. Cavitated solutions, low-intensity ultrasound effects, and photochromotherapy increase the effectiveness of the treatment of chronic endometritis and female infertility.


2021 ◽  
Vol 51 (4) ◽  
pp. 38-42
Author(s):  
M. G. Gazazyan ◽  
O. S. Khutsishvili ◽  
T. S. Lvanova ◽  
I. S. Lunova

Goal of the research: optimization of the diagnosis of chronic endometritis. Methodology: perspective research. Institution: Department of obstetrics and gynecology of the Kursk medical University. Material of the research: 67 patients suffering benign diseases of endometrium and myometrium connected with it. 59 patients with the diseases of the uterus of the same пaтe without chronic endometritis. Methods of the research: clinico-laboratory, ultrasonography, hysteroscopic, histologic, cytologic, microbiologic examination of the endometrium, PSR, radioimmunological method to determine progesterone rate in the blood plasma. Results of the research: the endoscopice variants of chronic endometritis are extreted: hyperplastic and hypoplastic (and also its forms - focal and diffusive). They are necessary stages achieving reliable diagnosis of the inflammatory process of endometrium a differential method of probing of endometrium depending on a variant and damage rate of chronic endometritis is worked out. Conclusion: the complex method of the diagnosis chronic endometritis including hysteroscopy with visual biopsy and cytologic-histologic examination of endometrium increases the quality of diagnosis by 64,4% in comparison with the traditional curettement of the endometrium and considerably decreases the number of posttraumatic and inflammatory complications.


2021 ◽  
Vol 12_2021 ◽  
pp. 110-118
Author(s):  
Mikhnina E.A. Mikhnina ◽  
Davydova N.I. Davydova ◽  
Kazantsev V.A. Kazantsev ◽  
Ellinidi V.N. Ellinidi ◽  
Bezhenar V.F. Bezhenar ◽  
...  

2021 ◽  
Vol 10 (3) ◽  
pp. 83-91
Author(s):  
N.Y. Pedachenko ◽  
R.A. Tukhtarian ◽  
I.L. Avetis'yan ◽  
T.L. Shemelko

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.


2021 ◽  
Vol 11 (4) ◽  
pp. 511-514
Author(s):  
Natalia Voropaeva ◽  
Lyudmila Lazareva ◽  
Irina Danusevich ◽  
Natalia Belkova ◽  
Uliana Nemchenko ◽  
...  

The research objective was to study the spectrum of the vagina and endometrium microorganisms in women with chronic endometritis (CE) in order to take adequate therapeutic measures. Methods and Results: We did a cross-sectional study in 47 women (average age of 35.38±5.19 years) with histologically confirmed CE. The vaginal microbiota and endometrial biopsies were assessed using microbiological research methods in accordance with the medical technology "Integral assessment of the state of the vaginal microbiota." To identify the share of different types of microorganisms in the structure of the biocenosis, the coefficient of constancy of the species (C) was used. Only 19% of patients had a titer of Lactobacillus spp. within the age norm, while the deficit was observed in 80% of women. Among the representatives of Enterobacteriaecae, Escherichia coli and Klebsiella aerogenes were sown, which are considered to be random species (C=11% and C=2.1%, respectively). The average titer for E. coli was 3.6±1.3 lg CFU/swab and for K. aerogenes - 2.14 lg CFU/swab. An atypical variant of E. coli with hemolytic properties was found in only one sample. All isolates of the genus Staphylococcus were also random species (C did not exceed 25%). Coagulase-negative staphylococci (CoNS) were detected in 7 patients (C=15%), while the average titer was 2.1±0.4 lg CFU/swab. S. aureus was isolated from only one patient at a titer of 5 lg CFU/swab. Corynebacterium spp. were isolated in 11% of cases (C = 11% - random species), in a titer of 3.2±0.8 lg CFU/swab. Enterococcus spp. also belonged to random species (C=23.4%). At the same time, E. faecalis was inoculated in 19% of cases and E. faecium was sown in 4.3%, the average titer of which was 3.1±0.9 and 5 lg CFU/swab. Streptococcus spp. were recorded in only one case at a concentration of 5 lg CFU/swab. Fungi of the Candida were isolated as a random species in 8.5% of cases. The growth of microorganisms in endometrial samples was obtained only in 3 examined women with CE (6.4% of cases). The endometrial microbiota were represented only by random species, for which the C index ranged from 2.1% to 4.3%. Conclusion: The microbiological study of the microbiota of vaginal discharge showed the presence of dysbiotic disorders with a significant deficiency of lactobacilli (80%) without the dominance of representatives of the Lactobacillus spp. In the structure of opportunistic microflora, Escherichia coli, coagulase-negative staphylococcus, Enterococcus spp., and E. faecalis prevailed as random species. Representatives of the microbiota in endometrial biopsies were identified only in 6.4% of cases, and are represented by random species.


Author(s):  
A. E. Esedova ◽  
M. A. Idrisova ◽  
A. M. Gadzhieva

Introduction. A review of the literature considering the problem of reproductive health against the background of chronic endometritis is presented. According to the literature, in the etiology and pathogenesis of infertility and habitual miscarriage, the main cause is the «uterine factor» (24-62%). Chronic inflammation in the uterine mucosa can lead to infertility, which increases the significance of this pathology. It is proved that most often the causative agents of this disease are representatives of conditionally pathogenic microflora. Chronic endometritis is an unexplored pathology associated with unfavorable reproductive outcomes, such as unsuccessful implantation and repeated miscarriage. Most scientists assume that inflammation develops against the background of a long-term persistence of an infectious agent. According to other scientists, the cause of the occurrence and development of chronic endometritis is an autoimmune process that contributes to the progression of inflammation. The article describes the mechanisms of impaired receptivity, endometrial microcirculation and changes in the ratio of cells of the immune system. In this article, we aim to give an overview of the diagnosis, etiology, pathophysiology and treatment of chronic endometritis, its effect on endometrial receptivity and its relationship with reproductive dysfunction.The aim of the study is to identify the main discussed aspects of the management of patients with chronic endometritis, to determine promising diagnostic methods.Materials and methods. The analysis and systematization of the data were carried out on the basis of scientific publications in the common database of Cyberleninka and PubMed.Results and Discussions. The article discusses the methods of laboratory, ultrasound and instrumental diagnostics used in Russia and abroad. The» gold standard « of diagnostics is a histological examination of the endometrial tissue material on the 7th10th day of the menstrual cycle. The article describes the mechanisms of impaired receptivity, endometrial microcirculation and changes in the ratio of cells of the immune system.Conclusion. Chronic endometritis remains an important problem in modern society, as it has a social significance: the frequency of reproductive losses is at a high level. There is a need to further study the features of the etiology and pathogenesis of chronic endometritis in order to improve the presentation of the course of the inflammatory process and improve the methods of therapy and prevention of this disease for the realization of reproductive function.


2021 ◽  
Vol 73 (6) ◽  
Author(s):  
Antonio LA MARCA ◽  
Giorgia GAIA ◽  
Mario MIGNINI RENZINI ◽  
Carlo ALBONI ◽  
Elisa MASTELLARI
Keyword(s):  

Author(s):  
D. Kuznetsova

Purpose: to study the clinical and echographic manifestation of endometritis.Materials and methods. Clinical and echographic research was carried out on 19 red-and-white cows, in the conditions of the agricultural farm of the Druzhba breeding plant, Pavlovsky district, Voronezh region on the 30-32th day after calving using the Easi-Scan scanner from BCF Technology Ltd, Scotland. Before ultrasound examination to establish the diagnosis, all animals were examined, transrectal palpation of the uterus. Simultaneously with the ultrasound examination, a cytological study of the uterine mucosa was carried out. For this purpose, a probe was constructed from a metal catheter intended for artificial insemination of cows with sequins by the deep cervical method with rectal fixation of the cervix; a cytobrush of the Juno probe was attached to the tip of the instrument. To confirm the diagnosis, a laboratory study of cervical mucus was additionally carried out by the express method according to Whiteside, modified by N. I. Polyantsev and Yu. N. Popov.Results. According to the results of rectal examination and ultrasound diagnostics, the cows were divided into three groups: clinically healthy, animals with clinically pronounced chronic endometritis and with latent endometritis. In the group of healthy animals, individual superficial and vacuolated intermediate cells (6.17 ± 0.51) and single neutrophils (2.31 ± 0.32) were detected in smears. In the group of clinically healthy cows, no gram-positive coccobacillary microorganisms and cells of the basal layer of the uterine mucosa were detected. In the second group, in animals with clinically pronounced chronic endometritis, a large number of segmented neutrophils, lymphocytes and a large number of cocci were detected in smears. Thus, in one visual field, the number of gram-positive cocobacillary microorganisms fluctuated on average 764.45 ± 4.56 microbial bodies, while the number of neutrophils increased in comparison with clinically healthy animals by 20.84 times and averaged 48.14 ± 2 in the group. , 91, the percentage of the score averaged around 12.1%. Simultaneously with an increase in the number of leukocytes in animals, the number of epithelial cells of the uterine mucosa increased by 2.21 times, while individual basal cells were detected simultaneously with superficial and intermediate cells (0.75 ± 0.48). In smears obtained from animals of the third group of cows, there was a significant decrease in the number of coccobacillary microorganisms to 75-360 in one visual field in comparison with similar results in the group with a clinically pronounced form of chronic endometritis. The indicator for segmented neutrophils was 8.05 times higher than in clinically healthy cows, while in relation to clinically sick cows by 61.4% and amounted to 18.60 ± 2.23. In terms of the number of superficial, vacuolated intermediate and basal cells in sick animals with chronic clinically pronounced endometritis and latent endometritis, no significant changes were revealed (1.08 times), while in relation to clinically healthy animals, these indicators were 2.38 times higher. The degree of variation in the number of epithelial cells in the group of cows with latent chronic endometritis was insignificant, which indicates the stability of the trait.Conclusion. Ultrasound scanning allows you to identify the latent form of endometritis and establish degenerative changes in the tissues of the uterus. Ultrasound examination in cows in establishing a diagnosis - endometritis should be the decisive diagnostic method.


2021 ◽  
Vol 25 (4) ◽  
pp. 623-627
Author(s):  
V. E. Abdullaiev ◽  
A. M. Hryhorenko

Annotation. Hyperplastic processes of the endometrium can be triggered by a chronic inflammatory process. In addition, the importance of the presence of a long hyperproliferative process in the endometrium to accelerate genome modification with significant negative consequences of the development of oncogynecological pathology has been proved. The above risks require the development of clear diagnostic criteria for endometrial hyperplastic processes at the stage of non-invasive instrumental diagnosis. The aim of the study was to establish the features of the impact of chronic endometritis on the risk of neoplastic endometrial processes. A study of 161 women aged 18 to 53 years. Of these, 58 women had a verified diagnosis of endometrial hyperplastic process, and 71 women had endometrial hyperplasia due to chronic endometritis. The control group consisted of 32 women without signs of hyperplastic processes and chronic endometritis. Statistical data processing was performed on a personal computer using Microsoft Excel spreadsheets and the application package Statistica for Windows v.7.0, StatSoft Inc. (USA). All obtained quantitative data were processed by the method of variation statistics. A significant increase in uterine size was found in patients with endometrial hyperplastic processes, an increase in M-echo in patients with a combination of chronic endometritis and endometrial hyperplasia. The control group consisted of 32 somatically healthy women. Statistical data processing was performed on a personal computer using Microsoft Excel spreadsheets and the application package Statistica for Windows v.7.0, StatSoft Inc. (USA). All obtained quantitative data were processed by the method of variation statistics. A significant increase in uterine size was found in patients with endometrial hyperplastic processes, an increase in M-echo in patients with a combination of chronic endometritis and endometrial hyperplasia. The basal artery resistance index was found to be lower in the group of women with chronic endometritis. Similar indicators are established for the values of the pulsation index of the basal arteries of the uterus and the state of the spiral arteries. Thus, the method of ultrasound diagnosis of internal female genitals is a highly sensitive and specific method for the diagnosis of hyperproliferative processes of the endometrium, but has limited informativeness for the diagnosis of chronic endometritis. The combination of ultrasound diagnostics with dopplerometry of uterine vessels and endometrium (with the development of appropriate diagnostic criteria) allows to suspect chronic endometritis at the stage of pre-diagnostic hysteroscopy and subsequent pathomorphological and immunohistochemical examination.


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2182
Author(s):  
Amerigo Vitagliano ◽  
Mariangela Cialdella ◽  
Rossana Cicinelli ◽  
Carla Mariaflavia Santarsiero ◽  
Pantaleo Greco ◽  
...  

Background: Chronic endometritis (CE) and endometrial polyps (EPs) are common conditions in reproductive age women. CE is an infectious disorder of the endometrium characterized by signs of chronic inflammation at hysteroscopic and histological analyses. EPs are abnormal endometrial growths containing glands, stroma and blood vessels projecting from the lining of the uterus. During the last years, different authors have investigated the correlation between CE and EPs, with controversial results. The aim of this study was to summarize available evidence on the potential correlation between CE and EPs. Design: Systematic literature review and meta-analysis. Methods: Observational-studies were identified by searching electronic databases from their inception to September 2021. Only studies on pre-menopausal women were included. Statistical analysis was performed using MedCalc 16.4.3 (Ostend, Belgium) and Review Manager version 5.3 (Nordic Cochrane Centre, Cochrane Collaboration). The summary measures were reported as pooled proportion or odds ratio (OR) with 95% confidence interval (CI). The primary outcome was to evaluate the prevalence of CE in women with EPs. The secondary outcome was to determine the prevalence of CD-138-positive EPs among EPs. Tertiary outcomes were to compare the prevalence of CE in women with EPs versus women with a non-polypoid endometrium and to compare the prevalence of CE in women with a single EP versus women with multiple EPs. Results: Eight observational studies (n = 3225 patients) were included in quantitative synthesis. Pooled prevalence of CE among women with EPs was 51.35% (95% CI, 27.24–75.13%). Pooled proportion of CD-138-positive EPs among EPs was 70.73% (95% CI, 55.73–83.68%). Women with EPs showed higher prevalence of CE compared to women without EPs (OR 3.07, 95% CI 1.59–5.95). Women with ≥3 EPs had higher prevalence of CE then women with a single EP (OR 3.43, 95% CI 1.83–6.46). Conclusions: In pre-menopausal women, CE and EPs may have a dependent relationship and may represent two consequent steps of a common pathological process.


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