Volume 03 Issue 09-2023
13
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
09
P
AGES
:
13-17
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The article provides information on methods of assessing the state of the reproductive system in women with uterine
scars. The purpose of the study was to compare modern methods of evaluating the condition of the scar after surgical
intervention in different uteruses. 50 women selected for the study were diagnosed with secondary infertility after
uterine surgery in their anamnesis. The study was conducted in SamSMU clinic during 2023.
KEYWORDS
Secondary infertility, surgery, uterine scar, hysteroscopy, Iodine div inside the uterus.
INTRODUCTION
In modern obstetrics and gynecology, the number of
uterine pathologies is increasing year by year. Not only
pathology, but also the increase in the number of
surgical births raises the problem of uterine scars and
controversial questions related to its consequences.
Cesarean section (CS) operation is included in surgical
operation of moderate or severe degree. According to
information from various sources, complications after
CS surgery are 7-19.5% [1, 4, 11, 17, 20]. These
complications are explained by obstetric and
extragenital pathologies. Thus, according to Russian
authors, the frequency of endometritis after CK is 10-
20% and after spontaneous childbirth is 3-5% [2, 5, 10,
16]. According to the American Academy of Pediatrics
and the American College of Obstetricians and
Gynecologists (ACOG), endometritis develops in
approximately 60% of women who undergo medically
indicated CS and in 24% after elective CS [3, 6, 18, 19].
Research Article
SECONDARY INFERTILITY IN MODERN GYNECOLOGY
Submission Date:
September 08, 2023,
Accepted Date:
September 13, 2023,
Published Date:
September 18, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue09-03
Akhtamova Ozoda Fozilovna
Assistant, Department Of Obstetrics And Gynecology No. 1, Samarkand State Medical University, Samarkand,
Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 09-2023
14
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
09
P
AGES
:
13-17
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The purpose of the study.
Comparison of modern
methods of assessment of the condition of the scar
after surgical intervention in the uterus during
childbirth.
Research materials and methods. The study was
conducted in the gynecology department of the
SamDTU multidisciplinary clinic during 2023. 50 women
selected for the study were diagnosed with secondary
infertility after uterine surgery in their anamnesis. The
youngest patient was 28 years old, and the oldest was
42. However, most of them were women over 30 years
old. The average age of the patients was 34.3 ± 3.68
years.
Laboratory examinations included general blood and
urine analysis, biochemical blood analysis. Used
instrumental methods - ultrasound and hysteroscopy.
Hysteroscopy was performed for all patients under
general anesthesia with the help of Karl Stors
(Germany) apparatus and in accordance with the
general rules at the private clinic "Innova" under
contract.
All received materials were subjected to automated
statistical processing. Variational-statistical processing
of the research results was carried out with the help of
"Statistica 6.0" software, determining the main
variation indicators: average values (M), average errors
(m), standard deviation (p).
The reliability of the obtained results was determined
using Student's criterion. A difference between two
mean values is considered significant if the p-
parameter is less than 0.05. The confidence level was
at least 95%.
Tadqiqot
natijalari.
When
analyzing
patients'
complaints, all patients (100%) had secondary
infertility. The duration of secondary infertility varied
(from 1 to 5 years), on average it was 3.2±1.03 years.
The remaining complaints of the patients were
menstrual cycle disorder in 20%, increased duration of
menstruation in 28%, lower abdominal pain in 50%,
vaginal discharge in 60%. 26 patients (52%) had only one
scar on the uterus (p> 0.05). Only one patient had 3
scars (2 cesarean sections and 1 myomectomy), and the
remaining 23 (46%) had 2 scars.
Among the extragenital diseases of women, the most
common are: OF pathology (chronic tonsillitis,
gingivitis, dental caries, chronic sinusitis, chronic
allergic rhinitis), diseases of the cardiovascular system
(in most cases, hypertension), as well as thyroid gland
pathologies, shortness of breath Chronic inflammatory
diseases of the lungs (chronic bronchitis, chronic
pneumonia), chronic diseases of the urinary tract.
When
studying
the
anamnesis
of
women's
gynecological diseases, we were sure that many
inflammatory diseases are chronic. Exactly 40% of
women had symptoms of endometritis, 24% had
Volume 03 Issue 09-2023
15
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
09
P
AGES
:
13-17
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
symptoms
of
endocervicitis,
18%
had
their
combination, 10% had salpingo-oophoritis. It was found
that 44% of women with endometriosis received
treatment before the changes were noted.
Anemia was noted in 78% of the women who
underwent general blood analysis, in which 22 women
(44%) had mild anemia, 8 (16%) had moderate anemia,
and 4 (8%) had severe anemia. No significant changes
were noted in other indicators. Average number of
erythrocytes 3.6±0.75*1012, number of leukocytes
13.47±0.36*109,
number
of
platelets
287.86±36.44*109, reticulocytes 1.11±0.57%, Color index
0.83±0.07; erythrocyte sedimentation rate was
12.6±1.4 mm/h.
According to UST, the uterine cavity was enlarged in
24% of women. When assessing the scar area, changes
were noted in 48% of cases, focal changes, i.e. thinning,
were clearly identified in only 28% of women. An iodine
div in the uterus was detected in 72%.
According to the results of hysteroscopy, pathology of
the uterine cavity and iodine div were detected in
most women. In 74% of the studied women, silk sutures
were found inside the uterus and they were removed
during hysteroscopy. In addition, deformation of the
scar area was observed in all studied women, local
thinning of the scar, i.e. "niche" symptom was
detected in 80%. According to its expression, these
women can be divided into two groups. That is, women
with clearly expressed signs of the "niche" symptom -
34%, and women with signs of local thinning, but not
strongly expressed -66%. In addition, pathologies such
as endometrial micropolyposis (58%), chronic
endometritis (24%), placental polyp (4%), Asherman's
syndrome (8%), endometriosis foci (10%) were detected
during hysteroscopy.
CONCLUSION
In general, UST was found in 28% of uterine scar
changes, and hysteroscopy in 80%. In the detection of
intrauterine uterine bodies, almost no difference was
found between the two methods, but hysteroscopy
has the advantage that it is a method of diagnosis and
treatment at the same time.
REFERENCES
1.
Акетаева А. С., Смагулова Б. Н., Смаилова Л.
К.
Сравнительная
оценка
состояния
маточных труб у женщин с первичным и
вторичным бесплодием в сочетании с
эндометриозом //Валеология: Здоровье
,
Болезнь, Выздоровление. –
2022.
–
№. 1. –
С.
115.
2.
Ахтамова
О.
Ф.
ANTIPHOSPHOLIPID
SYNDROME AND MISCARRIAGE //УЗБЕКСКИЙ
МЕДИЦИНСКИЙ ЖУРНАЛ. –
2022.
–
Т. 3. –
№.
4.
Volume 03 Issue 09-2023
16
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
09
P
AGES
:
13-17
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
3.
АСКАРОВА
Ф.
К.
SERVITSITLAR
VA
HOMILADORLIK //ЖУРНАЛ БИОМЕДИЦИНЫ
И ПРАКТИКИ. –
2022.
–
Т. 7. –
№. 5.
4.
ДИОМИДОВА В. Н. и др. Современный
подход к применению ультразвуковой
эластографии при вторичном женском
бесплодии //Problemy Reproduktsii. –
2022.
–
Т. 28. –
№. 6.
5.
Тоджиева Н.И., Худоярова Д.Р., Базарова
З.З. Совершенствование методов
лечения
гиперпластических процессов эндометрия в
пременопаузе
-
Профессионал года. 2018. 81
-
84с
6.
Туракулова И. Э., Худоярова Д. Р.,
Элтазарова Г. Ш. Оптимизация диагностики
вторичного бесплодия //Достижения науки и
образования. –
2019.
–
№. 13 (54). –
С.
72-74.
7.
Шопулотова З. А., Зубайдиллоева З. Х.
ПЕРИНАТАЛЬНАЯ
НЕФРОЛОГИЯ:
ПРОФИЛАКТИКА
ОСЛОЖНЕНИЙ
У
БЕРЕМЕННЫХ
С
ХРОНИЧЕСКИМ
ПИЕЛОНЕФРИТОМ
//Центральноазиатский
журнал образования и инноваций. –
2023.
–
Т.
2.
–
№. 9. –
С. 79
-82.
8.
Akhtamova O. F. Comparisons of the
Treatments of Endometriosis //Research
Journal of Trauma and Disability Studies.
–
2022.
–
Т. 1. –
№. 10. –
С. 33
-38.
9.
Abdukhamidovna K. D. MANAGEMENT OF
PREGNANT
WOMEN
WITH
IDIOPATIC
THROMBOCYTOPENIC PURPLE //European
International Journal of Multidisciplinary
Research and Management Studies.
–
2023.
–
Т.
3.
–
№. 02. –
С. 16
-21.
10.
Akhtamova O. METHODS FOR CORRECTION OF
ANTIPHOSPHOLIPID
SYNDROME
//International Bulletin of Medical Sciences and
Clinical Research.
–
2023.
–
Т. 3. –
№. 4. –
С. 5
3-
59.
11.
Askarova F. K. The Negative Impact of Vitamin
D and Other Micronutrient Deficiencies in
Pregnant Women //Central Asian Journal of
Medical and Natural Science.
–
2021.
–
Т. 2. –
№.
6.
–
С. 380
-382.
12.
Iskandarovna T. N., Rakhimovna K. D. Risk
factors for the development of endometrial
hyperplastic processes in premenopause
//Биомедицина ва амалиёт журнали. –
с. 72.
13.
Jabeen F., Khadija S., Daud S. Prevalence of
primary and secondary infertility //Saudi J Med.
–
2022.
–
Т. 7. –
№. 1. –
С. 22
-8.
14.
Hasanova D. The governor is a woman who
lives with the pain of the people //Texas Journal
of Multidisciplinary Studies.
–
2021.
–
Т. 3. –
С.
57-58.
15.
Fozilovna
A.
O.,
Raximovna
X.
D.
Аntiphospholipiid syndrome and mission of
pregnancy //umuminsoniy vа
milliy qаdriyatlаr:
til, tа’lim vа mаdаniyat. –
2022.
–
Т. 1. –
С. 13
-15.
Volume 03 Issue 09-2023
17
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
09
P
AGES
:
13-17
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
16.
Fozilovna A. O., Rahimovna K. D. TO
DETERMINE
THE
INTERACTION
OF
MISCARRIAGE WITH ANTIPHOSPHOLIPIDS IN
THE BLOOD //ResearchJet Journal of Analysis
and Inventions.
–
2022.
–
Т. 3. –
№. 4. –
С. 1
-3.
17.
Fozilovna
A.
O.
MISCARRIAGE
AND
PREMATURE BIRTH //Open Access Repository.
–
2023.
–
Т. 4. –
№. 3. –
С. 1481
-1490.
18.
Kudratovna A. F. REALITIES OF THE TIME:
IDIOPATHIC THROMBOCYTOPENIC PURPLE
AND PREGNANCY //World Bulletin of Public
Health.
–
2022.
–
Т. 11. –
С. 22
-24.
19.
Khasanova D. PREMENSTRUAL SYNDROME IN
THE MODERN SCIENCE //International Bulletin
of Medical Sciences and Clinical Research.
–
2022.
–
Т. 2. –
№. 12. –
С. 16
-22.
20.
Shopulotova Z. COMPARATIVE ANALYSIS OF
CLINICAL CASES OF EXACERBATION OF
CHRONIC PYELONEPHRITIS IN PREGNANT
WOMEN //International Bulletin of Medical
Sciences and Clinical Research.
–
2023.
–
Т. 3. –
№. 8. –
С. 22
-25.
