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OPTIMIZING PRECONCEPTION PREPARATION FOR WOMEN WITH CHRONIC
HYPOPLASTIC ENDOMETRITIS
Kurbaniyazova Feruza
Samarkand State Medical University
Assistant of the Department of Obstetrics and Gynecology No. 1.
Sodikova Ozoda
Student of Samarkand State Medical University!
https://doi.org/10.5281/zenodo.10829371
Abstract.
The purpose of the study is to justify the refusal of antibacterial therapy for the
hypoplastic variant of chronic endometritis.
Key words:
hypoplastic variant of chronic endometritis; placental hydrolyzate; diosmin
600; antibiotic therapy.
ОПТИМИЗАЦИЯ ПОДГОТОВКИ К ЗАЧАТИЮ ЖЕНЩИН С
ХРОНИЧЕСКИМ ГИПОПЛАСТИЧЕСКИМ ЭНДОМЕТРИТОМ
Аннотация.
Цель исследования – обосновать отказ от антибактериальной
терапии при гипопластическом варианте хронического эндометрита.
Ключевые слова:
гипопластический вариант хронического эндометрита;
плацентарный гидролизат; диосмин 600; антибиотикотерапия.
Materials and methods.
The study included 116 patients with a difficult reproductive history (infertility, pregnancy,
unsuccessful attempts at IVF and PE), who after a comprehensive examination (hysteroscopy,
morphology and immunohistochemistry of the endometrium) were diagnosed with the hypoplastic
variant of chronic endometritis.
The work was carried out in two stages. At the first stage, the autoimmune genesis of the
disease was proven in the examination of patients. In the second stage, patients were divided into
two groups - the main group (84 women) and the control group (32 women). In the control group,
patients received traditional antibacterial therapy with simultaneous use of trophotropic agents
(placental hydrolyzate - Laennec, phlebotonic diosmin 600). In the main group, we avoided
antibacterial drugs, including only immunomodulating trophotropic drugs in therapy.
116 patients with hypoplastic variant of chronic endometritis, history of reproductive
failure (repeated pregnancy loss, infertility, multiple attempts at IVF and ET) were examined and
treated. The age of the women participating in the study was 26-41 years old, with an average of
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31.3 ± 4.7 years. The diagnosis of chronic endometritis was determined morphologically. All
patients underwent pelvic ultrasound to determine the type of endometritis, and Doppler
ultrasound was performed to assess blood flow. In addition, hysteroscopic, immunohistochemical
and bacteriological examination of the endometrium was used, systemic and local immune
indicators were also evaluated.
Currently, there are two approaches to solving the problem of chronic endometritis
treatment [1-4]. Some researchers consider this disease to be a pure inflammatory reaction that
requires antibiotic therapy [2, 3, 5, 6], while others consider chronic endometritis to be an
autoimmune process in which the use of antibiotics is unreasonable [7-9].
Undoubtedly, chronic endometritis often occurs in women with reproductive incapacity
(loss of normal pregnancy, infertility, multiple unsuccessful attempts at IVF and PE), and therefore
it is necessary to identify and correct it at the stage of preparation for conception. urgent task of
modern reproductive medicine [6, 10].
It is known that the greatest difficulty in restoring the endometrium is the hypoplastic
variant of chronic endometritis, in which the thickness of the endometrium in the "implantation
window" remains less than 8 mm. The literature [3, 4, 9] contains information about attempts to
restore the endometrium by introducing immunomodulators, stem cells, and physical therapy [2,
5]. The authors studied the possibilities of treating the hypoplastic variant of chronic endometritis
without the use of antibacterial therapy.
Results
. It was found that traditional therapy does not affect the cell composition of the
endometrium (CD3 +, CD4 +, CD8 +, CD56 + ) and humoral immunity indicators. When using
only immunomodulating trophotropic agents, positive trends were noted in the normalization of
the cell composition of the endometrium, the level of autoimmunity (IgG) decreased, the blood
supply to the myometrium and endometrium improved, and an increase in the thickness of the
endometrium was noted.
Summary
. The hypoplastic variant of chronic endometritis is a typical autoimmune
process in which antibiotics are useless. At the same time, positive trends in the use of
immunomodulating trophotropic agents showed the feasibility of their introduction.
The purpose of the study is to evaluate the effectiveness of the combined use of
immunomodulators and phlebotonics in the treatment of hypoplastic chronic endometritis and
justify the need to abandon antibacterial therapy.
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