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CHRONIC ENDOMETRITIS: A HIDDEN THREAT OF REPRODUCTION
Kurbaniyazova Aziza Zafarjonovna,
3rd year Master of Department of Obstetrics and Gynecology,
Samarkand State Medical University No. 1
Askarova Zebo Zafarovna
Samarkand State Medical University Clinical assistant, PhD
https://doi.org/10.5281/zenodo.11001588
Research relevance:
Endometritis is an inflammation of the inner lining of the uterus
(endometrium). The endometrium consists of two layers - basal (permanent) and functional,
completely renewed within 1 month under the influence of sex hormones. With the beginning of
each menstrual period, it gradually grows, preparing for possible fertilization. During ovulation,
the thickness of the endometrium is the greatest, creating favorable conditions for embryo
implantation. If pregnancy does not occur, the functional layer is separated during menstruation.
The correct direction of this process is the key to the normal functioning of the reproductive
system. However, the lining of the uterus is a finely regulated mechanism that can be damaged for
various reasons. One of these causes is inflammation.
Under normal conditions, the uterus is well protected from infection, but under certain
conditions, infectious agents enter the uterine cavity, actively multiply and develop, which leads
to inflammation of the endometrium.
It should be noted that endometriosis and endometritis are similar words, but they mean
completely different diseases. With endometriosis, there is a pathological proliferation of
endometrial-like cells outside the uterine cavity, with endometritis, we deal with inflammation of
the endometrium (the suffix "itis" usually indicates the inflammatory nature of the disease).
The incidence of endometritis among the population is increasing. Doctors attribute this to
the widespread use of intrauterine contraceptives, as well as an increase in the number of abortions
and various intrauterine interventions. In 80-90% of cases, the disease is detected in women of
childbearing age, which causes disturbances in their menstrual cycle and reproductive functions.
The purpose of the study:
Women with weak immunity, chronic infections and implanted
intrauterine devices are at risk. Causes of endometrial inflammation include:
non-observance of personal hygiene rules;
intercourse during menstruation;
frequent change of sexual partners, unprotected sex;
complicated birth, caesarean section;
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traumatic manipulations in the uterine cavity: abortion, diagnostic curettage, in vitro
fertilization;
endoscopic examination of the uterine cavity, hysterosalpingography;
violation of hygiene standards during diagnostic and therapeutic procedures;
gynecological diseases
: bacterial vaginosis, cervicitis, endometrial hyperplasia or polyp,
salpingo-oophoritis.
Research objectives:
There are acute and chronic forms of the disease, each of them has
its own etiology.
Acute endometritis develops as a result of complicated childbirth, abortion or the use of
intrauterine contraceptives, and usually manifests itself within 3-4 days after its appearance. The
cause of endometritis can be:
nonspecific microflora (staphylococci, streptococci, E. coli, etc.);
specific microflora (gonococcus, chlamydia, mycoplasma, mycobacterium tuberculosis);
viruses;
fungal infection;
protozoa (Toxoplasma) and parasites.
The chronic form of endometritis develops in the absence of adequate treatment of acute
inflammation. In addition, the disease can develop against the background of sexually transmitted
infections and autoimmune processes that disrupt the complex chain of antioxidant protection.
Often, inflammation is a defense mechanism of the div, which is carried out in response
to the impact of pathogenic factors, and as a result, it eliminates them from the div. But the long-
term inflammatory process characteristic of chronic endometritis does not have a protective effect,
on the contrary, it leads to destructive changes in the endometrial tissue.
Chronic endometritis is accompanied by structural changes in the endometrium - its
atrophy, hypertrophy or the formation of fibrous adhesions and small cysts. Hormonal changes
occur, the microflora and cell composition of the endometrium are disturbed. If the inflammation
spreads to the muscle layer, endomyometritis develops. If the infection spreads to all layers of the
organ, panmetritis develops - the most complex and difficult to treat form.
Expected results of the study: Specific - caused by pathogenic microorganisms;
nonspecific - occurs due to the use of intrauterine contraceptives, bacterial vaginosis
(increased infection of the endometrium), radiation therapy of the pelvic organs, instability of the
immune system.
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Morphological types of endometritis:
Conclusion
: atrophic - the disease occurs with atrophy of the glands, stromal fibrosis, later
infiltration by lymphoid elements and causes degeneration of the inner layers of the uterine cavity;
cyst - ducts of the glands are compressed by fibrous tissue, secretions accumulate and cysts
are formed;
hypertrophic - hyperplasia of the mucous membrane that develops against the background
of chronic inflammation.
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