Peculiarities of treatment and prevention of recurrences in women with intrauterine pathologies
DOI:
https://doi.org/10.12775/JEHS.2021.11.01.026Keywords
intrauterine synechiae, hyperplastic form of chronic endometritis, office hysteroscopy, autoplasma plateletsAbstract
The study is devoted to the problem of surgical treatment, rehabilitation program and prevention of recurrences in intrauterine pathologies (polyposis and uterine adhesion) in women with reduced reproductive potential. The urgency of this problem is characterized by a high frequency of abnormal uterine bleeding, hypomenstrual syndrome and amenorrhea, infertility and miscarriage. Clinical data include the own experience of treatment and rehabilitation of 66 patients; women with intrauterine synechiae (32 people) were included in group 1; 34 patients with hyperplastic form of chronic endometritis and polyposis were included in group 2. The control group included 30 healthy patients without gynecological pathology and menstrual irregularities. All women underwent therapeutic hysteroscopy with adgeolysis and polypectomy. In the postoperative period, 24 patients of the main group received the proposed program to restore the endometrium and its implantation potential. The comparison group included 42 patients with general principles of postoperative management. The key points of the proposed program were: immunomodulatory therapy, hormone replacement therapy and the use of autoplasma. As a result of the study, a reduction in the recurrence of the adhesive process was proved, as well as a significantly higher number of cases of pregnancy. Thus, for the comprehensive treatment of intrauterine pathology in young women with reduced reproductive potential it is important not only to use minimally invasive office hysteroscopy, an active postoperative rehabilitation period is of great importance too.
References
Bortsvadze Sh.N., Dzhibladze T.A., Ishchenko A.I., Zuiev V.M., Voloshchuk I.N., Briunin D.V. Infertility in women with intrauterine synechiae: modern aspects of diagnosis // Issues of Gynecology, Obstetrics and Perniatology 2013. – Vol.12, No.5. – P. 11-15.
Dubinin A.A. Comparative efficiency of operative hysteroscopy by Bettocchi method and hysteroresectoscopy in dissection of synechiae of the uterine cavity. А.А. Dubinin, K.V. Panidov, M.T. Tugushev // Materials of the XI All-Russian Scientific Forum. Mother and Child. – M., 2010. – P. 362-363.
Klimov V.S. Intrauterine synechiae in women with infertility: how to identify and treat? / V. S. Klimov, E. N. Dergunova. // Young Scientist. –
– No. 14.2 (148.2). – P. 25-29. – URL: https://moluch.ru/archive/148/41894/
Clinical and anamnestic data and outcomes of treatment of women with intrauterine synechiae / P.M. Khirieva, L.V. Adamian // Problems of Reproduction. – 2017. – No.6 (23). – P. 39-44.
Maksimova T.A., Dzhibladze T.A., Zuiev V.M., Ishchenko A.I., Khokhlova I.D., Briunin D.V. Minimally invasive interventions in endometrial and endocervical polyps in patients of reproductive age // Russian Bulletin of Obstetrician-Gynecologist 2017. – No. 1. – P. 67-71.
Makarenko T.A., Nikiforova D.E., Ulianova I.O. Intrauterine synechiae: features of surgical treatment and prevention of relapse // Medical Council. 2018. – No.7. – P. 146-151.
Modern methods of prevention and treatment of intrauterine synechiae: review article / P.M. Khirieva, L.V. Adamian, S.A. Martynov // Gynecology. – 2016. – No.5 (18). – P. 32-36.
Suslikova L.V., Serbeniuk A.V. Optimization of treatment cycles by ART methods in patients with tubal-peritoneal infertility by applying the injection scratching of autoplasma. Women’s Health. 2018. – No.5 (131). – P. 97-104.
Tsygankova O.Yu., Kropmaer K.P., Kravchenko E.N. Experience of using platelet-rich autoplasma in treatment of synechiae of the uterine cavity. – Mother and Child of Kuzbass. 2020 – No.2 (81). – P.35-37.
Tapilskaia N.I., Gzgzian A.M., Kogan I.Yu. Granulocyte colony-stimulating factor as a key regulator of the invasive potential of the embryo and endometrial receptivity // Journal of Obstetrics and Women’s Diseases. – 2019. – Vol. 68. – No.1. – P. 83-92. https://doi.org/10.17816/JOWD68183-92
Di SpiezioSardo A., Calagna G., Scognamiglio M., O’Donovan P, Campo R, De Wilde RL. Prevention of intrauterine post-surgical adhesions in hysteroscopy. A systematic review. Eur J Obstet Gynecol Reprod Biol, 2016, 203: 182-192.
Van Herendael BJ. Treatment of intra-uterine adhesions. Invited presentations and presentations by organisations and societies. 151 ПРАКТИКА International Journal of Gynecology & Obstetrics, 2012, 119S3: 161-260.
Ibrahim MI, Raafat TA, Ellaithy MI, Aly RT. Risk of postpartum uterine synechiae following uterine compression suturing during postpartum haemorrhage. Aust N Z J ObstetGynaecol, 2013, 53(1): 37-45
Chinese Society of Obstetrics and Gyneocology; Chinese Medical Association. Expert consensus on the diagnosis and management of intrauterine adhesions in China. Zhonghua Fu Chan KeZaZhi, 2015, 50(12): 881-887.
Stefanescu A, Marinescu B. Diagnostic hysteroscopy – a retrospective study of 1545 cases. Maedica (Buchar), 2012, 7(4): 309-314.
Suslikova L. V., Serbenuyk A. V. Optimization of treatment by ART methods in patients with tubal-perientional infertility by application of the injectionscreetching procedure. RS Global WORLD SCIENCE. 2018. № 6(34). Vol. 6. P. 19-24.
Takai IU, Kwayabura AS, Ugwa EA, Idrissa A, Obed JY, Bukar MA. 10-year review of the clinical presentation and treatment outcome of Asherman’s syndrome at a center with limited resources. Ann Med Health Sci Res, 2015, 5(6): 442-446
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