Affiliation:
1. Peoples' Friendship University of Russia named after Patrice Lumumba
2. LLC “Medskan”
3. Peoples' Friendship University of Russia named after Patrice Lumumba; Research Center for Obstetrics, Gynecology and Perinatology named after academician V.I. Kulakov of the Ministry of Healthcare of the Russian Federation
Abstract
Objective: to evaluate the dynamics of echographic parameters of structural changes in the endometrium depending on the morphological type of chronic endometritis (CE) before and after etiotropic therapy.Material and methods. A retrospective cohort based on the results of examination of 140 patients of reproductive age with a verified diagnosis of CE before and after complex etiotropic therapy. A pelvic ultrasound was performed in the 1st phase of the menstrual cycle with measurements of the endometrial and uterine volume, followed by a calculation of the percentage endometrial/uterine volume ratio (EV/UCV). The groups of hypoplastic, mixed, and hyperplastic morphotypes were formed according to the values of EV/UCV. The B-mode examination included the assessment of the structure and echogenicity of the uterine cavity mucosa; the line of closure or divergence of the endometrial layers; the external contour of M-echo; the presence of liquid in the uterine cavity, and acoustic artifacts, in particular reverberation, as a sign of gas bubbles.Results. An increase in the thickness and volume of the endometrium, and EV/UCV was obtained after therapy in the hypoplastic morphotype. There were no changes in the thickness or volume of the endometrium in the mixed morphotype. A significant decrease in the thickness and volume of the endometrium, and EV/UCV were found in the hyperplastic morphotype. In all morphotypes, the endometrium remained mostly hyperechoic and heterogeneous, with an abnormal midline.Conclusion. The hypoplastic and mixed morphotypes are characterized by more persistent endometrial changes that are difficult to treat. Pathological signs were eliminated much more often in the hyperplastic morphotype. The results of the study demonstrate the absence of a complete reduction in the analyzed ultrasound criteria of CE after end of treatment for all morphological types.
Reference18 articles.
1. Gynecology: National guide / Eds V.I. Kulakov, I.B. Manukhin, G.M. Savelyeva. M.: GEOTAR-Media, 2007. 1072 p. (In Russian)
2. Utkin V.E., Kulavsky V.A. Inflammatory diseases of the pelvic organs in women. M.: GEOTAR-Media, 2015. 112 p. (In Russian)
3. Sukhikh G.T., Shurshalina A.V. Chronic endometritis: a guide. M: GEOTAR-Media, 2013. 64 p. (In Russian)
4. Cicinelli E., Tinelli R., Lepera A. et al. Correspondence between hysteroscopic and histologic findings in women with chronic endometritis. Acta Obstet. Gynecol. Scand. 2010; 89 (8): 1061–1065. https://doi.org/10.3109/00016349.2010.498496
5. Radzinsky V.E., Petrov Yu.A. et al. Pathogenetic features of macrotypes of chronic endometritis. Kazan Medical Journal. 2017; 98 (1): 27–34. https://doi.org/10.17750/KMJ2017-27 (In Russian)