RATIONAL METHODS OF DIAGNOSTICS OF CHRONIC ENDOMETRITIS TYPES AFTER PREGNANCY TERMINATION AMONG WOMEN WITH CHRONIC PYELONEPHRITIS AND ANEMIA

The article shows different effectiveness of endometrial evaluation methods among women with pregnancy termination on the background of CP and anemia, their complementarity in the allocation of CE types - a proven cause of early reproductive losses. Clear connection is obvious between the lack of pregravid preparation on the background of chronic EGD and high CE frequency, the diagnosis and the treatment of which at the pre-grading stage seem to be the best tactics for the prevention of various degrees of violations of the "fetal-endometrial" interaction. Objective of the research: to evaluate the effectiveness of the diagnostic stage in the management of women after abortion on the background of chronic pyelonephritis (CP) and anemia. Materials and methods of the research: A group of 431 women with terminated pregnancy due to anemia (n=246) and CP (n=185) was prospectively examined. Research methods: clinical and statistical analysis, sonography, hysteroscopy, pathomorphological examination of the biopsy of the uterine mucosa/removed material with visually obvious pathology and/or revealed by sonography. Results of the research: The effectiveness of diagnosing chronic endometritis types (hypoplastic and hyperplastic) with hysteroscopy is shown and confirmed morphologically - with the allocation of characteristic features, typical of each group. Indicators of sensitivity and specificity of methods for diagnosing the hyperplastic type (92.6% and 66.7% - sonography, 97.5% and 77.2% - hysteroscopy) were higher than with the hypoplastic one (79.2% and 68.6% - sonography, 89.6% and 74.4% -hysteroscopy). The histological verification of the CE (chronic endometritis) pattern took place in 83.5%, with a greater frequency of the hypoplastic variant in CP (50.3% versus 24.8% in anemia) (p <0.05) and hyperplastic - in half of the samples with anemia - one and a half times more often (p <0.05). The amount of samples with an "incomplete" CE morphological picture in the EGD (extragenital diseases) group was 39.2%. Detailing of endometrial histological studies in a group of women with pregnancy termination on the EGD background showed the presence of endometrial polyps - in 5.5%, intrauterine synechium - 2.0%, unchanged mucosa - 9.3%. Different effectiveness of endometrial evaluation methods among women with pregnancy termination on the background of CP and anemia shows their complementarity in the allocation of CE types - a proven cause of early reproductive losses. Clear connection is obvious between the lack of pregravid preparation on the background of chronic EGD and high CE frequency, the diagnosis and the treatment of which at the pre-grading stage seem to be the best tactics for the prevention of various degrees of violations of the "fetal-endometrial" interaction. Conclusion: Clarification of the concepts of CE pathogenesis in hypo- and hyperplastic types during a comprehensive study of women with abortion on the EGD background will allow for differentiated management tactics, involving a set of measures to restore the structural and functional viability of the uterine mucosa.