Changes in uterine hemodynamics after treatment of chronic endometritis; [Изменения гемодинамики матки после лечения хронического эндометрита]

Objective: to evaluate the hemodynamics of the uterus and endometrium after therapy for chronic endometritis in women of reproductive age. Material and methods. A prospective cohort study of 158 patients with a verified diagnosis of “chronic endometritis” was conducted before and after complex etiotropic therapy. Ultrasound examination was performed in the 1st phase of the menstrual cycle with measurements of Vmax, Vmin, Vmean, PI, RI, the diameter of the uterine arteries with subsequent calculation of the arterial perfusion index. The degree of vascularization of the uterus and endometrium was assessed using the VI, FI, VFI indicators obtained during 3D angioscanning. Results. In the hypoplastic morphotype, there is a persistent decrease in the arterial blood supply to the uterus, which is combined with hypovascularization of the endometrium both before and after treatment. In the hyperplastic morphotype, the arterial blood supply is not impaired, but in the endometrium, hypervascularization detected before therapy is reliably reduced due to the disappearance of venous stasis during treatment. In the mixed morphotype, there are no pronounced disturbances in arterial hemodynamics; the blood supply to the endometrium after treatment significantly increases, which indicates the absence of a violation of venous outflow and the restoration of the macrovascular network of the mucous membrane of the uterine cavity. Conclusion. Pathological blood supply to the uterus and endometrium is associated with the degree of severity of venous outflow disorder and the reparative capacity of the endometrium, which change against the background of complex etiotropic therapy depending on the morphological type, which allows us to judge the therapeutic effect. © 2024 VIDAR Publishing House. All rights reserved.