Objective.To determine the characteristics of hemodynamics of the uterus with endometritis.Material and methods.A retrospective analysis of 420 patients of reproductive age (19–53 years old) diagnosed with endometritis. The comparison group consisted of 323 women aged 17–52 without gynecological pathology.Blood flow indicators in the uterine arteries, such as maximum systolic, end-diastolic, and average blood flow velocity (Vmax, Vmin, Vmean), were estimated, and an arterial perfusion index (API) was calculated. With 3D reconstruction of the uterus in angioregime, a vascularization index (VI), a flow index (FI) and a vascular flow index (VFI) of the uterus and endometrium were obtained.Result.An increase in Vmax, Vmin, Vmean, as well as VI, VFI of the uterus and VI, FI and VFI of the endometrium in the early and middle proliferative phase of the cycle. API had monotonous values, but it should be taken into account in conjunction with VI.Conclusions.Echography combined with color mapping, spectral Doppler graphics and vascularization index determination using 3D in angio mode is a highly effective method for the diagnosis of endometritis. Characteristic changes in hemodynamics in endometritis manifest as a violation of the venous outflow in the uterus and, especially, in the endometrium, in the presence of hypervascu larization according to data VI in the aggregate of regulatory or reduced indicators of API.
Aim. Despite significant advances in modern gynecology, endometritis is often unrecognized, being the main reason leading to persistent infertility or repeated pregnancy loss. There are 3 morphological types of chronic endometritis: hyperplastic, hypoplastic and mixed. The aim of the study was to develop ultrasound signs and hemodynamic features of various morphological types of chronic endometritis. Matherials and Methods. A retrospective analysis of 162 patients of reproductive age (22-50 years old) diagnosed with endometritis was carried out. The comparison group consisted of 96 women 17-42 years old without gynecological pathology (P > 0.05). The study was conducted in the proliferative phase of the cycle up to 10 days. The hemodynamics of the uterus and endometrium was evaluated on the basis of Doppler blood flow parameters in the uterine arteries, the calculation of arterial perfusion index (API), vascularization index (VI) and flow index (FI) of the uterus and endometrium obtained by 3D Doppler. Results. Depending on the morphotype of endometritis, hemodynamic features were evaluated. It was revealed that in the hypoplastic type, to which patients are related with the ratio of the endometrial volume to the volume of the uterus less than 2.5%, there is a significant (P < 0.05) decrease API, as well as hypovascularization of the uterus. Hypervascularization of the uterus and endometrium was observed both with a mixed morphotype, when the ratio of the endometrial volume to the volume of the uterus was from 2.5 to 9.0%, and in the case of a hyperplastic morphotype, when the volume of the endometrium to the volume of the uterus exceeded 9.0%. AIP was no different from healthy women. Conclusions. Diagnosis of impaired blood supply to the uterus will allow reasonable treatment and restore the reproductive function of women.
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