Prevention of chronic endometritis after miscarriage in the first trimester of pregnancy
Objective. To reduce the risk of inflammatory complications after miscarriage in the first trimester. Materials and methods. The investigation enrolled 117 patients aged 18 to 35 years after vacuum aspiration for the ovum remains. On the first day and after 1 month, all the patients were examined using Inbioflor, Femoflor and blood IgA, IgM, and IgG tests, a hemostasiogram, and pelvic ultrasound. Twenty-five patients were excluded from the study because they had been detected to have pathogenic obligate bacteria. The remaining patients were divided into 2 groups: 45 and 47 individuals. All the patients received preventive anti-inflammatory therapy: oral doxycycline hydrochloride and a probiotic (Lactobacillus rhamnosus and Lactobacillus reuteri); sertaconazole was once administered intravaginally in patients with candidiasis. Group 1 had additionally magnet-and-laser and ozone therapy. Results. On the first day, the mean number of lactobacilli in the bioassays was 42.5±8.2% of the total bacterial mass (TBM) and that of opportunistic pathogenic bacteria was 2 to 10%. After treatment, the number of lactobacilli increased (p<0.05) and reached normal values, and that of opportunistic pathogens decreased (p<0.05), with the exception of anaerobes (more than 10% of the TBM) in Group 2. During treatment, IgA and IgM levels normalized; IgG increased significantly (p<0.05). There was hypercoagulation before treatment and normal coagulation after treatment (p<0.05). Pelvic ultrasound revealed no changes characteristic of the inflammatory process in Group 1 and showed expansion of the uterine cavity with a heterogeneous mass, as well as M-echo thickening in 10.6% of cases in Group 2; additional treatment was performed. Conclusion. The investigators could restore the vaginal microbiota and the state of hemostasis, improve the immune status, and prevent possible inflammatory complications. In Group 1, the results of treatment were better; physiotherapy enhanced its efficiency.Ozolinya L.A., Savchenko T.N., Ovsepyan N.R., Bahodurova H.A., Overko A.V.
Keywords
miscarriage
Femoflor and Inbioflor
IgA
IgM
IgG
hemostasiogram
magnetic and laser therapy
ozone therapy
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Received 27.04.2021
Accepted 03.06.2021
About the Authors
Lyudmila A. Ozolinya, Dr. Med. Sci., Professor, Professor of the Department of Obstetrics and Gynecology, Faculty of Medicine, Pirogov Russian National Medical Research University, Ministry of Health of Russia. Tel.: +7(495)490-02-61; +7(903)718-66-74. E-mail: ozolinya@yandex.ru. ORCID: 0000-0002-2353-123X; Spin code: 9407-9014.125367, Russia, Moscow, Ivankovskoye Shosse, 7 (Central Clinical Hospital of Civil Aviation).
Tatyana N. Savchenko, Dr. Med. Sci., Professor, Professor of the Department of Obstetrics and Gynecology, Faculty of Medicine, Pirogov Russian National Medical Research University, Ministry of Health of Russia. Tel.: +7(495)490-02-61; +7(968)478-36-76. E-mail: 12111944t@mail.ru. ORCID: 0000-0001-7244-4944; Spin code: 3157-3682.
125367, Russia, Moscow, Ivankovskoye Shosse, 7 (Central Clinical Hospital of Civil Aviation).
Nona R. Ovsepyan, obstetrician-gynecologist, INVITRO LLC. Tel.: +7(495)363-03-63. E-mail: nona.ovsepyan@mail.ru. ORCID: 0000-0002-7190-5910.
125047, Russia, Moscow, 4th Tverskaya-Yamskaya str., 16-3.
Khushnuda A. Bakhodurova, student of the 5th year of the International Faculty, Pirogov Russian National Medical Research University, Ministry of Health of Russia.
Ministry of Health of Russia. Tel.: +7(969)154-09-09. E-mail: xbaxodurova@mail.ru. ORCID: 0000-0001-9533-4051; Spin code: 4128-7012.
117997, Russia, Moscow, Ostrovityanova str., 1.
Alexey A. Overko, student of the 5th year of the Medical Faculty, Pirogov Russian National Medical Research University, Ministry of Health of Russia.
Tel.: +7(916)472-57-23. E-mail: leha.overko@yandex.ru. ORCID: 0000-0002-4629-9074; Spin code: 5519-2836. 117997, Russia, Moscow, Ostrovityanova str., 1.
For citation: Ozolinya L.A., Savchenko T.N., Ovsepyan N.R., Bahodurova H.A., Overko A.V. Prevention of chronic endometritis after miscarriage in the first trimester of pregnancy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 7: 180-186 (in Russian)
https://dx.doi.org/10.18565/aig.2021.7.180-186
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