Search

The objective of the present work was to study the functional characteristics of the microcirculation system in the women of late reproductive age presenting with chronic endometritis before and after a course of contrast massage. Three types of functional changes in the microcirulation system were distinguished based on the results of laser-assisted Doppler flowmetry. All of them were characterized by high coefficients of correlation with the results of dopplerometry of uterine blood flow and underwent dynamic changes in the course of the treatment. The study has demonstrated the high therapeutic effectiveness of the contrast massage technique as a tool for inducing hemodynamic changes in the small pelvis basin in the women suffering from chronic endometritis.

The endometrial receptivity is a complex of structure-functional characteristics of endometrium with clear temporal and spatial constants, conditioning the ability of endometrium to the implantation. The aim of our research was a studying of morphological and molecular aspects of the endometrial receptivity disorders at chronic endometritis. The basic studied group included cases of chronic endometritis (CE) with unknown etiology (30 patients) and with CE under autoimmune thyroiditis (26 patients with presence of antithyroid antibodies--ATA). All patients had different disorders of reproductive function; some of them were infertile. More over 73% of all studied patients were of the 26-40 ages old. The control group was presented by endometrium of healthy surrogate mothers (10 cases). The research was done on the Pipelle biopsies of endometrium, which was taken in the secretory phase (the period of "implantation window"). For confirmation of the CE diagnosis, the endometrium of women with ATA was taken in the proliferative phase too. Morphological, immunohistochemical and statistical (nonparametric analysis of Mann-Whitney) methods were used. As the primary antibodies were used CD68, CD138, CD56, Ki-67, Apaf-1, LIE The structure analysis of pinopodes was carried out by stained paraffin slices (CytoViva Technologies Inc., Auburn, AL, USA) with using of the traditional and luminescent microscopy (the definition is over 100 nm). Structure and molecular changes of endometrium at CE include inflammatory infiltration, fibroblastic reactions and alteration of extracellular matrix; apoptosis of functional layer leading to its insusceptibility to the regulatory signals. Disorders of endometrial remodeling in the "implantation window" determine the result of implantation and can be reason of the infertility. The reduced receptivity at CE is characterized by decrease of mature pinopodes and low expression of LIF in the surface epithelium.

With the aim of studying the causes of peculiarities of female reproductive function and secondary sterility as a result of 100 cesarean sections by M. Stark's modified method, we have attempted to determine the immune status of organisms of women in post-operational period, in post-operational purulent septic complications and in post-operational process of uterus involution. As a result of hysteroscopy and metrosalpingographic tests it has been established that a secondary sterility after cesarean section carried out according to M. Stark modification is manifested 2.5 times less than after traditional method of cesarean section which widely used nowadays.

The microcirculation in the intestinal wall was evaluated in 42 women in the postoperative period using contact biomicroscopy in laparoscopy with a microhysteroscope. The dynamic contact biomicroscopy unlike other clinico-laboratory data allowed prognosis of the development or progress of peritonitis and choice of the strategy of treatment.

In severe genitoperitonial tuberculosis, conglomerate forms of the disease, and liquid accumulation between intestinal loop adhesions, laparotomy may verify the diagnosis in the shortest time while other diagnostic methods cannot be used due to contraindications for them. The operation should be maximally saving and only diagnostic. Timely combined antituberculous treatment concurrently with surgical interventions yields good results of recovered reproductive function.

The sympathoadrenal, parasympathetic, and humoral mechanisms of regulation of the autonomic nervous system, as well as the strain and reserve of the adaptive reactions of the body were examined in 57 pregnant women with chronic inflammations of the genitals and their newborns in the early neonatal period. The sympathoadrenal autonomic regulation predominated in pregnant women, whereas in the newborns imperfect adaptive restructuring of the body was observed in the early neonatal period.

A study of 118 puerperants+ revealed that Doppler metry objectively evaluated the artery blood flow in the postpartum uterus. There was a progressive increase in uterine vascular resistance in the uncomplicated postpartum period following spontaneous labour, whereas there was a reduction in peripheral resistance in the endometritis-complicated period, which caused a rise in the end-diastolic blood flow. Postpartum uterine blood flow following cesarean section displayed low peripheral resistance in the presence or absence of an inflammatory process.

Blood concentrations of LH, FSH, estradiol, prolactin, growth hormone, cortisol, testosterone and progesterone have been examined in 76 patients with active tuberculosis of the internal genitalia (group 1), 18 patients with longterm sequelae of clinically asymptomatic tuberculosis (group 2) and 41 patients with nontuberculous diseases of the internal genitalia. Abnormalities were identified in 56.5% of group 1 patients, 33% of group 2 and 46.4% of group 3 patients. The patients with active tuberculosis characteristically had a low gonadotropin and estradiol secretion. High prolactin levels were related to pituitary adenoma or tuberculous infection; polycystic ovaries were a cause of testosterone and stress of examination of cortisol elevation.

We studied the volume compactness of the arterial, capillary and venous parts of the microcirculation channel after 24, 48, 72 and 96 hours of the aseptic inflammation and after local application of the carbon-mineral sorbents in the rat's uterus. The local sorption decreased the reaction of the inflammation in the endo- and myometrium.

The measurement of colloid-oncotic pressure (COP) in 160 women with pyoseptic disease (pyodermia, soft-tissue abscesses, suppurative mastitis, endometritis, sepsis) has demonstrated a regular pattern of change, depending on the clinical condition. A classification of COP disorders has been proposed, identifying the hyperoncotic state (COP above 3.29 kPa), normoncotic state (COP between 2.84 and 3.29 kPa) and hypo-oncotic state (COP below 2.84 kPa), on which a differential remedial therapy is based. A reliable assessment of COP values during the infusion therapy can only be made by means of oncometry, since estimations of any kind lead to considerable error.