Efficiency of a complex of sanitation therapy in pre-gravid preparation of women with chronic endometritis

One of the leading causes of impaired implantation of the fetal egg is chronic endometritis. Currently, microbial-viral associations play an increasingly important role in the genesis of chronic endometritis. The aim of the study was to evaluate the effectiveness of combined immunomodulatory sanitation at the stage of pre-pregnancy preparation in women with chronic endometritis who have a history of abortion in the first trimester or failure of assisted reproductive technologies.

The aim of the study was to evaluate the effectiveness of combined immunomodulatory sanitation at the stage of pre-pregnancy preparation in women with chronic endometritis who have a history of abortion in the first trimester or failure of assisted reproductive technologies.

Materials and methods. A comparative bacteriological and morphological analysis of the metroaspirate and the flora of the cervical canal before and after treatment was performed. In 67.2 % of cases, cultural studies of metroaspirate did not reveal a significant concentration of the etiological agent. At the same time, both viral (31.2 %), bacterial (20.3 %), and viral-bacterial associations (48.4 %) were identified in all subjects from the cervical canal. At the first stage, all patients were prescribed antibacterial therapy within 14 days, according to the revealed sensitivity. To eliminate the viral lesion or reduce the viral load, an antiviral agent of the nucleoside analog group was used in combination with local vaginal sanitation. In the main group, a combined drug (interferon alpha-2b human recombinant 50 thousand mg) was used for 10 days. IU + metronidazole 250 mg + fluconazole 150 mg), in the comparison group dequalinium chloride 10 mg for 6 days. At the 2^nd stage of complex therapy, identical methods of rehabilitation of patients with chronic endometritis were used in both groups, in the form of prescribing phase-by-phase hormone therapy and physiotherapy.

Results. The effectiveness of treatment was assessed 3 months after the end of treatment based on the elimination (or reduction of the quantitative load) of the pathogen and restoration of the morphological structure of the endometrium. In 30 patients of the main group (88.2 %), there was a decrease in the detection rate of lymphoid infiltrates and plasma cells in endometrial tissue compared to 22 patients (73.3%) from the comparison group (p < 0.05). It was noted that in these patients, the titers of microflora were within the reference values with a predominance of Lactobacillus spp.

Conclusion. The use of interferon alpha-2b as part of combined rehabilitation therapy had a synergistic effect and improved the decontamination effect in mixed bacterial and viral infections of both the cervical canal and the endometrium.

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