RU2703548C1 - Method for integrated treatment of aseptic chronic endometritis following interruption of non-developing pregnancy - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to gynecology and pelotherapy. Method for integrated treatment of aseptic chronic endometritis following interruption of non-developing pregnancy involves a combined treatment according to a scheme that involves ultrasonic irrigation of the uterine cavity with solution of 0.01 % miramistin and rectal and application mud therapy, wherein the therapeutic regimen includes four courses. Each of four courses of treatment consists of 5 procedures of ultrasonic irrigation of uterus cavity with 0.01 % miramistin solution, cavitated with ultrasound, each of which lasts not more than 4 minutes, and 12 procedures of mud treatment, including rectal introduction of tampon with therapeutic mud, heated to 37–39 °C, with simultaneous application of the same dirt on the "panties" for 40–50 minutes.

EFFECT: invention allows to considerably reduce the level of pro-inflammatory cytokines in blood serum, restore vaginal microbiota normocenosis, improve morpho-functional state of endometrium, leading to reduction of risk of subsequent adverse pregnancy losses.

1 cl, 1 ex

Description

The invention relates to medicine, namely to gynecology, peloid therapy and reflexology.

Analogs:

The following treatment methods are known: No. 2377028 Method for vaginal mud therapy Maidan A.I., No. 2377001 Method for rectal mud therapy Maidan A.I., No. 2522382 Method for the treatment of chronic endometritis Danusevich I.N.

However, all the presented methods are not effective enough, since there is no reorganization of the focus of chronic inflammation.

Prototype:

Closest to the proposed method is patent No. 2522382 A method for the treatment of chronic endometritis Danusevich I.N. However, this method involves the use of unheated mud, which reduces its healing properties. In addition, with this method there is no reorganization of the focus of chronic inflammation.

The purpose of the invention:

The aim of the invention is to optimize the rehabilitation of women after vacuum aspiration of the uterine cavity due to a failed miscarriage, restore the morphological and functional potential of the endometrium, reduce the risk of subsequent adverse pregnancy losses.

The invention:

The method includes 4 courses of rehabilitation treatment, which consists of a combination of intrauterine irrigation with a 0.01% solution of miramistin, cavitated by ultrasound, and combined rectal and application peloid therapy. Treatment begins on day 2 after vacuum aspiration of the uterine cavity due to a failed miscarriage. Ultrasonic cavitation with a frequency of 25 kHz is carried out for 4 minutes, followed by rectal introduction of a tampon with therapeutic mud at a temperature of 37-39 ° С and at the same time applying the same mud to the “panties” zone for 40-50 minutes.

From day 5 of the next three menstrual cycles, the courses are repeated. An example of a specific implementation of the method.

A 26-year-old patient M. was admitted to the gynecology department with complaints of spotting spotting from the genital tract, menstruation delay of about three weeks.

A history of 3 pregnancies: 2 miscarriages in the early stages, 1 non-developing pregnancy for a period of 7 weeks.

The department conducted an examination: OAK, OAM, blood biochemistry, ultrasound. According to the results of the examination, the diagnosis was made: Non-developing pregnancy of 7 weeks. OAA Miscarriage.

A woman underwent vacuum aspiration of the uterine cavity under short-term intravenous anesthesia. The post-abortion period without features.

Intrauterine ultrasound irrigation was performed with a 0.01% solution of miramistin using a cavitation ultrasound apparatus AK100 Fotek. Irrigation using the uterine advanced tip started on the 2nd day after the interruption of a failed miscarriage. The course consisted of five procedures of ultrasonic cavitation of the uterine cavity, each of which lasted no more than 4 minutes. Local percutum mud swabs and mud applications were performed on the third day after abortion immediately after cavitation irrigation of the cavity, and amounted to 12 procedures in total. In the next menstrual cycle on day 5, the patient repeated a course of intrauterine irrigation and mud therapy. Subsequent courses are conducted in a similar manner.

After termination of an undeveloped pregnancy as a result of studying the structure of the microbiota by PCR-real-time, severe dysbiosis was diagnosed. After a complex triple application of the method of ultrasonic cavitation irrigation of the uterine cavity in combination with peloid therapy, significant differences in the structure of microbiocenosis were determined: the contents of Gardnerella vaginalis, Ureaplasma (ureal + parv), Atopobium vaginae, Eubacterium spp, Leptotrihia sppus Candida, decreased. According to the results of microflora research, a normocenosis is exhibited.

The patient revealed an increase in the level of pro-inflammatory factors in the blood serum. As a result of applying the integrated approach, the content of TNF-α decreased from 10.4 to 4.1 pg / ml, IL-6 from 8.5 to 2.1 pg / ml, IL-8 from 73.3 to 36.3 pg / ml

After the rehabilitation treatment, the woman was under observation. Six months after the last course, the patient confirmed an ultrasound scan using the uterine pregnancy method, which ended with an urgent delivery of a live fetus with an Apgar score of 9/10 points.

The features of the invention distinctive from the prototype:

In contrast to the prototype, we offer a combination of mud therapy and ultrasonic cavitation irrigation of the uterine cavity. In this case, mud heated to 37-39 ° is used, which enhances the thermal effect, which has an additional therapeutic effect on the focus of chronic inflammation.

1. Combined treatment: mud and intrauterine irrigation with a 0.01% solution of miramistin, cavitated ultrasound at a frequency of 25 kHz

2. Dirt at a temperature of 37-39 ° C

3. 4 courses of rehabilitation treatment

4. A simple and effective algorithm for the rehabilitation of women with aseptic chronic endometritis after an abortion.

Positive effect:

The combined use of ultrasonic irrigation of the uterine cavity and the combination of vaginal irrigation with mud applications together have a more pronounced therapeutic effect.

A comprehensive approach using irrigation of the uterine cavity with cavitated ultrasound solution in combination with peloid therapy can significantly reduce the level of pro-inflammatory cytokines in the blood serum, restore vaginal normocenosis, improve the morphological and functional state of the endometrium, leading to a decrease in the risk of subsequent adverse pregnancy losses. The combination of ultrasonic irrigation with peloid therapy mutually potentiates the therapeutic effect of both methods.

Claims (1)

A method for the complex treatment of aseptic chronic endometritis after termination of an undeveloped pregnancy, which includes combined treatment according to the scheme, which includes ultrasonic irrigation of the uterine cavity and rectal and application mud therapy, characterized in that the treatment regimen includes four courses, each of which consists of 5 procedures of ultrasonic irrigation of the uterine cavity a solution of 0.01% miramistin, cavitated by ultrasound, each of which lasts no more than 4 minutes, and 12 mud treatments, including rectal e introduction of the tampon with mud, heated to 37-39 ° C, with simultaneous applique of the same mud at the zone "pant" 40-50 minutes.