Проблемы диагностики и лечения хронического эндометрита у женщин репродуктивного возраста

Abstract

Aim. To study the controversial issues of diagnosis and treatment of chronic endometritis (CE) and its impact on fertility, according to foreign and domestic authors. Key points. Although immunohistochemical study for plasma cells is considered the gold standard for diagnosing CE, it has limitations. The need to achieve consensus on the diagnostic criteria for cholecystitis was noted in order to exclude the influence of heterogeneity of studies on the assessment of treatment results. An integrated approach based on knowledge about the pathogenesis of CE facilitates the selection of adequate treatment. The positive role of antibacterial therapy in resolving CE is undoubted. In recent years, the need to restore immune defense in CE has been widely discussed. The importance of a complex of natural antimicrobial peptides and cytokines in restoring fertility and improving pregnancy outcomes has already been proven in several publications. Physiotherapeutic methods continue to be studied, and the most popular currently are cavitated solutions, peloids, electropulse and magnetic therapy. Conclusion. The diagnostic criteria for CE require a clear definition. Treatment of CE should include broad-spectrum antibiotic therapy, immunomodulatory therapy, and physiotherapy. Keywords: chronic endometritis, infertility, recurrent miscarriage, antibiotics, immunomodulators, peloid therapy, ultrasonic cavitation, interference therapy, magnetotherapy, laser therapy.