Abstract
Among the causes of tubal pregnancy are the main inflammatory diseases of female genital organs, presence of adhesions in the pelvis, which developed as a result of previous laparotomy. The purpose of experimental and clinical studies was to increase the effectiveness of reproductive health in women with advanced tubal pregnancy and to develop new approaches to improve its techniques using endoscopy, anti−adhesion drugs, placental cryoextract, physiotherapy and assisted reproductive technologies. To justify the use of these methods, an experiment was performed in 196 adult female Wistar rats and 90 female BALB / C mice. There were analyzed the data of clinical observations of 518 women for whom different methods of treatment and rehabilitation of reproductive function were used. It was proven that the use of streptodornase with streptokinase in the patients helped to reduce the incidence of adhesions by 1.6 times; polyethylene oxide with carboxymethyl cellulose, streptodornase with streptokinase and cryoextract of the placenta did in 2.2 times; sodium hyaluronate, streptodornase with streptokinase and cryoextract of the placenta increased it in 2.6 times compared with the intraoperatively detected degree of adhesion. To optimize the method of recovering reproductive function in the patients with tubal pregnancy, the use of laparoscopic organ−preserving treatment with intraoperative administration of anti−adhesive drugs as well as a combined physiotherapeutic treatment was advisable. The inclusion of assisted reproductive technologies in the above two−stage treatment of the patients who did not become pregnant naturally contributed to the onset of uterine pregnancy in 64.9−75.7 % of cases, which did not differ significantly from this index in the control group. Key words: tubal pregnancy, reproductive function, laparoscopy, tubotomy, radio wave energy, adhesion process, anti−adhesion barrier, physiotherapeutic treatment, model of premature ovarian failure, placental cryoextract.
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