THE INFLUENCE OF AN INFECTIOUS AGENT ON THE DEVELOPMENT OF HYPERPLASTIC PROCESSES OF THE ENDOMETRY IN THE EARLY REPRODUCTIVE AGE

Abstract

The problem of hyperplastic processes of the endometrium (HPE) in women of reproductive age is a potential cause of reduced fertility and the risk of developing oncological pathology, which has been steadily increasing in recent years, attracting the increased attention of clinicians.
 The aim: to analyze the role of an infectious agent in the development of hyperplastic processes of the uterine mucosa in women of early reproductive age for the formation of risk groups for the occurrence of endometrial hyperplasia and polyps.
 Materials and Methods: 90 patients in early reproductive age were examined, who were divided into groups: the main group included patients with histologically verified atypical hyperplastic pathology of the endometrium (polyps of the uterine body and atypical hyperplasia of the endometrium) (n = 60). The control group consisted of 30 healthy volunteer patients of the same age category. The patients of the main group underwent a diagnostic hysteroscopy with endometrial biopsy, material was collected from women of the control group with prior consent using Peipel-biopsy with subsequent examination of the material. Bacteriological analysis of the material from the uterine cavity included the study of aerobic and anaerobic flora using a set of selective differential diagnostic nutrient media.
 Results and Discussion: Data on the role of microbial and viral factors in the development of atypical endometrial hyperplasia in women of early reproductive age are given. The structure of microbial insemination of the uterine cavity in such women has been established. Cytomegalovirus antigens in hyperplastic endometrium were found in 38.3 % of cases. The obtained data make it necessary to carry out high-quality infectious screening for the formation of risk groups regarding the occurrence of hyperplastic changes of the uterine mucosa.
 Conclusions: In patients of early reproductive age with atypical hyperplasia of the endometrium, the persistence of bacterial agents in the uterine cavity in insignificant concentration was noted in all examined, viral - in 38.3 %, which reflects the significant etiological role of bacterial and viral infection, which participates in the implementation of the inflammatory process and formation of hyperplastic pathology. Pathogenetic features of bacterial-viral infection of the genital tract of patients with hyperplastic endometrial pathology determine the need for high-quality infectious screening with the formation of risk groups and subsequent etiopathogenetic treatment.