The women of reproductive age have actual aspects of pathology of endometrium
Authors: Strakhovetska Yuliya 
Published: February 2025

The objective: optimization of tactic of conduct of women of reproductive age is after the delete of endometrial polyps on the basis of study of antioxidant status of organism and uterine blood flow.Materials and methods. 165 women of reproductive age took part in research. From them – 150 with endometrial polyps and 15 practically healthy women of reproductive age with regular ovulatory by a menstrual cycle, which did not have gynaecological diseases in anamnesis, and made a control group. The criteria of exception of patients from research were: malignant pathological process in the organs of the reproductive system or other localization, hormone-producing ovarian tumour, uterine fibroids and adenomyosis, and also pregnancy and lactation.A complex clinical-and-laboratory inspection which included a echographic inspection was conducted all women, Doppler, coloured Doppler mapping organs of small pelvis, hysteroscopy with the separate diagnostic scraping off of cervical canal and cavity of uterus, morphological research of remote polyps and determination of parameters of antioxidant status.Results. Ultrasonic research of organs of small pelvis in combination with coloured Doppler mapping and enables the curves of speeds of blood flow nono-invasive to estimate the change of indexes of blood flow to myo- endometrium in case of occurring of endometrial polyps. For patients with endometrial polyps as compared to the women of control group in the follicle phase of menstrual cycle for certain the low values of resistance index were determined only in radial and basale arteries (in radial arteries – 0,58±0,01 and 0,66±0,01, respectively; p<0,01; in basale arteries – 0,50±0,01 and 0,57±0,01, respectively; p<0,01). Reliable decline of vascular resistance for patients with endometrial polyps in radial and basale arteries and, respectively, vasodilatation of vessels of uterus, obviously, it can explain enhanceable maintenance of estrogen and estrogen receptors. From our data, in arcuate arteries at glandular polyps an arterial blood flow appeared in 93,8%, and at glandular-fibrotic polyps – in 61,2%, in radial arteries – 89,2% and 45,9% respectively, in basale arteries 81,5% and 35,3%, respectively. Research results rotined that stromal fibrosis mainly had met for patients which have glandular-fibrotic endometrial polyps. Leykocyte-histiocytic infiltration was characteristic to the glandular polyps, and lymphocytic infiltration – glandular-fibrotic to the endometrial polyps. Both glandular and glandular-fibrotic polyps were characterized by the thick-walled vessels. Vessels with the sclerosis of walls met only in glandular-fibrotic polyps in 17,4% cases. Found out by us considerable violations in antioxidant status for patients in the first days after operative interference as compared to analogical indexes for patients with the endometrial polyps to the operation conditioned by operating stress.Conclusions. For prognostication of possible risk of relapse of endometrial polyps after their operative delete it is suggested to conduct the Doppler monitoring with the use of method of coloured Doppler mapping in the basale and radial arteries of uterus in a postoperative period in a dynamics. With a purpose to normalization of antioxidant status is expedient and grounded in quality the mean of antirecurrent therapy to use the algorithm in methodology of which stopped up naturally evolutional the formed models developed by us, one of which there is co-operation of water-reducing and fatty components of the antioxidant system and, in particular, glutathione, ascorbic acid and tocopherol. Other natural model which an organism produced as a result of phylogenesis and protracted natural selection is a non-invasive electronic satiation of organism with the purpose of suppression freely radical to activity, neutralization and detoxication of tissue.A positive therapeutic effect is got after the algorithm which includes the complex use of antioxidant preparations (thioctic and ascorbic acid, alfa-tocopherol and indole-3-carbinol) in combination with the non-invasive satiation of tissue by electrons developed by us, can allow to revise some traditional going near treatment of hyperplastic processes of reproductive organs for women, that, no doubt, requires the modern methodological and methodical approaches scientifically grounded.Keyword: endometrial polyps, relapse, antioxidant status, uterine blood flow.