Signs of endometrial inflammation. Classic symptoms of endometritis in women and effective treatment tactics. Clay compress
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Often, as a result of difficult childbirth, complicated abortions, infertility, miscarriage, and various gynecological interventions, women are faced with a diagnosis of endometritis. Currently, the vast majority of cases of the disease, if treated in a timely manner, can be successfully treated and are completely cured.
Endometritis– inflammation of the inner mucous layer of the uterine body (endometrium). The development of inflammation in the endometrium is provoked by viruses and various opportunistic microorganisms: gonococci, E. coli, staphylococci, streptococci, chlamydia and trichomonas. This disease is quite common and is often accompanied by inflammation of the muscle tissue of the uterus.
Description and types of endometritis
With this disease, the internal mucous membrane in the uterine cavity, which is very important in the functioning of the female body, is affected, its most fragile and sensitive upper layer - the endometrium. There are many factors for the occurrence of the disease, as well as its varieties.
According to the form of manifestation, the disease occurs in:
- Acute, which mainly manifests itself immediately after infection with pathogenic bacteria or pathogenic viruses as a result of mechanical damage and is characterized by severe symptoms.
- Subacute, which can develop as a complication of acute endometritis. Typically occurs in patients with weak immune systems. At this stage, the disease develops into a chronic form. It is urgent to start treatment, because it is the subacute form of E. that can lead to female infertility. During treatment, the doctor prescribes antibiotics, complex preparations from medicinal plants, and physiotherapeutic procedures.
- Chronic (latent) form. Chronic E. develops as a result of infection with infections that are transmitted through sexual contact. The patient may not be aware of her problem. The disease is often discovered after a comprehensive infertility examination.
According to the etiological principle, everything forms of endometritis divided into:
- Specific. This disease, which affects the mucous layer of the uterus, is caused by strictly defined types of microorganisms - tuberculosis bacteria, herpes simplex viruses, pathogens of toxoplasma, mycoplasma, gonococci, candida, protozoa, cytomegaloviruses, fungal flora. Also the causative agents of ailments are diseases that are sexually transmitted.
- Nonspecific. All other forms of disease in the uterine cavity, when it is not possible to detect a specific pathogenic pathogen of opportunistic microflora, are nonspecific.
Causes of endometritis
There are quite a large number of causes of infection of the uterine cavity by various bacteria. Often the cause of the disease is minimally invasive diagnostic procedures, so you can catch the disease even while staying in a medical institution.
Infection is promoted by:
- Poor personal hygiene.
- Non-regular sexual partners. Often, the infection enters the uterine cavity from the vagina during casual sexual intercourse and unprotected sexual intercourse with a carrier of the infection.
- Weakened immune system.
- Gynecological interventions. Abortions, therapeutic and diagnostic curettages, probing of the uterine cavity can become a factor of inflammation.
- Hysteroscopy or endoscopic interventions. When performing microsurgical manipulation for the purpose of diagnosis, it is also possible to get inflammation of the uterine cavity.
- Mechanical injury to the integrity of the uterus and cervix during childbirth. Sometimes, after labor is completed, the placenta is not born and the doctor has to scrape it out, damaging the inner lining of the uterus.
- Deep postpartum tears in the cervix.
- Dishormonal disorders.
- Concomitant chronic diseases.
- Installation of the IUD. Often, after the installation of intrauterine contraceptives, as a result of injury to the cervix, the inner mucous layer of the uterine body becomes inflamed.
- Physical intimacy during menstruation without protection. Sexual contact during menstruation, even with a healthy partner, can become a factor in the development of endometritis.
- Chronic stress conditions.
Main symptoms of endometritis
The disease in the initial stages can occur latently, without the manifestation of pronounced symptoms, so a woman cannot detect endometritis in a timely manner and consult a doctor for treatment. This is precisely what threatens serious consequences - female infertility, thickening of the walls of the uterine cavity, or the formation of intrauterine adhesions. Severe symptoms are characterized by an acute form of endometritis.
Symptoms of manifestation acute endometritis :
- Increase in body temperature to 38-40° C.
- Mild pain in the lower abdomen of an aching or pulling nature, radiating to the sacrum or lower back.
- Bleeding from the uterus.
- Changes in the menstrual cycle. Observed during the transition from acute to chronic form.
- Copious vaginal discharge. Cloudy discharge resembling clots and containing blood and pus with an unpleasant characteristic odor.
- Deterioration in general health.
Symptoms when chronic endometritis :
- Vaginal discharge. In this form, they correspond in smell and color to the causative agents of the disease. With trichomoniasis, the discharge is profuse and foamy green in color. With gonorrhea - cloudy yellowish-green mucous discharge.
- Changes in the length of the menstrual cycle. Heavy and prolonged periods are observed, more than seven days.
- Spotting at the beginning and after the menstrual cycle.
- Slight or, conversely, heavy discharge during menstruation.
- Repeated spontaneous cases of termination of pregnancy before the natural term.
- A woman’s inability to conceive a child for a long time (infertility).
- A weak and fleeting feeling of pain in the lower abdomen.
- Increased body temperature, often subfebrile, within 37.2° C.
Diagnosis of endometritis
When you first contact the doctor, based on clinical signs and a medical history, a presumptive diagnosis of endometritis is established. At this stage, the doctor asks about all the symptoms that worry the patient.
In addition to this information, a number of activities and laboratory tests are also carried out:
- On a gynecological chair, the uterus is examined and the discharge is assessed by smell, quantity, color.
- Examination of a vaginal smear for bacterial culture. Based on the results of bacteriological examination of a vaginal smear, it is possible to more accurately determine the infectious causative agent of the disease and its reaction to various medications.
- Collection and immunohistochemical examination of a vaginal smear. It is carried out to detect infection and the number of leukocytes in the smear.
- Blood test - general analysis.
If necessary, and to establish an accurate diagnosis, additional examinations are carried out:
- Diagnostic intrauterine curettage.
- Histological examination of the endometrium. To confirm the diagnosis of changes in the mucous membrane (the inner mucous layer of the uterine body).
- Ultrasound examination of the uterus and appendages of the female genital organ.
- Endoscopic examination.
- Enzyme-linked immunosorbent test for antibodies (ELISA). The test also helps identify sexually transmitted diseases.
- PCR diagnostics. Polymerase chain reaction is a highly accurate research method used to identify numerous specific infections.
This diagnosis of E. is quite sufficient, however, at different stages of the disease different diagnostic methods will be carried out. Patients with this disease and in order to avoid the likelihood of developing complications of a septic nature in the form of pelvioperitonitis, peritonitis, undergo treatment in medical institutions in a hospital setting.
Features of treatment of endometritis
The treatment regimen for the disease depends on the results of the examination. With properly selected treatment, this disease can be completely healed in a week, and women who are faced with the disease will have a chance to become pregnant and give birth to completely healthy babies. As a rule, treatment is carried out with broad-spectrum antibiotics.
For successful treatment, drug treatment is used in combination with physiotherapeutic treatment, vitamins and agents that improve microcirculation, and, if necessary, hormonal drugs are prescribed. As an addition to traditional therapy prescribed by a gynecologist, traditional medicine is used in timely treatment.
Treatment of endometritis with drugs.
When treating E., a qualified doctor first of all prescribes antibiotics, which help relieve inflammation and reduce discharge. In addition, antibacterial therapy, which is best performed in the early stages of detection and course of the disease. Patients are often prescribed protected drugs.
If the disease is not very severe, the doctor may prescribe antibiotics, during which the woman can even continue breastfeeding the child. If the pathology is severe, you will still have to stop breastfeeding and undergo treatment with strong antibiotics.
Drugs, as a rule, are prescribed in the form of tablets, administered as droppers or intravenous injections, as well as local remedies to get rid of itching and burning sensation in the vaginal area.
In addition to antibiotics, an experienced doctor may prescribe the use of antifungal drugs in parallel.
Basic medications for the treatment of endometritis:
- Antispasmodics. A group of medications that eliminate painful attacks of spastic pain. In a hospital setting, the patient is administered the drug twice a day. Medicines reduce pain in the lower abdomen and sacral spine.
- Antibiotics. In the early stages of the development of the disease, antibiotics with a diverse range of effects are prescribed. In a medical facility, these drugs are administered by injection. When treated at home, they are prescribed in tablet form.
- Antifungal medications. If necessary, the prescription of antibiotics is combined with the simultaneous use of antifungal drugs, due to the possible risk of developing candidiasis.
- Antipyretic. Such drugs are prescribed when the patient has an elevated body temperature.
- Agents that relieve swelling of the mucous membrane. To block histamine in the body, fairly effective and safe decongestant drugs are prescribed. These medications help reduce the size of the uterus, relieve inflammation and tissue swelling.
Treatment of endometritis with topical medications
If the disease was caused by an infection that is transmitted through sexual contact, in this case, in addition to antibiotics, the doctor prescribes topical medications. Suppositories and medicinal substances in the form of suppositories help to quickly get rid of secretions and destroy pathogenic microorganisms directly at the source of infection.
Suppositories and ointments used in the treatment of endometritis:
- Preparations with the active substance – chlorhexidine, the action of which is aimed at combating bacteria, viruses and fungal diseases. Effectively used in the treatment of endometritis caused by microorganisms of the genus Trichomonas, opportunistic bacteria Gardnerella and chlamydia. Medicines in the form of suppositories are given twice a day. In the morning and in the evening before bed.
- Combined candles, universal action. These drugs are effective against pyogenic bacteria, fungi of the genus Candida, microorganisms of the genus Trichomonas and Gram (+) bacteria. Such a wide variety of effects of drugs is due to the substances contained in the suppositories. To cure E., medications are given two times a day for ten days.
- Drugs prescribed after ultrasound examination and confirmation of the presence of adhesions and severe inflammation in the uterine cavity. The drugs have antioxidant, pronounced immunomodulatory, anti-inflammatory effects. Thanks to the components included in the preparations, swelling of the uterus is reduced and adhesions are destroyed.
- Combined vaginal capsules. The suppositories contain antimicrobial and antifungal substances. The main advantage of the product is that its components do not cause disruption of the beneficial microflora of the vagina. Suppositories are used for E. caused by Gram (+) and Gram (-) microorganisms.
- Vaginal suppositories, actively used in gynecological practice. Thanks to the substances contained in their composition, the drug has a pronounced antimicrobial, antifungal, antiprotozoal effect, and also helps to accelerate the process of formation of the stratum corneum. The drug is used in the treatment of acute and chronic forms of E., the causative agent of which is infections transmitted through sexual intercourse.
- Suppositories containing iodine, which has an inhibitory effect on the growth and reproduction of pathogenic and opportunistic microorganisms. The drug is characterized by antiseptic, antifungal, disinfectant and antiprotozoal effects, and has a wide spectrum of antimicrobial activity. The medicine is effective against E., the development of which is provoked by fungus, viruses and bacteria (including Staphylococcus aureus and Escherichia coli), as well as protozoa.
Physiotherapy for endometritis
In case of E., for therapeutic effects on certain organs or on the entire body, the use of physiotherapy is an important component of treatment, because it helps to improve the conductivity of drug therapy and the rapid recovery of the patient.
Physiotherapeutic treatment methods are prescribed to reduce pain (analgesic methods), relieve inflammation in the uterine mucosa and restore the structure of the endometrium (reparative and regenerative methods), and activate local immunity (immunostimulating methods).
Physical methods of treating patients with endometritis:
- UHF therapy. An anti-exudative technique that affects the body with a high-frequency electromagnetic field and helps reduce the inflammatory process.
- Reparative and regenerative methods. The method involves carrying out procedures using laser therapy with infrared radiation on the area of the projection of the uterus, paraffin therapy - using medical paraffin, iodine-bromine baths, radon baths, hydrogen sulfide, as well as peloid therapy procedures - limiting the release of fluid and swelling of tissues, promoting the development of connective tissue and treatment with ozokerite therapy.
- The analgesic method is ultraviolet irradiation (UVR). Medium wave ultraviolet irradiation in erythemal doses. UVR of the vaginal mucosa leads to the death of most pathogenic microorganisms. The method will be especially effective if the cause of the disease is vaginosis.
- Immunostimulating methods: LOC therapy, heliotherapy, thalassotherapy treatment, SUV irradiation in suberythemal doses, air bath treatment.
- Interference therapy. The essence of the method is the effect on the human body of two medium-frequency currents, which form the so-called interference low-frequency current, while having a positive effect on tissue. This therapy raises the pain threshold and due to this, subjective pain irritation disappears.
- Laser therapy. Exposure of the tissue of the mucous layer of the uterus to radiation of light waves of a certain length increases local immunity, improves microcirculation and promotes rapid healing of damaged tissue. Laser radiation also has a certain bactericidal effect, causing the death of pathogenic microorganisms.
- Magnetotherapy. An alternative medicine method using the influence of a magnetic field on the human body reduces inflammation and swelling, improves microcirculation, increases metabolic processes in the mucous layer of the uterus, promoting rapid healing and restoration of damaged tissue. In addition, local immunity and other cells of the immune system are activated, and the protective forces of the female body are increased.
- Ultrasound therapy (UT). Exposure to ultrasound at a certain frequency causes a number of changes in the tissues of the body, promoting the activation and acceleration of metabolism. Microcirculation and tissue trophism also improve, connective tissue loosens, which prevents the formation of adhesions.
- Electrophoresis. The treatment procedure is aimed at penetrating the drug deep into the tissue under the influence of an electric current using copper, iodine, zinc, and 10% calcium iodide solution to treat pain.
Although relatively harmless, physiotherapeutic procedures still have some contraindications that should be taken into account when prescribing.
The use of physiotherapeutic treatment of endometritis is absolutely contraindicated in the following cases:
- acute period of the disease;
- purulent E. (metroendometritis);
- pelvioperitonitis;
- during pregnancy;
- uterine bleeding;
- neoplasms (tumors in the affected area);
- polycystic ovary syndrome;
- when the internal mucous layer of the uterine body (endometrium) grows outside the uterine cavity.
In other cases, the use of physiotherapeutic treatment is decided by the attending gynecologist and physiotherapist.
Hormonal treatment
In view of the fact that the cause of inflammation of the internal functional lining of the uterus can be not only infections and bacteria, but also a violation in the processes of development and rejection of the mucous layer, the attending physician may prescribe hormonal medications (usually oral contraceptives) for three to six months. .
Taking combined oral contraceptives helps restore the menstrual cycle, and after a woman stops taking OCs against the background of the so-called contraceptive pill withdrawal syndrome, pregnancy can quite often occur.
Treatment with folk remedies
When treating E., gynecologists often prescribe traditional medicine to eliminate vaginal discharge. However, it should be remembered that if this disease was caused by quite dangerous microorganisms and viruses, then it will not be possible to cure endometritis without special help and taking medications.
With O.E. You cannot use treatment only with traditional medicine. Traditional medicine for the treatment of the disease suggests douching with infusions or decoctions of medicinal herbs.
Recipes from traditional healers:
- Coltsfoot grass. Tannins contained in the plant have a pronounced antibacterial and anti-inflammatory effect. To prepare the decoction, pour 50 grams of crushed raw materials into one liter of boiling water and leave for four hours. After this, strain and take one tablespoon four to five times a day.
- Bay leaf. To carry out the treatment procedure, you will need 20 grams of dry raw materials. Pour the plant into a deep enamel container, add water and boil for about five minutes. Let the broth cool a little and sit on a bucket, wrapped in a terry sheet. Carry out the procedure before bedtime for two weeks. The decoction is excellent for inflammation of the genitourinary system.
- Stinging nettle leaves. The plant suppresses the inflammatory process, has an antimicrobial effect, stimulates metabolism in the body and improves the contractile activity of the muscular walls of the uterus (myometrium). To prepare the medicine, pour one tablespoon of crushed raw materials into one liter of boiling water and leave for three hours. Strain the broth and take one tablespoon of the broth four times a day, 30 minutes before meals and before bed.
- Sea buckthorn oil. This is an old and quite effective method. It is necessary to soak a cotton swab wrapped in a sterile bandage with sea buckthorn oil. Place the tampon overnight. The duration of treatment is two weeks. The oil relieves inflammation and helps heal cervical tissue.
- Herb St. John's wort. To prepare the decoction, you need to pour 20 grams of dry raw material into half a liter of boiling water and simmer for about ten minutes over low heat. Strain the finished product and take 1/2 tbsp three times a day.
- Blueberries. A decoction of the berries of the plant inhibits the development of inflammation, has an astringent, antimicrobial and slight diuretic effect. To prepare the potion, pour one hundred grams of dried berries of the plant into one liter of cold water, bring to a boil and boil for ten minutes. Cool the broth and consume 1/2 tbsp. (100 milliliters) 3 r/day.
- Forest hay. You need to place an armful of hay in a bucket and fill it with five liters of water. Bring to a boil and remove from heat. Place the patient on a bucket and wrap herself in a blanket. You need to sit until the broth cools. The duration of treatment is two weeks.
- Dried fern leaves. You need to pour 20 grams of raw material with 280 milliliters of cold water and boil for two minutes. Strain the finished broth and consume 70 milliliters three to four times a day. The duration of treatment is two weeks.
- Citrus fruits. Wash well and thoroughly dry one large orange and one lemon each. Grind tropical fruits in a blender or grind in a meat grinder. Add ten drops into the resulting mass. onion juice and 10 grams of sugar. Cover the jar with a lid and shake well. Take the drug one teaspoon three to four times a day. The duration of treatment is three weeks.
Endometritis and pregnancy, after childbirth
It is impossible to become pregnant with endometritis, endure a normal pregnancy and give birth to a healthy child. Moreover, if the disease is not cured in a timely manner, then the developed pathology can lead to incurable infertility. With the development of E., the complex processes of conception and implantation of the embryo into the mucous membrane that covers the inner surface of the uterus are disrupted, and this makes the mechanism of development and gestation impossible.
During pregnancy This disease is one of the most dangerous, so you cannot treat this problem irresponsibly. At the first signs of the disease, you should immediately consult a doctor and have endometrial scrapings tested. If the diagnosis is confirmed, it is necessary to immediately begin treatment, and if the doctor prescribes antibiotic therapy, one cannot refuse, otherwise, as the disease develops, the consequences can be extremely dire - the fetus will die.
To increase the chances of successful conception, in the future you need to undergo treatment with hormonal therapy, which will have a beneficial effect on the normal course of pregnancy.
E. after childbirth is a common complication after a difficult delivery, and is usually diagnosed using ultrasound.
The causes of postpartum E. are considered:
- Complication of a normally developing pregnancy (preeclampsia).
- A prolonged labor period, especially if the child has been without amniotic fluid for a long time.
- Birth of a large baby, malpresentation of the fetus.
- Narrow birth canal.
- A woman gives birth after her forty-first child.
- Childbirth at an early age - before the age of nineteen.
- Placental abruption prematurely.
- Infection of a woman in labor with an STD.
Is it possible to have sex with endometritis?
It is not recommended to enter into intimate relationships with endometritis, because this can not only provoke complications during the course of the disease, but also cause infection of the sexual partner. During sexual intercourse, the integrity of the mucous plug secreted by numerous glands is disrupted - a barrier that blocks the entrance to the uterine cavity and prevents infection of this area from the external genitalia and the environment. If you do not use a mechanical means of protection (condom), infection from an unhealthy partner can enter the uterus and cause E..
Intimacy with endometritis can be complicated:
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- Spread of microbial infection to neighboring organs and throughout the body.
- The occurrence of adhesions and nodes in the fallopian tubes leads to infertility. This creates an obstacle to the movement of the egg into the uterus and makes it impossible to get pregnant and carry a child to term normally.
- The appearance of polyps in the uterus.
- Germination of the mucosal layer into the muscle tissue of the uterus (myometrium) and beyond the uterine mucosa, directly into the abdominal cavity. With adenomyosis, scars form in the uterus, which prevent the conception of a child. In addition, spotting and pain during sexual intercourse are constantly observed.
- Cysts form. Constant inflammation leads to the formation of benign neoplasms in the uterus or ovaries.
- The danger of pregnancy failure (miscarriage) in the early stages and the likelihood of premature birth.
- Malfunctions of the menstrual cycle.
Prevention of endometritis
Preventive measures for this disease are aimed at eliminating factors predisposing the occurrence of the inflammatory process and the penetration of pathogenic microorganisms into the uterine cavity, and if this does happen, at their speedy elimination.
Measures to prevent endometritis include:
- Timely treatment of infections transmitted through sexual intercourse.
- Treatment of complications that arise during childbirth.
- Refusal of artificial termination of pregnancy (abortion).
- Regular gynecological examinations and examination of the microflora of a woman’s vagina after childbirth and before medical procedures.
- A woman’s attentive attitude towards herself: maintaining personal hygiene of the genital organs, promptly contacting a qualified obstetrician-gynecologist.
- Lead a healthy lifestyle (HLS), prevent diseases and improve health.
- Using condoms during sexual intercourse.
- Strengthen the immune system.
The inflammatory process of the uterine mucosa, called endometritis, causes women a lot of trouble, because the uterus, inflamed from the inside, can no longer fully function.
If the disease is not treated on time or treatment is completed earlier than expected, the result may be permanent miscarriages and infertility.
In this review, we will look at how to diagnose a dangerous disease, its first signs, main symptoms, and treatment tactics for uterine endometritis in women.
Clinical signs of different forms of the disease
Like many gynecological diseases, it may not manifest itself for a long time, which makes it difficult to identify the problem and leads to the development of significant consequences.
After all, when the symptoms appear, the disease will already be carrying out its destructive activities in the body with might and main.
The disease has two main forms - acute and chronic, each has different symptoms.
What is endometritis:
Spicy
This form of the disease usually manifests itself 3–4 days from the onset of development. Its first signs:
- copious, cloudy, liquid vaginal discharge that may have an unpleasant odor;
- temperature increase in the range of up to 39 ° C;
- the uterus is dense, enlarged, manual examination gives unpleasant, painful sensations;
- cardiopalmus;
- general weakness;
- pulling or aching, radiating to the sacrum or lower back, pain of varying intensity in the lower abdomen;
- uterine bleeding, which develops in rare cases;
- accumulation of pus in the uterus in severe cases.
If treatment is not started at this stage of the disease, it becomes chronic.
The acute stage of the disease lasts about 10 days, can manifest itself with severe symptoms, but is cured faster than chronic.
Subacute
This is an intermediate stage of the disease, which occurs during chronicity of the acute stage.
A woman who did not see a doctor at the acute stage of the disease calms down and decides that self-recovery has begun, because the symptoms at this stage weaken and/or become scarce.
What's happening:
- menstrual irregularities are most often expressed by a decrease in blood secretion during menstruation until complete disappearance;
- the localization of pain does not change, but it is less pronounced;
- if the temperature rises, then to subfebrile levels (37–38 ° C);
- due to the fact that the regeneration of the functional layer of the endometrium is impaired, and also because inflammation affects the vessels of the uterus, bleeding may develop that occurs at the end of menstruation (which is taken for prolonged menstruation).
Chronic
The transition to usually occurs with an untreated acute form of the disease.
Its manifestation is most often asymptomatic, which makes detection difficult, or is accompanied by the following symptoms:
- temperature rises to 37–38 °C, but it may remain normal;
- slight spotting before and after menstruation;
- vaginal discharge, the nature of which depends on the type of pathogen that caused endometritis;
- menstrual irregularities, prolonged periods are possible, lasting more than a week;
- the uterus enlarges and becomes painful;
- pain in the lower abdomen, radiating to the lower back.
Menstruation, nature of pain, discharge and other main manifestations
The symptoms of endometritis are multifaceted, therefore, it is impossible to say that the disease will manifest itself with any specific symptoms. It all depends on the general condition and the infectious agent that caused the disease.
The nature of menstruation changes unambiguously, and can range from their complete disappearance to manifestations bordering on bleeding.
This is influenced by changes in the contractile function of the uterus, the stage and degree of change in the regenerative abilities of the endometrium, and transformations in the structure of the mucous membrane.
The nature of the discharge also changes depending on the type of pathogen. If the cause of inflammation was Trichomonas, the woman will be bothered by copious foamy discharge, and gonococci cause purulent yellow-green discharge.
Localized in the lower abdomen and radiating to the lower back and sacrum, they cannot be the basis for a diagnosis, because similar symptoms can be caused by other gynecological diseases and diseases of the lower part of the spine.
Diagnostics
How to determine endometritis, is it possible to detect it without testing? Diagnosis is based on medical history, determining whether there have been surgical interventions or other invasive procedures.
A gynecological and general examination, laboratory tests (blood, cultures, bacterioscopy, etc.) are performed.
Usually diagnosis is done in the following sequence:
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Is it possible to cure uterine endometritis at home, what is the drug treatment, how to treat the disease with folk remedies and methods? Everything will be discussed in detail in the next section.
How to treat correctly
For endometritis self-medication is prohibited. All treatment regimens are selected only by the attending physician and are carried out under his direct supervision.
Since in any type of inflammation of the endometrium there is a microbial factor, the disease is treated with the prescription of antibiotics.
Since it is impossible to identify all pathogens, the doctor may prescribe combination antibacterial therapy, which includes several antimicrobial drugs belonging to different pharmacological groups.
This makes it possible to achieve maximum effectiveness of the treatment regimen and the highest percentage of destruction of possible pathogens.
For greater effectiveness, drugs administered both intravenously and intramuscularly are simultaneously prescribed.
The duration of the main course of therapy depends on the form of the disease and the state of the immune system. But the course must be completed, otherwise serious consequences cannot be avoided.
If inflammation began after childbirth, a possible cause is pieces of the placenta remaining in the uterus. Then they are removed and the organ cavity is washed with antiseptic solutions.
After an abortion, inflammation can be caused by the remaining fertilized egg. To stop the development of the process, foreign biomaterial is also removed and the cavity is washed.
Physiotherapy is also needed. Prescribed mud therapy, magnetic therapy, UHF heating, paraffin baths, electrophoresis.
Such measures improve local blood circulation, stimulate the functioning of the genital organs, and in the chronic phase of the disease will promote the outflow of pus and mucus from the uterine cavity.
Prescribed drugs and regimens for their use
The basis of effective therapy for endometritis is antibiotics, which can quickly eliminate unpleasant symptoms and stop the spread of infection throughout the reproductive system.
The objectives of treatment are to remove infection from the uterus, prevent its spread to neighboring organs, reduce the risk of chronicity of the disease, restore the normal functioning of the reproductive organs, and normalize menstruation.
What antibiotics are used to treat - the names of the most effective ones
Antibacterial drugs are selected depending on the type of pathogen. For endometritis, the following antibiotics are prescribed:
- Clindamycin affects streptococci and staphylococci, usually combined with Gentamicin;
- Ampicillin used together with other drugs or as monotherapy;
- Gentamicin effectively acts on gram-negative bacteria, often combined with Clindamycin or Ampicillin and Metronidazole;
- Levofloxacin belongs to the group of fluoroquinolones, neutralizes many microorganisms (even Pseudomonas aeruginosa) that cause inflammation;
- Doxycycline inhibits chlamydia, has a bacteriostatic effect;
- Cefoxitin effectively affects gram-negative bacteria (including penicillin-resistant) and gram-positive cocci;
- Cefazolin prescribed mainly after childbirth, used to prevent the disease;
- Cefotaxime highly effective against gram-negative bacteria;
- Metronidazole used against protozoan microorganisms, anaerobic bacteria. Often combined with Gentamicin and Ampicillin.
Average, The duration of treatment ranges from 10 to 14 days, during which the drugs are taken 2-3 times a day. 2–3 days after starting treatment, it is already possible to evaluate the effectiveness of the antibiotic.
Additional medications
An integrated approach to therapy involves influencing all manifestations of the disease.
In addition to antibiotics, usually Prescribe drugs that stimulate the immune system, which is important during the subacute phase of the disease.
Depending on the specifics of the situation, sedatives, desensitizing and restorative drugs, antispasmodics, hemostatics, painkillers, and vitamins are also prescribed.
After the main course of treatment for several months hormone therapy is carried out, for which oral contraceptives are prescribed.
This helps restore the menstrual cycle and protect against unwanted pregnancy during the recovery stage.
Vaginal suppositories
When choosing candles, you need to consider many parameters. In acute forms of the disease, they are usually not used, since antibiotics are sufficient.
But if endometritis is accompanied by vaginal dysbiosis or a sexually transmitted disease, then suppositories help achieve the effectiveness of therapy.
Medicinal suppositories are prescribed in the following situations:
- inflammation of the cervix and/or vagina;
- chronic course of the disease;
- adhesions in the pelvic area.
Suppositories cannot replace the main treatment.
They are used as a component of auxiliary therapy and are prescribed only by the attending physician.
Depending on the situation, candles may include:
- antibiotics of various effects, while the composition also contains antifungal components, so that when bacteria are suppressed, fungi do not begin to develop in the vagina;
- antiseptics that destroy microorganisms or prevent their growth;
- components of medicinal plants with soothing, healing, antimicrobial and anti-inflammatory properties;
- proteolytic enzymes for the prevention and treatment of adhesions.
What folk remedies can supplement therapy?
Attempts to treat endometritis only with folk therapy are unacceptable, because the main component of the treatment regimen is antibiotics, the action of which in this case cannot be replaced by any herbs.
Medicines from the public pharmacy can only be used as additional means of treatment.
Hog queen
The action of the plant normalizes hormonal levels.
A decoction of the herb, which should be consumed for a long time, also reduces the growth of the mucous layer, stops bleeding, relieves inflammation and pain, which often accompany endometritis.
To prepare the decoction, add a tablespoon of crushed dried raw materials to 200 ml of boiling water and brew like tea. You need to drink 1.5 cups of decoction per day, divided into several doses.
Strengthen the effect of the boron uterus you can add bergenia root. This will support the immune system and help treat untreated inflammation.
In combination with bergenia root, boron uterus is taken for 3 weeks, then a break is taken for 5–10 days.
Other herbs
St. John's wort helps to recover from endometritis, used as an independent remedy or in herbal teas. To St. John's wort you can add coltsfoot, horsetail, thyme, nettle, buckthorn bark, calamus root.
All components are taken in equal parts and brewed at the rate of 1 tbsp. spoon of crushed raw materials per 100 ml of boiling water. The tea is infused for several hours, taken several times a day, 100 ml.
Plantain, known for its antibacterial and anti-inflammatory properties, can also provide significant assistance.
An infusion of this plant slows down the spread of infection and strengthens the immune system.
It is brewed as tea at the rate of 1 teaspoon of raw material per 100 ml of boiling water, consumed before meals three times a day. The daily norm is 200 ml of infusion.
Fern regulates the menstrual cycle well, having antibacterial and hemostatic properties, so it is recommended to use it for heavy bleeding or heavy periods.
A tablespoon of raw material is poured into 250 ml of boiling water and left to cool. Drink 200 ml of infusion per day, dividing it into 4 parts.
Prevention
Let's talk about disease prevention.
Basic preventive measures are actions that exclude the occurrence of inflammation of the reproductive organs. All sexually transmitted infections should be cured immediately and completely.
It is necessary to promptly identify and treat postpartum complications, avoid abortions, and undergo gynecological examinations and ultrasounds on time.
Personal hygiene should be maintained, reducing the risk of infection entering the uterine cavity, all sexual contacts must be protected, because the use of a condom not only protects against unwanted pregnancy, but also protects against sexually transmitted infections.
If a woman suspects she has endometritis, she should consult a doctor immediately, especially if she has recently had intrauterine interventions.
The disease can be cured completely, but the key to success is timely initiation of treatment and compliance with all recommendations of the attending physician.
The mucous layer of the uterus, the endometrium, remains unchanged for about a month, then it separates and is replaced by a new layer. This condition is ideal and remains so in a healthy uterus. What is endometritis? If microbes enter the uterus, sterility is disrupted and its protective layers, including the endometrium, become inflamed. The disease endometritis occurs, the symptoms and treatment of which will be discussed below.
Bacteria can infect the mucous membrane quickly, and acute painful symptoms of endometritis in women begin to occur. The disease will become acute. If treatment of this form was carried out, but turned out to be ineffective, and the disease did not go away, but only lay hidden, it becomes chronic.
The signs of chronic endometritis are not so pronounced and are not even noticeable at first glance. The disease can only be determined by doing the necessary examination.
Acute endometritis of the uterus is often caused by mechanical damage, and chronic inflammation is caused by diseases of the genital tract.
Endometritis is a fairly common occurrence, especially after childbirth. Endometritis after an abortion is also not uncommon, as is the case after various genital surgeries. Fortunately, it can be treated well.
Kinds
The disease can occur in several forms: acute, subacute and chronic. Depending on the causative agent of the infection, there can be specific (endometritis against the background of Trichomonas, tuberculosis bacteria and other bacteria) and nonspecific endometritis (caused by opportunistic microbes). There are other types:
- Focal – chronic endometritis, affecting the mucous membrane partially in patches;
- Purulent is one of the most dangerous forms. Occurs due to the accumulation of pus due to an infectious disease. In a bacteria-conquered uterus, blood clots and placental remnants clog the cervix, making the outflow of contents difficult;
- Autoimmune endometritis is a form of disease in which antibodies are formed in the uterus to its own endometrial cells. Chronic autoimmune endometritis becomes possible when local immunity is impaired;
- The hyperplastic process of the endometrium is classified as a benign oncological disease. Pathology can be detected in women and girls at any age, but the largest number of cases is observed during menopause;
- Postpartum purulent-catarrhal endometritis is an acute inflammation in which the contractile function of the uterus is disrupted and pus is formed. However, this classification is more used when treating animals rather than people;
- Post-abortion endometritis - occurs as a result of infection during a traumatic intervention to terminate a pregnancy. The consequence of such a disease can be focal endometritis;
- Postpartum gangrenous - occurs after deep trauma during childbirth with damage to anaerobic bacteria. There is a high temperature, complete lack of appetite, rapid pulse, and discharge with a putrid odor.
There may also be endometritis after hysteroscopy, after vacuum aspiration, since all this is an intervention in the internal environment of the reproductive organ.
Causes
Endometritis of the uterus is inflammatory in nature. Inflammation of the endometrium occurs due to E. coli, streptococci, chlamydia, staphylococci, trichomonas, and viruses.
All these microorganisms enter the female organ in several ways:
- From the cervix or vagina;
- With the help of lymph;
The most common causes of endometritis are insufficient adherence to hygiene rules after childbirth and abortion (due to poor-quality curettage of decidual tissue). If, after the endometrium, the myometrium (muscle tissue) becomes infected, the disease turns into metroendometritis.
Endometritis, what is it? Let's take a closer look.
In a healthy uterus there are two layers: basal and functional. The latter is rejected by the body once a month and excreted along with menstruation. The basal layer works to create a new functional layer.
The structure of the functional layer is very fragile: glandular cells are located between the cylindrical cells, and spiral arteries fill the remaining space. This structure is disrupted immediately after viruses or microbes enter this environment.
What can cause disruption of the structure of the endometrium of the uterus? The causes of endometritis are:
- Hysteroscopy;
- Inaccurate douching;
- Probing of the uterus.
Endometritis after curettage of the uterine cavity is also a common phenomenon. Up to 60% of diseases occur in the period after childbirth (20% after natural and 40% after cesarean section). This occurs due to hormonal and immune changes in the body, remnants of decidual tissue, as well as a general weakening of the body.
Diagnostics
When visiting a doctor, he will first listen to all the patient’s complaints. Then he will conduct a gynecological examination, during which he will evaluate the discharge for quantity, color and smell, and also take a smear for further analysis. This will help identify infectious agents.
If necessary, the gynecologist prescribes additional diagnostics of endometritis, namely: donating blood for analysis, ultrasound. The disease can lead to hardening of the uterus, damage to the fallopian tubes and ovaries. An ultrasound will help to see and assess the extent of infection. Echography will help determine the shape and size of the compaction on the mucous membrane, the soreness of the uterus, and whether the endometrium is necrotic or not. You can also see areas of fibrous and sclerotic formations. To identify endometritis, more extensive diagnostics may be required.
Symptoms
Already a few days after the manipulations in the uterine area, some unpleasant sensations may occur. How to determine endometritis? This can be done according to the following criteria:
- Body temperature ceases to be normal and rises to 39 degrees;
- Headaches and loss of appetite may occur;
- The lower abdomen groans from pain, both strong and weak, radiating to the lower back;
- Discharge from endometritis has an unpleasant odor and may contain bloody clots;
- Painful urination, pain during defecation. The reason for this is the inflamed and enlarged uterus;
- In rare cases, uterine bleeding. It occurs more often in women who use intrauterine devices. In such patients, endometritis occurs with particular severity. Bleeding may occur in the middle of the monthly cycle. The source of bleeding is most often the area of the endometrium, where there is pronounced cell necrosis.
A woman can feel such manifestations of the disease for 7-12 days. If you endure them or self-medicate without choosing the right option, the vivid symptoms may disappear. They will be replaced by other signs of endometritis, characterizing sluggish endometritis.
How does the chronic form manifest? Its symptoms are not as severe as in the acute form. They can be masked for a long time and be insignificant, so the patient may not pay attention to them. Still, you need to listen to your body and consult a doctor if you have the following signs:
- Pain in the abdomen is not severe or aching;
- Low temperature within 37 - 37.5 degrees;
- Brown vaginal discharge with pus. They correspond to the disease they are caused by: gonorrhea, trichomoniasis and other diseases. Purulent endometritis occurs;
- Menstruation becomes longer and sometimes lasts more than 7 days.
Endometritis, which manifests itself in a chronic form, leads to structural changes in the mucosa, which are associated with the formation of cysts and impaired tissue nutrition. It is for these reasons that patients develop infertility and the inability to bear a child, because the fertilized egg does not have the opportunity to attach to the walls of the uterus.
Symptoms of the disease may vary depending on several factors. These include: the state of the woman’s immunity, the patient’s age, the area affected by bacteria, the presence of predisposing conditions (the disease is especially severe against the background of an IUD, childbirth and miscarriages).
Treatment
Having identified the patient's endometrial symptoms, treatment is prescribed accordingly. The acute form is almost always treated in a hospital with close medical supervision.
Timely treatment of the chronic form will lead to the fact that endometritis in women will quickly pass, without leaving serious consequences (including infertility). How to treat? Acute inflammation of the uterus is treated in several stages:
- Antibiotics are used intravenously. More often it is metragil with cephalosporins, gentamicin is administered intramuscularly. This combination of drugs helps to achieve great results if several types of microorganisms are to blame for the disease;
- Antimicrobial drugs Fazizhin, Tinidazole are prescribed if inflammation of the uterine mucosa is caused by Proteus, Trichomonas, anaerobic bacteria;
- If there are fetal remains or placental remains, curettage of the uterine cavity is performed;
- Immunity is increased with the help of Cycloferon, T-Activin, Viferon, Lykopid. In addition, tincture of eleutherococcus and ginseng are added here, and taking vitamins is mandatory;
- Pain can be relieved with Diclofenac, Indomethacin, No-Spa;
- Physiotherapy completes the treatment.
They often resort to physical forms of treatment - applying cold to the suprapubic part. By acting on skin receptors, cold has an analgesic and anti-inflammatory effect. This method is carried out with breaks of half an hour every two hours.
If the diagnosis of inflammation of the uterine mucosa is chronic, treatment is somewhat different, since it should be aimed at destroying the specific causative agent of the infection. To do this, by analyzing smears for culture, the cause is determined and, depending on it, a certain course of antibiotics or antiviral drugs is prescribed.
In addition, the following are assigned:
- Absorbable preparations such as Lidaza or Aloe in ampoules;
- Hormonal contraceptives Regulon, Yarina. They can be replaced with drugs that contain artificial progesterone Duphaston, Utrozhestan. They have antioxidant effects and help normalize the monthly cycle;
- Drugs responsible for stimulating the immune system Riboxin, Wobenzym, Actovegin;
- Solution of y-aminocaproic acid. It can be used to stop bleeding. It is injected into the uterine cavity at a dose of 3-5 ml for 5-7 days in a row;
- Therapeutic mud, UHF, magnetic therapy, electrophoresis with iodine, zinc. The procedures are carried out with the aim of activating blood circulation in diseased organs and stimulating their function;
- Inflammation of the inner lining is treated by using microwaves in the centimeter range or a UHF magnetic field. In the third year of the disease, ultrasound or iodine electrophoresis is performed.
The most effective is considered to be the introduction of medications directly into the uterus, thereby achieving the highest concentration of such drugs in the lesion.
Simultaneously with the treatment of the woman, treatment of her sexual partner is also carried out.
It is considered that the treatment was successful and the danger has passed if the signs of endometritis are completely destroyed: the infection is eliminated, the monthly cycle is normalized, pain is eliminated, reproductive function is restored, and the structure of the endometrium is restored.
Complications
Professional treatment, specially selected for each specific person, brought to full recovery, will help to avoid the patient’s problems in the future. Why is endometritis dangerous? Consequences can be caused by both forms of the disease. They may appear as follows:
- Adhesions form in the area of the female reproductive organ;
- Development of endometriosis;
- Problems arise with pregnancy and childbirth. There may be pregnancy outside the uterine cavity, stillbirth, miscarriage, or infection of the baby;
- Placental insufficiency occurs;
- There may be bleeding;
- There is a risk of polyp formation;
- The inflammatory process can spread to the fallopian tubes and ovaries;
- The appearance of pain can become chronic, endometrial tissue begins to die necrotically.
In order to prevent all these troubles, a woman should take care of her health in advance.
Prevention
In order to avoid illness in the form of consequences after cesarean section, abortion and other interventions in the uterus, doctors prescribe antibacterial drugs.
Maintaining 100% sterility during all medical procedures should be the law for all actors. Prevention of endometritis also includes maintaining sexual hygiene.
Timely treatment of all infectious diseases is also a means of preventing uterine endometrial disease.
In addition, all women need to learn to monitor and take care of their health. Visiting a gynecologist twice a year is a guarantee of timely detection of infections and treatment without complications.
Treatment of chronic, acute and other endometritis - in the largest gynecology clinic in Moscow
Endometritis is an inflammatory process in the uterine mucosa, which is a significant risk factor for the formation of the uterine form of infertility. In the absence of a full course of treatment, problems may arise associated with conceiving a child and an increased risk of developing gynecological diseases such as uterine fibroids, endometriosis, hyperplasia and endometrial polyps.
Make an appointment with a gynecologist and we will solve the issue together!
Endometritis: what is it?
The inner lining of the uterus, which grows and sheds every month, is called the endometrium. When an infection gets inside the cavity and an inflammatory process occurs, endometritis develops. There are various variants of the disease.
According to the severity of inflammation:
- acute endometritis;
- subacute endometritis;
- chronic endometritis.
By degree of distribution:
- diffuse endometritis;
- focal endometritis.
According to the depth of the inflammatory process:
- superficial endometritis;
- endomyometritis, in which the muscle tissue of the uterus is damaged.
Causes of endometritis
A prerequisite for the occurrence of an inflammatory process is the presence of infection.
These can be opportunistic microbes (staphylococcus, streptococcus, E. coli), but most often endometritis occurs due to infection with sexually transmitted microorganisms, which include:
- chlamydia;
- mycoplasma;
- gonococci;
- Trichomonas;
- herpes viruses;
- fungal diseases.
In addition to the presence of microbes, predisposing and contributing factors to endometritis are of great importance:
- high sexual activity with frequent changes of sexual partners;
- any options for artificial termination of pregnancy;
- complications during childbirth (tight placenta, cesarean section, postpartum endometritis);
- any therapeutic and diagnostic gynecological procedures (diagnostic hysteroscopy, hysteroresectoscopy, diagnostic scraping from the uterine cavity, hysterosalpingography);
- long-term wearing of an intrauterine contraceptive device;
- decreased immune defense against the background of common serious diseases.
Endometritis: symptoms
Due to the paucity of symptoms, the presence of chronic endometritis is usually detected during an examination for infertility.
Vivid manifestations of the inflammatory process in the uterine cavity occur with acute endometritis, in which the following typical symptoms are observed:
- pain in the lower abdomen of varying severity;
- increased body temperature with a more pronounced reaction in the evening;
- copious purulent discharge from the genital tract.
Chronic endometritis is characterized by minimal and unexpressed manifestations, which include:
- periodically occurring aching or nagging pain in the abdomen;
- menstrual irregularities (scanty or prolonged menstruation);
- periodic vaginal discharge with an unpleasant odor;
- psychological disorders and problems in sexual life;
- infertility and miscarriage.
A woman, having consulted a doctor with complaints about the absence of pregnancies, undergoes a full course of examination, during which typical signs of endometritis are discovered.
Diagnosis of endometritis
The inner lining of the uterus, which grows and sheds every month, is called the endometrium. When an infection gets inside the cavity and an inflammatory process occurs, endometritis develops. There are different types of endometritis.
Ultrasound examination of endometritis
Echography is carried out on days 5-7 and 21-24 of the menstrual cycle. Typical ultrasound signs of chronic endometritis will be the following manifestations:
- heterogeneity and unevenness of the endometrial structure;
- change in the thickness and uniformity of the M-echo, indicating thinning of the inner surface of the uterus;
- enlargement and expansion of the uterine cavity due to exudate and the presence of gas bubbles;
- change in the thickness of the walls of the uterus with the appearance of small brushes in the muscle layer.
The presence of ultrasound signs alone will not be the basis for an accurate diagnosis. A prerequisite is a coincidence with clinical symptoms and the results of other examination methods.
Laboratory tests for endometritis
For quality treatment, it is necessary to identify the causative factor of endometritis. To do this, the doctor will evaluate the results of the following studies:
- vaginal smears;
- bacterial cultures from the vagina, cervical canal and uterine cavity;
- taking blood from a vein to test for antibodies to sexually transmitted infections;
- special studies (PCR) that allow high-precision detection of bacteria and viruses.
Diagnostic hysteroscopy of endometritis
A visual examination of the uterine cavity will be required if there are complications or to clarify the extent of the lesion. It is optimal to use mini-hysteroscopy to identify problems with the endometrium. During an endoscopic examination, the doctor will see the following manifestations of the disease:
- the presence of focal defects on the inner surface of the uterus;
- thinning of the endometrium;
- vascular disorders in the uterine mucosa;
- presence of inflammatory fluid.
During hysteroscopy, the doctor will definitely take a small piece of the mucous membrane for histological examination, which will be ideal for diagnosing chronic endometritis.
Endometritis in women: treatment
Any therapeutic measures depend on the severity of the inflammatory process and the presence of symptoms that disrupt menstrual and reproductive functions.
Treatment of acute endometritis
At the 1st stage of treatment, if there is a temperature reaction, severe pain and vaginal leucorrhoea with typical ultrasound signs, the doctor will begin treatment by prescribing antibacterial drugs.
For pain relief and to reduce the inflammatory response, nonsteroidal anti-inflammatory drugs (NSAIDs) should be used.
At stage 2, if the condition improves, the doctor will use medications to increase immunity and physiotherapeutic measures. Electrophoresis or phonophoresis with anti-inflammatory drugs, ultraviolet irradiation of blood, and laser therapy will give an excellent effect.
Treatment of chronic endometritis
The main goals of treating chronic inflammation of the uterine mucosa include:
- normalization of ovarian function with regulation of hormonal functions;
- improvement of blood flow in the pelvic area;
- creating conditions for pregnancy;
- improvement of a woman’s psychological state;
- relief from periodic pelvic pain;
- increasing immune defense.
In most cases, at stage 1 it is necessary to use an antibacterial or antiviral drug, the choice of which depends on the type of microorganism and the detected sensitivity to drugs.
An excellent effect will be achieved by using hormonal drugs that will act on the uterus and ovaries, providing excellent therapeutic effects. Typically, the doctor will use oral contraceptives for 3-6 months.
Symptomatic therapy includes angioprotectors (medicines to improve blood flow), vitamins, and immunomodulators.
Non-drug treatment options include:
- irrigation of the uterine cavity with antiseptics;
- electrophoresis or phonophoresis with anti-inflammatory solutions of copper, zinc, iodine;
- phototherapy using infrared laser;
- ozone therapy;
- balneotherapy (baths, mud);
- Spa treatment.
An excellent result of treatment of acute or chronic endometritis is the normalization of menstruation and the onset of the desired pregnancy.
Endometritis: prognosis
The degree of damage to the uterine mucosa is of great prognostic significance for getting rid of endometritis. If injury or inflammation damages only the functional layer of the endometrium (the one that is shed monthly), then complete recovery is guaranteed.
If damage has occurred to the basal layer (the deep part of the endometrium from which the functional layer is formed), then the prognosis for getting rid of chronic endometritis is much worse. Even if a full course of treatment is carried out, it is impossible to restore all functions of the endometrium with guaranteed certainty.
Prevention of endometritis
To prevent any types of endometritis, the following recommendations must be followed:
- exclude any options for artificial termination of pregnancy;
- use intrauterine contraception only after childbirth;
- when changing sexual partners frequently, use protected sex;
- promptly treat inflammation in the vagina;
- lead a healthy lifestyle and eat right, avoiding a decrease in immunity;
- strictly follow the doctor’s recommendations when treating acute endometritis;
- perform any diagnostic tests only according to strict indications.
With chronic endometritis, the most unpleasant thing will be infertility. If conception occurs despite proper treatment, you should be wary of complications during pregnancy. Every woman should be aware: interrupting the very first pregnancy in her life is unacceptable, because this with a high degree of probability can cause chronic endometritis.
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Zhumanova Ekaterina Nikolaevna
Head of the Center for Gynecology, Reproductive and Aesthetic Medicine, Candidate of Medical Sciences, doctor of the highest category, Associate Professor of the Department of Regenerative Medicine and Biomedical Technologies of Moscow State Medical University named after A.I. Evdokimova, board member of the Association of Aesthetic Gynecologists ASEG.
- Graduated from the Moscow Medical Academy named after I.M. Sechenova, has a diploma with honors, completed clinical residency at the Clinic of Obstetrics and Gynecology named after. V.F. Snegirev MMA named after. THEM. Sechenov.
- Until 2009, she worked at the Clinic of Obstetrics and Gynecology as an assistant at the Department of Obstetrics and Gynecology No. 1 of the MMA named after. THEM. Sechenov.
- From 2009 to 2017 she worked at the Federal State Institution “Treatment and Rehabilitation Center” of the Ministry of Health of the Russian Federation
- Since 2017, he has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine of Medsi Group of Companies JSC.
- She defended her dissertation for the degree of Candidate of Medical Sciences on the topic: “Opportunistic bacterial infections and pregnancy”
Myshenkova Svetlana Aleksandrovna
Obstetrician-gynecologist, candidate of medical sciences, doctor of the highest category
- In 2001 she graduated from the Moscow State Medical and Dental University (MGMSU)
- In 2003, she completed a course of study in the specialty “obstetrics and gynecology” at the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences
- He has a certificate in endoscopic surgery, a certificate in ultrasound diagnostics of pathologies of pregnancy, fetus, newborn, in ultrasound diagnostics in gynecology, a certificate of a specialist in the field of laser medicine. He successfully applies all the knowledge acquired during theoretical classes in his daily practice.
- She has published more than 40 works on the treatment of uterine fibroids, including in the journals “Medical Bulletin” and “Problems of Reproduction”. He is a co-author of methodological recommendations for students and doctors.
Kolgaeva Dagmara Isaevna
Head of pelvic floor surgery. Member of the scientific committee of the association for aesthetic gynecology.
- Graduated from the First Moscow State Medical University named after. THEM. Sechenov, has a diploma with honors
- She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov
- Has certificates: obstetrician-gynecologist, specialist in laser medicine, specialist in intimate contouring
- The dissertation is devoted to the surgical treatment of genital prolapse complicated by enterocele
- The sphere of practical interests of Dagmara Isaevna Kolgaeva includes:
conservative and surgical methods of treating prolapse of the walls of the vagina, uterus, urinary incontinence, including the use of high-tech modern laser equipment
Maksimov Artem Igorevich
Obstetrician-gynecologist of the highest category
- Graduated from Ryazan State Medical University named after academician I.P. Pavlova with a degree in general medicine
- Completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology Clinic named after. V.F. Snegirev MMA named after. THEM. Sechenov
- Proficient in a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access
- The scope of practical interests includes: laparoscopic minimally invasive surgical interventions, including single-puncture access; laparoscopic operations for uterine fibroids (myomectomy, hysterectomy), adenomyosis, widespread infiltrative endometriosis
Pritula Irina Alexandrovna
Obstetrician-gynecologist
- Graduated from the First Moscow State Medical University named after. THEM. Sechenov.
- She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
- She is certified as an obstetrician-gynecologist.
- Possesses the skills of surgical treatment of gynecological diseases on an outpatient basis.
- He is a regular participant in scientific and practical conferences on obstetrics and gynecology.
- The scope of practical skills includes minimally invasive surgery (hysteroscopy, laser polypectomy, hysteroresectoscopy) - Diagnosis and treatment of intrauterine pathology, cervical pathology
Muravlev Alexey Ivanovich
Obstetrician-gynecologist, gynecological oncologist
- In 2013 he graduated from the First Moscow State Medical University named after. THEM. Sechenov.
- From 2013 to 2015, he completed clinical residency in the specialty “Obstetrics and Gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University named after. THEM. Sechenov.
- In 2016, he underwent professional retraining at the State Budgetary Institution of Healthcare of the Moscow Region MONIKI named after. M.F. Vladimirsky, specializing in Oncology.
- From 2015 to 2017, he worked at the Federal State Institution “Treatment and Rehabilitation Center” of the Ministry of Health of the Russian Federation.
- Since 2017, he has been working at the Center for Gynecology, Reproductive and Aesthetic Medicine of Medsi Group of Companies JSC.
Mishukova Elena Igorevna
Obstetrician-gynecologist
- Doctor Mishukova Elena Igorevna graduated with honors from the Chita State Medical Academy with a degree in general medicine. She completed clinical internship and residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
- Mishukova Elena Igorevna has a full range of surgical interventions for gynecological diseases, including laparoscopic, open and vaginal access. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingoophoritis, etc.
- Mishukova Elena Igorevna is an annual participant in Russian and international congresses and scientific and practical conferences on obstetrics and gynecology.
Rumyantseva Yana Sergeevna
Obstetrician-gynecologist of the first qualification category.
- Graduated from the Moscow Medical Academy named after. THEM. Sechenov with a degree in general medicine. She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University named after. THEM. Sechenov.
- The dissertation is devoted to the topic of organ-preserving treatment of adenomyosis using FUS ablation. He has a certificate as an obstetrician-gynecologist and a certificate in ultrasound diagnostics. Proficient in the full range of surgical interventions in gynecology: laparoscopic, open and vaginal approaches. He is a specialist in providing emergency gynecological care for diseases such as ectopic pregnancy, ovarian apoplexy, necrosis of myomatous nodes, acute salpingoophoritis, etc.
- Author of a number of published works, co-author of a methodological guide for doctors on organ-preserving treatment of adenomyosis using FUS ablation. Participant of scientific and practical conferences on obstetrics and gynecology.
Gushchina Marina Yurievna
Gynecologist-endocrinologist, head of outpatient care. Obstetrician-gynecologist, reproductive specialist. Ultrasound diagnostics doctor.
- Gushchina Marina Yurievna graduated from Saratov State Medical University. V.I. Razumovsky, has a diploma with honors. She was awarded a diploma from the Saratov Regional Duma for excellent achievements in studies and scientific activities, recognized as the best graduate of Saratov State Medical University named after. V. I. Razumovsky.
- She completed a clinical internship in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the First Moscow State Medical University. THEM. Sechenov.
- He is certified as an obstetrician-gynecologist; ultrasound diagnostics doctor, specialist in laser medicine, colposcopy, endocrinological gynecology. She has repeatedly completed advanced training courses in “Reproductive Medicine and Surgery” and “Ultrasonic Diagnostics in Obstetrics and Gynecology.”
- The dissertation work is devoted to new approaches to differential diagnosis and management tactics for patients with chronic cervicitis and early stages of HPV-associated diseases.
- Proficient in the full range of minor surgical interventions in gynecology, performed both on an outpatient basis (radiocoagulation and laser coagulation of erosions, hysterosalpingography) and in a hospital setting (hysteroscopy, cervical biopsy, cervical conization, etc.)
- Gushchina Marina Yuryevna has more than 20 scientific published works, is a regular participant in scientific and practical conferences, congresses and conventions on obstetrics and gynecology.
Malysheva Yana Romanovna
Obstetrician-gynecologist, gynecologist for children and adolescents
- Graduated from the Russian National Research Medical University. N.I. Pirogov, has a diploma with honors. She completed clinical residency in the specialty “obstetrics and gynecology” at the Department of Obstetrics and Gynecology No. 1 of the Faculty of Medicine of the First Moscow State Medical University. THEM. Sechenov. Graduated from the Moscow Medical Academy named after. THEM. Sechenov with a degree in general medicine
- She completed clinical residency in the specialty “Ultrasound Diagnostics” at the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky
- Has a Certificate from the FMF Fetal Medicine Foundation confirming compliance with international requirements for 1st trimester screening, 2018. (FMF)
- Abdominal organs
- Kidney, retroperitoneum
- Bladder
- Thyroid gland
- Mammary glands
- Soft tissues and lymph nodes
- Pelvic organs in women
- Pelvic organs in men
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- In the 1st, 2nd, 3rd trimester of pregnancy with Doppler ultrasound, including 3D and 4D ultrasound
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Kruglova Victoria Petrovna
Obstetrician-gynecologist, gynecologist for children and adolescents.
- Victoria Petrovna Kruglova graduated from the Federal State Autonomous Educational Institution of Higher Education "Russian Peoples' Friendship University" (RUDN).
- She completed clinical residency in the specialty “Obstetrics and Gynecology” on the basis of the department of the Federal State Budgetary Educational Institution of Additional Professional Education “Institute for Advanced Training of the Federal Medical and Biological Agency.”
- He has certificates: obstetrician-gynecologist, specialist in the field of colposcopy, non-operative and operative gynecology of children and adolescents.
Baranovskaya Yulia Petrovna
Ultrasound diagnostics doctor, obstetrician-gynecologist, candidate of medical sciences
- Graduated from the Ivanovo State Medical Academy with a degree in general medicine.
- She completed an internship at the Ivanovo State Medical Academy, a clinical residency at the Ivanovo Research Institute named after. V.N. Gorodkova.
- In 2013, she defended her thesis on the topic “Clinical and immunological factors in the formation of placental insufficiency” and was awarded the academic degree “Candidate of Medical Sciences.”
- Author of 8 articles
- Has certificates: ultrasound diagnostics doctor, obstetrician-gynecologist.
Nosaeva Inna Vladimirovna
Obstetrician-gynecologist
- Graduated from Saratov State Medical University named after V.I. Razumovsky
- Completed an internship at the Tambov Regional Clinical Hospital, specializing in obstetrics and gynecology.
- He is certified as an obstetrician-gynecologist; ultrasound diagnostics doctor; specialist in the field of colposcopy and treatment of cervical pathology, endocrinological gynecology.
- Repeatedly took advanced training courses in the specialty “obstetrics and gynecology”, “Ultrasonic diagnostics in obstetrics and gynecology”, “Fundamentals of endoscopy in gynecology”
- Proficient in the full scope of surgical interventions on the pelvic organs, performed by laparotomy, laparoscopic and vaginal approaches.
Endometritis– inflammatory disease of the uterine mucosa. Inflammation of the uterine mucosa cannot but affect its muscle layer. In this case, a diagnosis is made metroendometritis, which can be much more often found listed on the first page of the diagnosis and, from a prognostic point of view, is much worse for the patient. In order to understand the differences and similarities of these diagnoses, it is necessary to touch a little on the structure of the uterus.
The uterus consists of: the cervix, the body of the uterus and the fallopian tubes. In the topic we are discussing, it is most important to consider the structure of the uterine body. It consists of the endometrium (the mucous membrane of the uterus - it is its rejection that is accompanied by bleeding during menstruation, the fertilized egg is implanted here), myometrium (its muscular membrane, which stretches during pregnancy, allowing the organ to increase many tens of times) and perimetry (outer, serous membrane - is a continuation of the layers of peritoneum from the bladder). Despite the fact that the endometrium and myometrium can be distinguished both visually and histologically, the connection between them is very, very close, which leads to the fact that pathological processes in one almost immediately affect the other layer.
The endometrium consists of two fundamentally different layers: the functional one - the one that exfoliates at the end of each menstruation and the basal one, which causes the formation of a new functional layer, and, therefore, determines the onset of the next menstruation. The functional layer is represented by one layer of cells, shaped like cylinders (cylindrical epithelium), between which are located glandular cells (produce the necessary mucus) and the terminal branches of small spiral arteries, which are located in large numbers here. This structure, single-layer cells and the presence of a large number of small vessels, is quite fragile and susceptible to adverse effects.
It is damage to the above structures that leads to the possibility of infection and the occurrence of an inflammatory process - endometritis. However, as mentioned above, the close connection of all layers of the uterus with each other and the absence of protective barriers between them very soon leads to the transition of endometritis to metroendometritis.
Causes of endometritis
As mentioned above, the first and main cause of endometritis is damage to the uterine mucosa, leading to the development of an inflammatory process. We must also understand that simple damage cannot lead to serious complications. Only the presence of reduced immunity, existing low-grade inflammation and non-compliance with sanitary standards during manipulation can lead to inflammatory changes. The causes of damage may primarily be:
1. Curettage of the uterine cavity (medical abortion, curettage for bleeding and suspected cancer)
2. Probing of the uterine cavity
3. Hysterosalpingography (examination of the uterus and fallopian tubes, most often for the purpose of “blowing” in the treatment of infertility)
4. Hysteroscopy (endoscopic examination of the uterine cavity)
5. Placement of intrauterine contraceptives
6. Inaccurate douching
A special place is occupied by postpartum endometritis, which often occurs even in well-developed endometritis, which is primarily due to a significant decrease and restructuring of the woman’s immune system. As a rule, the process spreads quite quickly to the muscle layer and represents a serious complication of the postpartum period.
Endometritis is a polyetiological disease - caused by a group of pathogens, with the possible predominance of one. The most common pathogens are:
In addition, viruses and protozoan microorganisms can also serve as pathogens.
Causes of chronic endometritis
The development of chronic endometritis is associated with inadequate treatment of acute endometritis or with an undiagnosed process, in which the infection exists in the tissues for a long time. The causative agent can be all of the above.
Symptoms of endometritis
Symptoms of endometritis are sometimes not clearly expressed, and the woman, unfortunately, does not pay attention to them, which subsequently leads to more severe inflammation of not only the mucous membrane, but also the muscular layer of the uterus, requiring hospitalization and inpatient treatment. Consequently, minimal knowledge of the signs of endometritis and the causes of its occurrence, timely contact with a doctor with these symptoms can prevent its transition to metroendometritis and allow doctors to significantly improve the quality of life of their patients.
Endometritis can be acute or chronic. If the treatment and diagnosis of acute endometritis, as a rule, does not present much difficulty, then the chronicity of the process causes many difficulties, both in diagnosis and in treatment. This is another reason why you should immediately consult a doctor at the first symptoms of endometritis.
Symptoms of acute endometritis
Most often, endometritis occurs after artificial termination of pregnancy. It goes without saying that criminal abortion in most cases leads to a similar complication due to the almost complete lack of compliance with sanitary standards. The disease begins with:
1. increase in body temperature to 38-39° C;
2. the appearance of serous, serous-purulent and bloody-purulent discharge from the genital tract - a particularly important symptom, coupled with anamnesis and general malaise, which makes it possible to differentiate endometritis from inflammatory lesions of the lower genital tract (bacterial vaginosis, colpitis, etc.);
3. the appearance of pain in the lower abdomen, radiating to the sacrum
4. general malaise.
In such a situation, you should not wait for everything to go away on its own and self-medicate - endometritis is an inflammatory disease, and any inflammatory disease tends to spread far from the location of the primary focus. Any self-medication in this situation, postponing a visit to an obstetrician-gynecologist leads to an inevitable increase in the risk of severe purulent-septic complications requiring long-term hospital treatment, which may well result in amputation of the uterus and the spread of infection - sepsis, with further death. Therefore, when the first symptoms appear, a woman who has recently given birth, undergone abortion, or undergone any invasive diagnostic procedure should immediately consult a doctor and undergo a detailed examination.
In the picture: pink – normal tissue; the rest are inflammatory changes
It is necessary to clarify that we can talk about endometritis only if there are prerequisites for this - in the past there were some processes that affected the integrity of the uterine mucosa. In the absence of such, it is inappropriate to talk about endometritis if uncharacteristic discharge, pain or any other symptoms appear.
Symptoms of chronic endometritis
For chronic endometritis, it is difficult to identify symptoms that differ from the acute form. The symptoms, in this case, are “fuzzy”. Characteristic symptoms of chronic endometritis include:
1. Constantly lasting temperature for a long time.
2. Irregular uterine bleeding. Intermenstrual bleeding is associated with increased endometrial vascular permeability during ovulation. This change in blood vessels is also observed in healthy women, but blood cells are not visible in the discharge. The reasons causing uterine bleeding include a decrease in the contractile activity of the uterus and a violation of the aggregation properties of platelets.
3. The presence of constant discharge from the external genital tract, often of a putrefactive nature.
4. Pain during bowel movements.
Chronic endometritis does not prevent conception, which occurs in the presence of ovulation. In combination with concomitant ovarian dysfunction or other genital diseases, chronic endometritis causes reproductive dysfunction - infertility and spontaneous miscarriages, including habitual ones.
Diagnosis of endometritis
When contacting a doctor, you should tell him in detail your entire medical history and all the symptoms that led you to him, since already at this stage it becomes possible to assume that the patient has endometritis. In addition to your medical history, the doctor must:
1. will subject you to a gynecological examination in the speculum and palpation of the uterus - as a rule, the organ is enlarged in size and reacts painfully to touch; During the examination, the doctor will evaluate the nature of the discharge: its color, smell, consistency, quantity;
2. take smears - it is thanks to the simple taking of smears that most of all endometritis pathogens are detected; will take the material for sowing - in this way you can study in more detail the nature of the pathogen by growing it on a special nutrient medium, as well as determine the degree of its response to a particular medical drug;
3. They will take your blood for clinical and biochemical analysis (as a rule, already in the clinical blood test there will be a sufficient number of indicators to confirm the diagnosis - leukocytosis is detected in the blood, a shift in the leukocyte formula to the left, acceleration of ESR.);
4. Do an ultrasound of the uterus if possible (if you come in with already “developed” metroendometritis, in some hospitals the examination may be postponed). The main ultrasound signs of endometritis will be: thickening of the uterine mucosa, possibly blood clots and pus (in cases complicated by hemato- and pyometra), remnants of placental tissue, changes in the echogenicity of myometrial tissue during metroendometritis. Often the inflammatory process affects the fallopian tubes and ovaries, which is also clearly visible on ultrasound. In chronic endometritis, in addition to unevenly thickened endometrium, myometrium with altered echogenicity, adhesions in the uterine cavity can also be detected, which, in turn, can become a real cause of infertility.
Diagnosis chronic endometritis may cause difficulties, since the symptoms will be similar to many diseases of the female genital area. In this case, constant sowing of the same flora, as well as constant low-grade inflammation, will be indicative.
Treatment of endometritis
In case of early diagnosis of endometritis, outpatient treatment is possible, but under the constant supervision of an obstetrician gynecologist. Typically, treatment will consist of antipyretics and a combination of antibacterial drugs.
Treatment of acute endometritis
Unfortunately, the vast majority of women go to the doctor quite late, which leads to hospitalization and long-term treatment. In this case, you should study in detail the patient’s condition and the level of prevalence of the process and the reasons that caused it. Most often, treatment begins with:
1. intravenous antibiotic therapy: cephalosporins in combination with metragil and intramuscular gentamicin. Treatment can last from 5 to 10 days, depending on the need (cephalosporins are often replaced with aminoglycosides);
2. if there are “residues” in the uterine cavity - parts of the fetus during an incomplete abortion, the remains of the placenta after childbirth and cesarean section, curettage of the uterine cavity after infusion (intravenous drip) therapy with antibiotics is indicated;
3. use of vitamin therapy and immunomodulators;
4. application of physiotherapeutic treatment.
Treatment of chronic endometritis
Treatment of chronic endometritis is based on the effect on a specific pathogen. To do this, again, it is absolutely necessary to take smears for culture and susceptibility to antibiotics. Both an antibacterial treatment regimen (as in acute endometritis) and antiviral drugs are used.
A high therapeutic effect has been achieved by administering medications, including antibiotics, directly into the uterine mucosa. The method ensures the creation of a high concentration of medicinal substances in the focus of chronic inflammation.
In addition to this, be sure to:
1. separation of adhesions surgically (preferably hysteroscopy)
2. hormonal therapy, most often oral contraceptives, in women who want to become pregnant in the future.
Physiotherapy is widely used in the treatment of both acute and chronic endometritis in the phase when the first, most difficult period has passed and the woman is compensated. Mandatory in a hospital setting. Physiotherapeutic methods include: low-intensity UHF therapy (exposure to an ultra-high-frequency electromagnetic field) with a wavelength of 1-10 m; infrared laser therapy, etc. First of all, this makes it possible to achieve: improved outflow of fluid and pus accumulated in the uterine cavity and helps to strengthen local reparative functions.
Postpartum endometritis
A special place is occupied by postpartum endometritis, as a frequent and dangerous complication of the postpartum process. As a rule, it is inseparable from metroendometritis, is acute and makes itself felt quite early.
The main reasons are the remains of placental tissue and infection due to non-compliance with sanitary standards.
Treatment is inpatient. It consists of massive antibacterial therapy, and when the process subsides, removal of all remnants from the uterine cavity. Unfortunately, it is not uncommon for there to be complications leading to septic complications, and in this case the prognosis may be unfavorable - surgical intervention (amputation of the uterus may be necessary).
If you are breastfeeding, avoid breastfeeding for the duration of antibacterial therapy and for a week or two after it.
Strict adherence to a diet outside the hospital is not required. Enough: limiting fatty foods, drinking plenty of liquids, eating fruit. In case of inpatient treatment, bed rest and a diet excluding fatty and hard-to-digest foods are mandatory.
As a rule, acute endometritis with timely treatment does not require any special rehabilitation. After treatment, you need to remain under the supervision of a doctor for some time. It is possible to use physiotherapeutic procedures: radon, hydrogen sulfide and air baths, under the supervision of a physiotherapist.
Complications of endometritis
The most dangerous complications of endometritis include the spread of infection: hematogenously - through the blood; lymphogenic - lymph; along the ascending - through the fallopian tubes and descending - the cervix, vagina. This leads to “blood poisoning” - sepsis. Other complications include:
- Chronization and outcome in chronic endometritis;
- formation of pyometra - accumulation of pus in the uterine cavity, due to occlusion (obstruction of the cervix and the inability of pus to come out);
- joining the fallopian tubes and appendages to the process – salpingitis and oophoritis;
- pelvioperitonitis - as a result of pus entering the pelvic cavity.
Late complications that occur with inadequate treatment include:
- menstrual irregularities;
- infertility;
- constant pain in the lower abdomen.
The list of complications does not end there, since the inflammatory process can be the cause of any pathology that may emerge later. Therefore, early presentation and adequate treatment play a significant role in preventing the development of severe complications.
Folk remedies for treating endometritis
It is imperative to touch upon the population’s craze for self-medication with folk remedies. Endometritis is an inflammatory disease that can lead to extremely serious consequences. Its treatment is the responsibility of qualified obstetrician-gynecologists. Treatment should be carried out using all the latest available means to achieve maximum effect in a short time. It was mentioned above that endometritis and metroendometritis are very common in the postpartum period. As evidence of the seriousness of the pathology, the following figures can be cited: from the 17th century to the beginning of the 20th century, the scourge of all maternity hospitals around the world was childbirth (or puerperal) fever - endometritis, successively turning into metroendometritis and sepsis, sometimes claiming up to 50% of lives! all postpartum women. Any experiments with folk remedies for self-medication can end disastrously for the patient.
Prevention of endometritis
Measures to prevent endometritis include eliminating factors that predispose to the occurrence of an inflammatory disease. Timely treatment of sexually transmitted infections and all complications that arise during childbirth, refusal of abortion is the surest way to prevent endometritis.
In addition, earlier breastfeeding and the administration of contractile and immunomodulatory drugs can also serve as means of nonspecific prevention.
It is mandatory to examine the woman after childbirth, perform ultrasound and gynecological examinations.
However, the greatest preventive measure can only be a woman’s attentive attitude towards herself and timely contact with a qualified obstetrician-gynecologist.
Obstetrician-gynecologist Kupatadze D.D.