No abstract

BACKGROUND: Chronic endometritis is a clinical and morphological syndrome in which, due to persistent endometrial damage to the endometrium by an infectious agent, multiple secondary morphofunctional changes occur that impair cyclic transformation and receptivity of the uterine mucosa. AIM: This study aimed to reveal morphological features of the endometrium in patients with atrophic chronic endometritis and impaired hemodynamics in the endometrium. MATERIALS AND METHODS: The study involved 86 female patients divided into two groups. Group 1 comprised 44 patients with chronic endometritis and impaired endometrial hemodynamics. Group 2 included 42 patients with chronic endometritis without impaired microcirculation in the endometrium. The patients underwent endometrial pipelle biopsy for histological and immunohistochemical examination to determine the expression of VEGF, TGF- and CD138 during the proliferative phase of the menstrual cycle. RESULTS: Histological examination revealed vascular sclerosis, plasma cells, inflammatory infiltrates, stromal fibrosis, granulomas, and hemorrhagic foci in patients with atrophic chronic endometritis and impaired hemodynamics. CONCLUSIONS: While examining the morphological picture of atrophic chronic endometritis with impaired hemodynamics, the formation of scar tissue was noted resulting in impaired blood circulation, which leads to focal hemorrhages in the uterine mucosa. According to immunohistochemical analysis, patients with impaired endometrial hemodynamics showed a statistically significant decrease in VEGF and an increase in TGF- expression, which indicates the severity of fibrosis.

This article presents a clinical case in a woman with a full two-legged uterus. This pathology in the patient was revealed by ultrasound examination in 2013. There is one spontaneous miscarriage in the anamnesis; later, the patient did not become pregnant with regular sexual activity without contraception. A comprehensive examination of the patient was carried out. It was decided to conduct a hysteroscopy, during which one cervical canal was identified, in the area of the internal pharynx, a division into two hemipolostas was visualized. In the future, the patient underwent Strassmanns reconstructive plastic surgery, which is the gold standard for this pathology. Laparatomic metroplasty is a safe and effective procedure for women with a bicornuate uterine malformation. The postoperative period was uneventful. A year later, the patient became pregnant in the natural cycle. Pregnancy proceeded without complications, culminating in the birth of a healthy child.