The aim: The purpose of this study was to assess the long-term outcomes of restoration of reproductive function after surgical and medical treatment of ectopic pregnancy, taking into consideration the patency of the fallopian tubes and the incidence of uterine pregnancy. Materials and methods: A two-stage experimental approach was used to address research objectives. In the first stage, a retrospective analysis of 615 histories of patients with ectopic pregnancy has been performed. In a second stage – we examined 140 patients, which were divided into three groups, depending on the type of treatment. The first group consisted of patients with a disturbed ectopic pregnancy, who were treated with laparotomy and tubectomy. The second group included patients with exacerbated ectopic pregnancy, who were operated by laparoscopic access. Lastly, the third group comprised of women with ectopic pregnancy who were treated with methotrexate. The main source of information used for clinical and anamnestic analysis was “medical card-patient” (f. 003 / o). Results: The number of patients diagnosed with ectopic pregnancy increased from 2005 to 2015. In 2005 and 2006, the laparotomy operations were 86.88% and 83.33%, but conservative management only 13,16% and 16,67%, respectively. In 2015, the number of patients treated with methotrexate was more than half (51.35%) compared with 2010 and 2005 increased to 16.97% and 38.19% respectively, and laparotomy operations decreased from 86.88% in year 2005 to 18.92% in year 2015. Conclusions: The data showed that in women who underwent medical treatment with cytostatic, the patency of the fallopian tubes was significantly better than after surgical treatment. In cases of interrupted ectopic pregnancy for which laparotomy with the removal of the motor tube was applied, infertility of tubal peritoneal genesis developed in 60% of cases, which is consistent with the existing literature. Statistical analysis of the structure of ectopic pregnancy showed that in 2005 dominated interrupted ectopic pregnancy, due to late diagnostic and hospitalisation, that led to urgent laparotomy operations rather than conservative treatment.
The aim: To conduct a morphological study of endometrial tissue to identify changes characteristic of viral lesions to develop improved antirelapse treatment of HPE in women of reproductive age. Materials and methods: We surveyed 90 patients of the gynecological department who sought medical for hyperplastic processes of the endometrium in reproductive age. All women underwent hysteroscopy, the resulting material was subjected to morphological examination. Results: It became known that the virus is involved in the pathogenesis of endometrial hyperplasia. It is likely that it exists in epitheliocytes not only as a “passenger”, but also as an etiological factor. It became known that it was in complex hyperplasia with atypia that the percentage reached the highest level, which is a precancerous condition. Conclusions: Typical morphological change of the endometrium – multinucleation, multinuclearity and koilocytotic atypia in women of childbearing age with HPE – was revealed. The presence of infectious pathogens in the endometrium of patients with HPE can be regarded as one of the possible triggers for the development of hyperplastic processes.
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