Chronic Endometritis and Antimicrobial Resistance: Towards a Multidrug-Resistant Endometritis? An Expert Opinion

Microorganisms, Journal Year: 2025, Volume and Issue: 13(1), P. 197 - 197

Published: Jan. 17, 2025

Chronic endometritis (CE) is a persistent inflammatory condition of the endometrium characterized by abnormal infiltration plasma cells into endometrial stroma. Frequently associated with repeated implantation failure, recurrent pregnancy loss, and infertility, CE significantly impacts women's health, contributing to conditions such as uterine bleeding endometriosis. Treatment typically involves antibiotic therapy; however, efficacy these treatments increasingly compromised rise antimicrobial resistance (AMR). This paper examines critical links between AMR CE, proposing strategies enhance clinical management optimize treatment outcomes.

Language: Английский

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Advancements in Hysteroscopic Diagnosis and Management of Endometritis

Diagnostics, Journal Year: 2025, Volume and Issue: 15(3), P. 243 - 243

Published: Jan. 21, 2025

Infertility remains a complex clinical challenge, with intrauterine pathologies contributing to significant percentage of in vitro fertilization (IVF) failures. Chronic endometritis (CE) has gained attention due its potential association unexplained infertility and recurrent miscarriage. This review explores the role hysteroscopy diagnosing treating CE. The endometrium undergoes dynamic changes orchestrated by ovarian steroids, disturbances may lead CE, characterized plasma cell infiltration. Diagnosis traditionally relies on histopathologic examination, but offers real-time imaging, revealing specific macroscopic alterations associated However, diagnostic accuracy varies, prompting need for standardized criteria. CE been linked poor reproductive outcomes, emphasizing importance effective treatment. Antibiotic therapy is common approach, doxycycline as first-line regimen. Hysteroscopic polypectomy, targeting non-infectious emerges promising treatment, demonstrating fertility benefits. underscores significance providing insights into impact outcomes infertile women. Further prospective studies are needed validate these findings establish unified

Language: Английский

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ІНДИКАТОРИ ПОРУШЕНЬ ГУМОРАЛЬНОЇ ЛАНКИ ІМУНІТЕТУ У ХВОРИХ НА ХРОНІЧНИЙ ЕНДОМЕТРИТ

Актуальні питання педіатрії акушерства та гінекології, Journal Year: 2025, Volume and Issue: 2, P. 61 - 64

Published: Jan. 22, 2025

Мета дослідження – вивчення індикаторів порушень гуморальної ланки імунітету у хворих на хронічний ендометрит. Матеріали та методи. Проведено ретроспективне когортне в медичному центрі репродуктивного здоров’я «Дамія» (Івано-Франківськ). У було включено 30 жінок віком від 28 до 38 років з анатомічно нормальною маткою, позитивною реакцією ендометрит (ХЕ) (основна група), які отримували традиційне лікування. Групу контро­лю склали здорових етапі підготовки материнства чоловічим фактором непліддя. Товщину ендометрія вимірювали періовуляторну фазу 13–14-й день циклу за допомогою ультразвукового апарата GE Voluson S8. Прозапальні цитокіни, зокрема фактор некрозу пухлин-α (TNF-α), інтерлейкін-10 (IL-10), визначали імуноферментним аналізом реактивів виробництва фірми «Вектор-Бест» (Україна). Результати їх обговорення. За віком, рівнем АМГ СD-138 групи пацієнтів були однорідними, без достовірних відмінностей. При дослідженні імунного статусу виявлено відмінності між основною контрольною групами. контролі TNF-α становив середньому (3,5±0,22) пг/мл, тоді як групі хронічного ендометриту цей показник (6,95±0,53) що більш ніж 2 рази переважало показники контролю (р<0,05). Показники IL-10 контрольній становили (8,96±0,43) основній достовірно знижувався і (5,14±0,18) р<0,05. Співвідношення контрольної становить 0,39±0,03, а 1,35±0,05, (р<0,05) вище порівняно показниками групи. Висновок. хронічному ендометриті жінок, лікують непліддя, спостерігають активізацію прозапальної імунітету, проявляється вигляді підвищення рівнів IL-10.

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Endometrial factors and pregnancy loss frequency in recurrent pregnancy loss patients: comparing RT-PCR microbiology, microbial cultures, and immunohistochemistry of endometrium biopsy

Journal of Applied Genetics, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 20, 2025

Abstract The objective of this study is to investigate the presence bacteria in endometrial samples from patients with recurrent pregnancy loss (RPL) and explore potential correlations between bacterial presence, chronic endometritis, previous history. Endometrial 90 RPL were analysed using RT-PCR detect 10 specific species. A subgroup 65 underwent additional microbial culture immunohistochemistry for plasma cell identification. Correlations number losses evaluated. We detected at least one out chosen DNA by 24.4% (22/90) samples. Patients PCR-identified had a significantly higher (median 3 vs 2, p = 0.01). No correlation was observed endometritis diagnosis. significant found detection PCR ( 0.03), though methods fewer positive cases. In patients, detecting selected species correlates losses. However, does not correlate diagnosis based on CD138 immunohistochemistry-identified count. These findings suggest role that may be independent classical inflammatory response associated endometritis.

Language: Английский

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Recurrent Implantation Failure: History, Etiology, Advances and Ongoing Challenges

Published: March 25, 2025

Infertility is the inability to conceive even after unprotected intercourse for more than 12 months. In India, prevalence of infertility has been growing extent that 10-15 percent couples experience this condition. Recurrent implantation failure (RIF) a complex medical condition in which becomes unsuccessful despite advancements Assisted Reproductive Technologies (ART). We lack clear understanding definition and standardisation RIF protocols. The etiology behind multifactorial, comprising both maternal embryonic factors. Maternal factors include endometrial abnormalities, environmental exposure, physical aspects, dysregulation immune system. Chromosomal aberrations such as aneuploidy are embryo-born impede implantation. latest studies have shed light on novel mechanisms RIF. Recent research identified miRNA can hinder processes, opening door many avenues targeted therapies, gene knockdown, modulation. This review comprehensive overview history, causes, advancements, challenges related

Language: Английский

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Chronic endometritis and recurrent reproductive failure: a systematic review and meta-analysis

Frontiers in Immunology, Journal Year: 2024, Volume and Issue: 15

Published: Aug. 16, 2024

Background The endometrium holds a crucial role in reproduction by supporting blastocyst adhesion, cytotrophoblast invasion and fetal development. Among the various uterine disorders, endometritis, particularly chronic endometritis (CE), has gained attention due to its association with adverse reproductive outcomes (recurrent pregnancy loss (RPL), recurrent implantation failure (RIF), infertility). between CE stresses necessity for comprehensive diagnostic therapeutic strategies optimize fertility support individuals their journey towards parenthood. Aim To explore relationship disorders. Methods Following PRISMA guidelines, systematic review meta-analysis using published data from 1990 2024 were carried out. Results A population of 1,038 women was included. Regarding CE-infertility association, positive correlation found, 19.46% rate infertile compared 7.7% controls (OR: 2.96, 95% CI 1.53-5.72, p 0.001). No significant observed RIF 1.10, 0.26-4.61, 0.90), rates both groups relatively comparable, 6.35% 5.8% controls. On opposite, strong RPL reporting 37.6% cases 16.4% 3.59, 2.46-5.24, &lt; 0.00001). Conclusions appears be associated infertility RPL, while no noted RIF. Systematic registration https://www.crd.york.ac.uk/prospero/#recordDetails PROSPERO, identifier CRD42024541879.

Language: Английский

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The Use of Photodynamic Therapy in the Treatment of Endometrial Cancer—A Review of the Literature

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(16), P. 8772 - 8772

Published: Aug. 12, 2024

Endometrial cancer is the most common malignant tumor of female reproductive system. It develops in mucous membrane lining inside uterine body—the endometrium, through abnormal and continuous growth cells originating from mucosa. In recent years, there has been a significant increase number cases European countries. Photodynamic therapy (PDT) an innovative dynamically developing medical procedure, useful treatment non-cancer tissue conditions. The PDT reaction involves activation photosensitizing substance with visible light, which turn leads to formation free oxygen radicals, contribute destruction cell. minimally invasive, few side effects, preserves organ anatomy function. Both diagnostics photodynamic as modern methods are becoming more popular many research units around world. They often practiced tested vitro experimental clinical practice, use rare. Comprehensive cooperation between scientists contributes taking steps towards obtaining new, synthetic photosensitizers, directing their physicochemical properties, showing impact on given organism. This review examines evidence for potential usefulness endometrial cancer. highlights that gaining popularity promising field research.

Language: Английский

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CHANGES IN THE INTENSITY OF UTERINE CIRCULATION IN PREGNANT WOMEN WITH A HISTORY OF CHRONIC ENDOMETRITIS

Neonatology surgery and perinatal medicine, Journal Year: 2023, Volume and Issue: 13(2(48)), P. 78 - 84

Published: Aug. 8, 2023

Introduction. An essential prerequisite for the normal course of pregnancy is a complete gestational remodeling blood circulation, when spiral arteries are transformed into uteroplacental vessels with reduced resistance and constant flow. Chronic endometritis characterized by morphofunctional changes in mucous membrane microcirculatory disorders pool arteries. If develops above disease, it may lead to disruption contribute increased fetoplacental flow.Aim. To study peculiarities flow uterine during women history chronic evaluate role preconception care prevention complications.Material Methods.303 were followed pregnancy. Of these, 135 received antepartum treatment (Group I), which included broad-spectrum antibiotics, hormone replacement therapy 3 months, L-arginine period first 17-18 weeks The other 168 no II). A control group 20 healthy patients without pre-pregnancy was also included.Doppler ultrasound performed at 5-6 gestation gestation. systolic-to-diastolic ratio (SDR) calculated as maximum systolic velocity end-diastolic velocity, pulsatility index (PI) difference between minimum diastolic velocities mean (RI) velocity.The obtained data processed using methods mathematical statistics, calculating sample values (M), variance (σ), standard error (m), applying Student’s t-test odds statistical software "STATISTICA" (StatSoft Inc., USA).During research, principles patient-centered accordance requirements Tokyo Declaration World Medical Association, International Recommendations Helsinki on Human Rights, Convention Rights Biomedicine Council Europe, Laws Ukraine, Orders Ministry Health Ethical Code Ukrainian physician.The paper an excerpt from initiative scientific research project Department Obstetrics Gynecology No. 2 Poltava State University, entitled “Optimization approaches management high risk obstetric perinatal pathology” (State registration number 0122U201228, duration:10.2022-09.2027).Results. In gestation, low component observed arteries, indicated relatively indices. Group II who became pregnant endometritis, increase SDR 11.3% (p<0.01), PI 36% (p<0.01) RI 36.2% (p<0.05) pregnancy, well weeks, 23% (p<0.001), 63% (p<0.001) 47.5% compared women. No significant indices found significantly higher those developed pre-eclampsia later these patients, SDR, PI, 12.4% (p<0.05), 21.7% 17.7% higher, respectively, than did not develop Furthermore, more vascular beginning severe pre-eclampsia. At weeks' Doppler pronounced accompanied arteries.In I both lower receive such treatment. favorable observed: incidence spontaneous abortion decreased factor 2.3 (OR 5.20; 95% CI [1.75-15.42]; p <0.05), 1.8 2.3; [1.25-4.31]; <0.05). same time, proportion moderate forms (85% cases versus 73% II) (15% 27%). duration disease manifestation (34.3±0.4 29.4±0.6 II).Conclusions: associated abortion, especially early This vasoconstriction spasm evidenced vessels, appears progresses weeks. It whose complicated development Preconception can reduce pre-placental circulation stage cytotrophoblastic transformation walls leads decrease preeclampsia, its forms.

Language: Английский

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Diagnosis and methods of treatment of chronic endometritis in women of reproductive age

Women s Health and Reproduction, Journal Year: 2024, Volume and Issue: 61(1)

Published: Jan. 1, 2024

Aim. To study the controversial issues of diagnosis and treatment chronic endometritis (CE) its impact on fertility, according to foreign domestic authors. Key points. Although immunohistochemical for plasma cells is considered gold standard diagnosing CE, it has limitations. The need achieve consensus diagnostic criteria cholecystitis was noted in order exclude influence heterogeneity studies assessment results. An integrated approach based knowledge about pathogenesis CE facilitates selection adequate treatment. positive role antibacterial therapy resolving undoubted. In recent years, restore immune defense been widely discussed. importance a complex natural antimicrobial peptides cytokines restoring fertility improving pregnancy outcomes already proven several publications. Physiotherapeutic methods continue be studied, most popular currently are cavitated solutions, peloids, electropulse magnetic therapy. Conclusion. require clear definition. Treatment should include broad-spectrum antibiotic therapy, immunomodulatory physiotherapy. Keywords: endometritis, infertility, recurrent miscarriage, antibiotics, immunomodulators, peloid ultrasonic cavitation, interference magnetotherapy, laser

Language: Английский

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CORRELATION RATIO OF CHRONIC ENDOMETRITIS WITH ANAMNESTIC FACTORS AND ULTRASOUND CHARACTERISTICS OF THE ENDOMETRIUM IN WOMEN OF REPRODUCTIVE AGE

Neonatology surgery and perinatal medicine, Journal Year: 2024, Volume and Issue: 14(1(51)), P. 69 - 75

Published: April 8, 2024

The diagnosis of chronic endometritis is problematic because its asymptomatic course and the need for invasive uterineprocedures to confi rm histologically. Therefore, it important identify factors that indicate a high risk this condition. Aim: aim study have statistically signifi cant correlation with presence CE in women reproductive age validate them by histologic examination endometrium.Material Methods. A retrospective analysis 400 histories who underwent hysteroscopyand endometrial biopsy was performed. Histologically, 154 (38.5 %) were found havechronic (the group endometritis), while 246 (61.5 otherconditions unrelated without endometritis). Analysis anamnestic ultrasound criteria associated an increased likelihood performed when comparing data from these groups. strength relationship between on one hand development other assessed calculating Kendall’s τ (tau) rank coeffi cient. mentioned factor considered strong (+++) cient 0.5 or higher, moderate (++) range 0.2 0.499, weak (+) 0.1 0.199. τ-coeffi value 0 0.099 indicated no endometritis.The conducted accordance principles patient- centered care, requirements Tokyo Declaration World Medical Association, international recommendations Helsinki Human Rights, Convention Council Europe Rights Biomedicine, laws Ukraine, Code Ethics Ukrainian Physician.The paper excerpt initiative scientifi c research project Department Obstetrics Gynecology No.2 at Poltava State University, entitled «Optimization approaches management pregnancy obstetric perinatal pathology» (State registration number 0122U201228, duration: 10.2022-09.2027) collaboration Pathological Physiology University.Results Discussion. determination allowed us strongestassociation endometritis. Among are 5 infectious factors: cervicitis past medical history (τ 0.625245229; p<0.0000000001); infl ammation uterine appendages 0.522536031; sexually transmitted diseases 0.547218916; urogenital ammatory sexual partner 0. 529314979; previous multiple use intrauterine contraception (τ-coeffi 0.502383401; 4 symptomatic consequential infertility 0.683492482; missed miscarriages 644489429; recurrent early loss 0.625942138; abnormal bleeding 0.650850348; criteria, such as local thickening form polyp 0.641820318; p<0. 0000000001); echogenicity endometrium 0.665249637; heterogeneity echo structure areas decreased 0.693152163; hyperechogenic structures basal layer 0.521658745; p<0.0000000001). In our opinion, combination criterion indicates probability absence signs, 1 symptomatic- To confirm representativeness method, we analyzed biopsies obtained curettage 100 factors. rmed histologically 87 women. Conclusion. Our proposed assessment high-risk endometritis, based infectious,symptomatic- consequential, allows predicting pathology % patients withoutтthe interventions. This helps improve patient selection hysteroscopy avoid unnecessary interventions planning pregnancy.

Language: Английский

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