Clinical role of manual and electropulse therapy in improving preconception care in patients with thin endometrium

Objective: to determine the efficacy of comprehensive preconception care programs, including sodium chloride baths, electropulse therapy, manual therapy, and their impact on the endometrium, uterine blood flow parameters according to ultrasound and Doppler ultrasound, as well as on the pregnancy rate in patients with chronic endometritis. Material and methods. The randomized study included 95 patients with chronic endometritis aged 28 to 45 years. In the main group, 32 women underwent a complex of electropulse therapy (10 procedures), sodium chloride baths (10 procedures), and manual therapy (5 sessions). In the comparison group, 32 patients received treatment consisting of electropulse therapy and sodium chloride baths. In 31 patients of the control group, restorative treatment was used, including electropulse therapy and fresh baths. Results. The arterial perfusion index increased by 2.6 times (p<0.05) in the main group, and by 2.36 times (p<0.05) in the comparison group. In the control group, this parameter demonstrated no significant changes. The systolic-diastolic ratio in the right uterine artery decreased by 6.18% (p<0.001) in the control group, by 9.18% (p<0.001) in the comparison group, by 20.8% (p<0.001) in the main group. The systolic-diastolic ratio in the left uterine artery decreased by 7.44% (p<0.001) in the control group, by 9.27% (p<0.05) in the comparison group, by 20.4% (p<0.001) in the main group. The reduction in the systolic-diastolic ratio after treatment in the main group was significantly greater than that observed in the control and comparison groups (p<0.001). Conclusion. Sodium chloride baths and manual therapy as part of comprehensive restorative treatment contribute to the improvement of endometrial structure and increase uterine blood flow volume. Manual therapy reduces vascular resistance, as evidenced by a decrease in the systolic-diastolic ratio in the uterine arteries. Electropulse therapy revealed no particular efficacy in the present study, and may be considered as part of a comprehensive therapy to enhance effects.