Evaluation of the state of the endometrium depending on the method of pregnancy termination and post-abortion period management

Preserving women's reproductive health after early artificial abortion is an extremely relevant task for modern healthcare systems. Aim - to investigate the functional state of the endometrium depending on the method of pregnancy termination and the peculiarities of post-abortion period management. Materials and methods. A prospective controlled study was conducted involving 160 women aged 18 to 43 years who underwent either medical abortion (Group I) or pregnancy termination by vacuum aspiration (Group II). Each group was further divided into two subgroups of 40 women each. Women in subgroups IA and IIA participated in a therapeutic and rehabilitation program aimed at preserving reproductive health after pregnancy termination, while women in the subgroups IB and IIB (control) received standard post-abortion care. Transvaginal sonography was performed on days 1-3, 14 days after the abortion, and on days 20-24 of the subsequent menstrual cycle. One month after the abortion, CD138, a marker of chronic endometritis, was assessed in endometrial biopsy samples. Statistical analysis was performed using SPSS 21. Results. Women experienced a decrease in endometrial thickness following pregnancy termination. It was found that a significantly lower proportion of women who participated in the proposed therapeutic and rehabilitation program had an endometrial thickness of less than 7 mm on days 20-24 of the next menstrual cycle after medical abortion and after vacuum aspiration. Furthermore, there was a significantly lower incidence of chronic endometritis among women who received the therapeutic and rehabilitation protocol after vacuum aspiration compared to the control subgroup: 1 case (2.5%) versus 6 cases (15.0%). Conclusions. The results indicate that effective preservation of women's reproductive health after artificial abortion requires a comprehensive approach, including a clear diagnostic algorithm and pathogenetically substantiated treatment and rehabilitation measures. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors.