{"paper_id":"415622c5-d1ec-4f8f-8136-d7ea684def43","body_text":"High risks of somatic pathology in women with chronic  endometritis  \nHealth Risk Analysis. 2017. no. 4                                                                                                                             57 \nUDC 618.14-002-036.12-07 \nDOI: 10.21668/health.risk/2017.4.06.eng  \nHIGH RISKS OF SOMATIC PATHOLOGY IN WOMEN WITH CHRONIC   \nENDOMETRITIS \nE.G. Kobaidze,  M.M. Padrul \nPerm State Medical University named after Academician E. A. Wagner, 26 Petropavlovskaya Str., Perm, 614000, \nRussian Federation \n \n \nAs women fertility is obviously decreasing at present, a number of people who, being at the reproductive \nage, suffer from various diseases is only growing and it is truly a vital issue. Chronic endometritis which is a \nproblem in contemporary gynecology and reproductive performance studies may cause menstrual function dis-\norders, anemia, and chronic pelvis pains syndrome.  Our research goal was to assess risks of somatic pathology \nevolvement and life quality of women suffering from chronic endometritis. The focus group was made up of 42 \npatients at their fertile age who suffered from chronic endometritis (n=42); the reference group consisted of \npractically healthy females at the same age (n=33) who applied to a gynecologist in order to make a choice on a \ncontraceptive.  \nWe detected that women with chronic endometritis had somatic pathologies much more frequently that \nwomen from the reference group; such pathologies included chronic gastritis, functional disorders in the bowels, \ngall-bladder diseases, urinary system diseases, and chronic rhinopharyngitis (relative risks varied from 1.25 to \n4.62;  p<0.05). High somatic pathology parameters indicate there is a decrease in immunologic protection and \nnon-specific reactivity to pathologic changes in molecular mechanisms involving tissue and cellular homeostasis \ndisorders. Patients form the focus group had lower life quality, weaker endurance and greater fatigue, lower \nemotional and social activity. \nWhen doctors of all specialities treat patients with chronic endometritis they are advised to apply health-\nrestoring treatment at any stage when a patient applies for medical assistance (and not only when she is getting \nready for a pregnancy). We highlight the necessity to create individual sets of pharmaceuticals, physiotherapy and \nbalneal techniques, and diet therapy for basic metabolic processes recovery, antioxidant processes recovery, im-\nmunologic protection and non-specific reactivity improvement. It is also necessary to treat not only gynecological \npathology, but also a concomitant somatic one.  \nKey words: reproductive age, chronic inflammatory pathology, somatic diseases, life quality, chronic en-\ndometritis, reproductive health. \n \n \n \n The World Health Organization sticks \nto the following reproductive health defini-\ntion: \"Reproductive health is a state of \ncomplete physical, mental, and social well-\nbeing; it does not mean simple absence of \nany diseases related to the reproductive \nsystem, its functions, and processes\". As \nfemale fertility is going down nowadays, \nmore and more people of reproductive age \nturn out to have various diseases, both of \nsomatic and gynecological genesis, which \ncan cause infertility, and it remains a very \nserious issue. A number of auxiliary repro-\nductive technologies aimed at treating in-\nfertility has grown over the last years. \nHowever, there are certain pathologies \nwhich are too difficult to treat and which \ncause unsuccessful embeddings in case \nwhen auxiliary reproductive technologies \nare applied. Particularly, nowadays the \n__________________________ \n \nÓ Kobaidze E.G.,  Padrul M.M., 2017 \nEkaterina G. Kobaidze – Candidate of Medical Science, Associate Professor of the Department of Obstetrics \nand Gynecology (e-mail: eka7i@yahoo.com; tel.: +7 (342) 236-39-30).   \nMikhayl M. Padrul – Doctor of Medical Science, Professor, Head of the Department of Obstetrics and Gy-\nnecology (e-mail: m-padrul@mail.ru; tel.: +7 (342) 236-39-30).   \n\nE.G. Kobaidze, M.M. Padrul \nHealth Risk Analysis. 2017. no. 4 58\nuterine factor is becoming a complicated \nand poorly treatable infertility issue all \nover the world. Epidemiological parame-\nters of chronic endometritis in women of \nfertile age are quite different, from 1% to \n70%; but its contribution into reproduction \ndisorders is not under any discussion \n[9, 12]. This pathology outcomes are indi-\nvidual in each case, as it is hardly possible \nto predict endometrial functional state in \nthese patients in spite of great number of \ncontemporary laboratory-diagnostic tech-\nniques for examining uterus mucous tunic \nstate. Chronic endometritis can become a \nserious problem for a patient: it causes \nmenstrual disorders in women, anemia, \nchronic pelvis pain syndrome, chronic fa-\ntigue, infertility, and it lowers overall life \nquality. We should also note that oncologic \ngynecological pathologies increase in pa-\ntients with chronic diseases in their case \nhistory and it accordingly proves it is nec-\nessary to get better insights into the issue \n[10, 14]. Inflammation process under \nchronic endometritis progresses wave-\nlike, specific clinic symptoms are absent, \netiological agents in endometrium are \nhard to identify, physiological factors of \nprotection from damage fail, disorders in \nendometrium receptivity evolve, a doctor \nand a patient tend to underestimate clini-\ncal signs, the disease can possibly have \nautoimmune character, and so, etiotoropic \ntherapy issue arises; all the above-said \ncharacterizes chronic endometritis nowa-\ndays. \nWhen endometritis occurs, acute or \nchronic inflammation evolves and a whole \nbody is involved in it to a certain extent. \nEndogenous protection systems and search \nfor universal regulators of physiological \nbody functions attract doctors' closest at-\ntention when it comes to complications \nprevention and rehabilitation. When patho-\ngenic factors exert their impacts on a body, \nbasic inflammatory and immune response \nschemes start to work: inflammation oc-\ncurs, antigen-representing cells start to \nfunction, an adaptive immune response \nevolves, immune lymphocytes-effectors \nmigrate, antibodies concentrations in in-\nflammation focus grow, antigens and tis-\nsues damaged by pathogens are destroyed, \nand decay products are discharged from a \nbody by its excretory systems, namely the \nliver, kidneys, bowels, etc.  [2, 7, 15]. \nChronic inflammation pathologies occur-\nrence in the gastrointestinal tract or urinary \ntracts are now considered by practicing gy-\nnecologists as related to chronic endome-\ntritis. Extragenital chronic inflammation \nfocuses can contribute into a decrease in a \nbody adaptive abilities and make for chron-\nic inflammation pathologies in the uterus. \nThere are opinions that any chronic infec-\ntion focus in a body, including chronic ad-\nnexitis, can be a source of infection which \npenetrates the gall bladder [3], thus causing \nchronic non-calculous cholecystitis. We \nshould note that possible reserve impacts \nexerted by inflammations in the gall blad-\nder on endometrium state are not studied \nenough. There are some data in literature \non pathologic impacts exerted by chronic \ntonsillitis on menstrual function develop-\nment in girls and on pregnancy complica-\ntions  [6]. There are also some data on mi-\ncroflora persisting in endometrium of pa-\ntients suffering from chronic endometritis \nbeing similar to that occurring in the pala-\ntine tonsils  [11]. Negative influence which \nchronic pyelonephritis has on pregnancy \ncourse is beyond any questions now [4, 5, \n13]. But its occurrence in gynecological \npatients is not well examined. And as a \nnumber of healthy women is decreasing \nnow, it is undoubtedly vital to assess their \nlife quality. Therapeutic approach im-\nprovement is not possible without imple-\n\nHigh risks of somatic pathology in women with chronic  endometritis  \nHealth Risk Analysis. 2017. no. 4                                                                                                                             59 \nmentation of recommendations obtained on \nthe basis of such research. \nOur research goal  was to assess life \nquality and risks for somatic pathology oc-\ncurrence in women suffering from chronic \nendometritis. \nData and methods. We performed our \nresearch in a form of clinical analytical pro-\nspective analysis. We examined 75 women \nof reproductive age permanently living in \nPerm (in 2015 and 2017). The examined \nwomen were divided into 2 groups: the first \none was made of practically healthy women \n(n=33), who applied to a doctor in order to \nmake a choice on a contraceptive; the sec-\nond groups was made of patients (n=42) \nsuffering from chronic endometritis. We \nused the following criteria to select and in-\nclude women into our sampling:  \n- chronic endometritis was diagnosed \nand the diagnosis was verified by morpho-\nlogic examinations;  \n- the disease was diagnosed more than \n1 year ago; \n- there was no acute somatic pathology \nor an exacerbation of the chronic one; \n- absence of any signs proving there \nwas exacerbation of chronic inflammatory \npathology in small pelvis organs (chronic \nsalpiginitis, oophoritis, endometritis, cervi-\ncitis, vaginitis).  \nComplex examinations performed on \npatients included passport data analysis, \ncase history analysis, menstrual and repro-\nductive functions assessment, general clini-\ncal and gynecological research, somatic pa-\nthologies detection, general clinical labora-\ntory tests, life quality assessment via SF-36, \nand statistical analysis techniques.  \nSF-36 questionnaire is a non-specific \none aimed at life quality (LQ) assessment. It \nis widely used in conducting research on \nlife quality of healthy population and \ngroups of patients with various chronic dis-\neases. Life quality was analyzed as per \nseveral scales  [1, 8, 16, 17]: \n1. Physical Functioning or PF. This \nscale shows to what extent physical state \nlimits physical loads; low scoring means a \nrespondent's physical activity is signifi-\ncantly limited by his or her health. \n2. Role-Physical Functioning or RP. \nThis scale determines how physical state of \na person influences his or her everyday \nlife; low scoring means that a person faces \ncertain limitations in his or her everyday \nlife caused by his or her health state. \n3. Bodily pain or BP. This scale allows \nto find out how intense a pain syndrome is \nand how it influences an examined person's \nability to pursue his or her everyday activi-\nties; low scoring also means that everyday \nactivities are seriously limited because of \npain. \n4. General Health or GH. This scale \nshows how a woman assesses her health \nand her resistance to diseases; low scoring \nproves there is health deterioration. \n5. Vitality or VT. The scale is based \non subjective feelings of a respondent and \nallows to assess whether he or she suffers \nfrom excessive fatigue or on the contrary is \nfull of energy; low scoring means fatigue is \nexcessive. \n6. Social Functioning or SF. This scale \nallows to assess satisfaction with social ac-\ntivity level; accordingly, low scoring \nproves social activities are also low. \n7. Role-Emotional or RE. The scale \nshows how emotional state influences a \npatient's everyday activities; low scoring \nmeans that working capacity is reduced \ndue to poorer emotional state. \n8. Mental Health or MH. The scale al-\nlows to assess patients' moods; low scoring \nproves a patient has increased anxiety. \nParameters on each scale vary from 0 \nto 100 scores, where 100 means absolute \nhealth. The higher scoring is, the higher \n\nE.G. Kobaidze, M.M. Padrul \nHealth Risk Analysis. 2017. no. 4 60\nlife quality is and the better health is; the \nresults are given in scores as per 8 scales \nmade up in such a way that a higher scor-\ning means a better life quality [16, 17]. Pa-\nrameters as per 2 groups were assessed and \nrepresented by the median (Me) and a per-\ncentile interval 25–75. We applied distribu-\ntion-free techniques (Mann-Whitney test \nfor comparing two independent samplings) \nto compare both groups and examine pos-\nsible correlations. To analyze dependences \nbetween a frequency of a parameter occur-\nrence (somatic and gynecologic pathology) \nin a group, we applied chi-square criterion \n(χ2). We analyzed discrepancies between \ngroups as per parameters occurrence fre-\nquencies also with χ2 criterion. We calcu-\nlated odds relation (OR) with 95%-\nconfidence interval and applied relative \nrisk with 95%-confidence interval as a way \nto assess risk factors and possibility of \nhealth disorders in female patients.  \nResults and discussion . Women from \nthe first group were from 19 to 44 (average \nage was 30.90±7.09 ); from the second, \nfrom 21 to 44 (average age was \n34.11±4.79). Reproductive case history \nanalysis in the first group revealed the fol-\nlowing peculiarities: 11 women had child-\nbirth in their case history (33.33±16.72%); \n5 miscarriages which happened  during \nfirst 5 gestation weeks were detected in \n15.15±12.71% women, χ2=3.46; p=0.06; \nwe didn't detect any frozen pregnancies in \nthis group; medical abortions were made in \n24.24±15.2% (8) cases, χ2=6.97; p=0.008, \nthat is, frequency of this parameter occur-\nrence in this group was statistically signifi-\ncant; 96.97±6.08% women practiced birth \ncontrol and used condoms to protect them-\nselves from unwanted pregnancies, and it \nproved that frequency of this parameter oc-\ncurrence was statistically significant for \nthis category of the examined women  \n(χ2=58.30; p<0.001). \nOur analysis of gynecological case his-\ntory which patients from the 1st group had \nrevealed that 6.06±8.46% women suffered \nfrom such proliferative uterus diseases as \nleiomyoma, and we didn't detect adenomy-\nosis in this group. We analyzed frequency \nof chronic reproductive system inflamma-\ntions occurrence and revealed that women \ndidn't have chronic salpiginitis, adnexitis, \nor cervicitis; chronic cervicitis led to sur-\ngery on the uterine neck in 2 patients \n(6.06±8.46%, χ2=0.52; p=0.473). Menstru-\nal cycle characteristics revealed that men-\narche occurred timely in 87.88±11.57% \n(29) women and we didn't detect any other \nmenstrual disorders in this group.  \nReproductive case history analysis \nperformed on women suffering from \nchronic endometritis revealed the follow-\ning: 57.14±15.42% (24) patients had pri-\nmary and secondary infertility, χ2=30.86; \np<0.001; 14 patients (33.33±14.69%) had \nchildbirth, 54.76±15.51% women had \nmedical abortions (p<0.001), and it indi-\ncated that frequency of this parameter oc-\ncurrence in this patients' group was statisti-\ncally significant. Pregnancy had an unfa-\nvorable outcome, namely miscarriage or \nfrozen pregnancy, in 26.19±13.7% \n(χ2=10.46; p<0.001) cases and it indicated \nthat frequency of this parameter occurrence \namong these patients was also statistically \nsignificant. 14.29±10.9% (6) women suf-\nfered from proliferative uterus diseases \n(leiomyoma) and frequency of this parame-\nters occurrence was also statistically signif-\nicant, χ2=4.49; p=0.034. Adenomyosis was \ndetected in 9.52±9.15% (4), χ2=2.36; \np=0.124, that is, the parameter was not sta-\ntistically significant in this group. Our \nanalysis of chronic reproductive system \ninflammations revealed that 40.48±15.3%, \n(χ2=18.88; p<0.001) suffered from chronic \nsalpiginitis and adnexitis; 47.62±15.56% \n(p<0.001), from chronic cervicitis; \n\nHigh risks of somatic pathology in women with chronic  endometritis  \nHealth Risk Analysis. 2017. no. 4                                                                                                                             61 \n52.38±15.56% (p<0.001) patients had sur-\ngery on the uterine neck in their case histo-\nry. Women suffering from chronic endo-\nmetritis had various menstrual function \ndisorders in 69.05±14.41% cases \n(χ2=10.46; p<0.001), algomenorrhea \n(28.57±14.08%; p<0.001) and profuse \nmenses (19.05±12.24% patients; p<0.001) \nwere statistically significant. Comparative \ncharacteristics of all the above mentioned \nparameters is given in Table 1.  \nTable 1 \nComparative characteristics of the obstetric-gynecological case history  \nbetween two groups \nSigns Groups \n1(n=33) % \nGroups 2 \n(n=42) % Chi2 R OR CI 95% \nChild birth  33,33 ± 16,0 33,33 ± 14,6 0,061 0,805 1,000 0,38; 2,63 \nInfertility  0 57,14 ± 15,4 15,584 0,001* 416,00 25; 4195,12  \nMedical abortion 24,24 ± 15,0 54,76 ± 15,5 5,896 0,015* 3,783 1,39; 10 \nMiscarriage 15,15 ± 12,0 26,19 ± 13,7 0,765 0,382 1,987 0,61; 6,43 \nFrozen pregnancy 0 26,19 ± 13,7 4,252 0,039* – – \nMenstrual dysfunctions 0 69,05 ± 14,4 22,517 0,001* – – \nLeiomyoma 6,06 ± 8,4 14,29 ± 10,9 0,591 0,442 – – \nAdenomyosis 0 9,52 ± 9,2 0,799 0,371 – – \nChronic salpiginitis 0 40,48 ± 15,3 8,527 0,003* – – \nChronic adnexitis 0 40,48 ± 15,3 8,527 0,003* – – \nChronic cervicitis 0 47,62 ± 15,5 11,234 0,001* – – \nSurgery on the uterine neck 6,06 ± 8,4 52,38 ± 15,5 16,155 0,001* 17,050 3,61; 80,56  \nContraception  96,97 ± 6,08 61,9 ± 15,1 7,716 0,005* 0,000 – \n Note:* – means that statistically significant discrepancies in a parameter occurrence frequency were de-\ntected between healthy women and those suffering from chronic endometritis  \n \nWhen we compared analyzed parame-\nters in healthy women and in female pa-\ntients with chronic endometritis we re-\nvealed that there were statistically signifi-\ncant discrepancies in occurrence frequency \nof medical abortion (made to get rid of \nunwanted pregnancy, the parameter was \nhigher in patients with chronic endometri-\ntis), chronic adnexitis and salpiginitis, \nchronic cervicitis, frozen pregnancy, and \ninfertility. \nAs per body mass index, healthy \nwomen from group I were divided into the \nfollowing sub-groups: 23 (69.7±16.3%) out \nof 33 women had normal parameters \n(18.50–24.99); 10 (30.3±16.3%) women \nhad excessive body weight and 1st degree \nobesity ( χ2=9.55; p=0.002). A share of \nwomen with normal body mass in group 2 \namounted to 69.05±14.41% (29); \n30.95±14.41% (13) had lipid metabolism \ndisorders; χ2=13.11; p<0.001. \n       We analyzed gastrointestinal tract \ndisorders in the examined women and re-\nvealed that 4 women (12.5±11.92%, \nχ2=2.40; p=0.121) in the first group (n=33) \nsuffered from chronic gastritis, and 3 \n(9.09±10.19%, χ2=1.40; p=0.237) had \nchronic pancreatitis; functional bowels dis-\norders (notably, irritable bowels syndrome) \nwere detected in 1 patient (3.03±6.08%), \ngall bladder disorders (including gall blad-\nder dyskinesia and biliary tracts dyskine-\nsia) were also detected in only 1 patient \n(3.03±6.08%). We didn't detect any urinary \nsystem disorders (chronic pyelonephritis, \ncystitis, or urethritis), or thyroid gland dis-\norders (hypothyroidism or hyperthyroid-\nism) in women from the first group.  We \ndetected 2 cases (6.06±8.46%, χ2=0.52; \n\nE.G. Kobaidze, M.M. Padrul \nHealth Risk Analysis. 2017. no. 4 62\np=0.473) of chronic respiratory tracts dis-\norders (chronic pharyngitis, rhinitis, or rhi-\nnopharyngitis). More than half of them had \nfood allergy or household chemicals aller-\ngy, 6 (18.18±13.68%, χ2=4.52; p=0.003) \nwomen had broad spectrum antibiotics al-\nlergy. \nGastrointestinal tract diseases analysis \nin the 2nd group (n=42) revealed that \n57.14±15.42% had chronic gastritis, and \n42.86±15.42% were healthy, χ2=30.86; \np<0.001; chronic pancreatitis was detected \nin 23.81±13.27% (10 women), χ2=9,19; \np=0.002; bowels functional disorders, in \n64.29±14.93% (27 patients), χ2=36.90; \np<0.001; gall bladder disorders were de-\ntected in 61.9±15.13% (26) cases, \nχ2=34.81; p<0.001. 21 patients \n(50±15.58%), had urinary system diseases \nχ2=25.40; p<0.001. Thyroid gland diseases \nwere detected in 5 (11.9±10.09%) women; \nchronic respiratory tract diseases, in partic-\nular, chronic rhinitis, in 19.05±12.24% pa-\ntients, χ2=6.77; p=0.009, and chronic rhi-\nnopharyngitis, in 28.57±14.08%, χ2=11.76, \np<0.001. 15 patients (35.71±14.93%, χ2= \n15.91; p<0.001) had broad spectrum \nantibiotics allergy. \nWe applied Mann-Whitney criterion \nand revealed statistically significant dis-\ncrepancies between 2 groups as per blood \nanalysis. Notably, women from the groups \n2 (patients with chronic endometritis) had \ngreater quantities of stab neutrophils, lym-\nphocytes, and monocytes, as well as low \nerythrocytes sedimentation rates, which \ncould possibly indicate their immune pro-\ntection was weaker, and their non-specific \nbody reactivity, lower (Table 2). \nComparison between patients from the \n1st and 2nd group allowed to reveal statisti-\ncally significant discrepancies between oc-\ncurrence frequency of such diseases as \nchronic gastritis, bowels functional disor-\nders, gall bladder diseases, urinary system \ndiseases, and chronic rhinopharyngitis. the \nabove-mentioned pathologies occurred \nmore frequently in patients suffering from \nchronic endometritis. We also detected sta-\ntistically insignificant discrepancies be-\ntween occurrence frequency of such param-\neters as body mass index deviations, chron-\nic pancreatitis, chronic rhinitis, antibiotics \nallergy in groups of healthy and sick wom-\nen. Comparative characteristics of the \nabove-mentioned pathologies is given in \nTable 3. \nTable 2 \nComparative characteristics as per blood analysis between 2 groups \nBlood analysis parameters \ngroup1 \n(n=33) \nMe \n(25%-75%) \ngroup 2 \n(n=42) \nMe \n(25%-75%) \np-level \nLeucocytes (10*9) 5,2 (4,7–5,5)  4,7 (4,1–5,3)  0,029* \nStab neutrophils  (%) 2 (1–2)  2 (2–3)  0,005* \nMonocytes (%) 9 (6–10)  11 (9–12)  0,003* \nLymphocytes (%) 31 (27–35)  36 (33–40)  0,001* \nThrombocytes (10*9) 244 (226–286)  221 (211–267)  0,024* \nErythrocytes sedimentation rate (mm/h) 13 (11–15)  7 (5–12)  0,001* \nHemoglobin g/l 127 (124–132)  124 (114–134)  0,246 \nNote:* –  means Mann-Whitney criterion allowed to reveal statistically significant discrepancies between \n2 groups. \n\nHigh risks of somatic pathology in women with chronic  endometritis  \nHealth Risk Analysis. 2017. no. 4                                                                                                                             63 \nTable 3 \nComparative characteristics of somatic pathologies between groups \nParameter \nGroup \n1(n=33) \n% \nGroup 2 \n(n=42) \n% \nChi2 Р OR CI 95% \nBMI 30,3 ± 16,3 30,95 ± 14,4  0,04 0,848 1,031 0,38; 2,77 \nChronic gastritis  12,5 ± 11,9 57,14 ± 15,4  13,6 0,001* 9,333 2,78; 31,39 \nChronic pancreatitis  9,09 ± 1,01 23,81 ± 13,2  1,9 0,172 3,125 0,78; 12,46 \nBowels functional disorders 3,03 ± 6,0 64,29 ± 14,9 27,1 0,001* 57,60 7,14; 464,79  \nGall bladder diseases 3,03 ± 6,0 61,9 ± 15,1 25,3 0,001* 52,00 6,46; 418,55  \nUrinary system diseases 0 50,0 ± 15,5 12,2 0,001* – – \nThyroid gland diseases 0 11,9 ± 10,0 1, 1 0,300 – – \nChronic rhinitis  6,06 ± 8,4 19,05 ± 12,2 1,4 0,229 3,412 0,67; 17,36 \nChronic rhinopharyngitis 6,06 ± 8,4 28,27 ± 14,0 4,8 0,029* 6,200 1,28; 30,07 \nAntibiotics allergy  18,18 ± 13,0 35,71 ± 14,9 2,015 0,156 2,500 0,84; 7,41 \nNote: * – means that statistically significant discrepancies in a parameter occurrence frequency were de-\ntected between healthy women and those suffering from chronic endometritis.  \n \nWhen we calculated relative health \ndisorders risk in terms of a significant so-\nmatic pathology in patients suffering from \nchronic endometritis, we obtained the fol-\nlowing results: chronic gastritis risk (RR) \nwas equal to 2.190, OR 95% 1.48; 3.24; \nbowels functional disorders (RR), 3.021, \nOR 95% 1.98;4.62; gall bladder diseases \n(RR), 2.889, OR 95% 1.92;4.34; urinary \nsystem diseases (RR), 2.571, OR 95% \n1.84;3.59; chronic rhinopharyngitis (RR) \n1.743, OR 95% 1.25;2.43 (correlation was \nthought to be significant at p < 0.05), and it \nindicated that women from the 2nd group \nran higher risks of somatic pathologies oc-\ncurrence. Bearing our research goals in \nmind, we analyzed women's questionnaires \nas per life quality and revealed statistically \nsignificant discrepancies between two \ngroups as per two scales. We should high-\nlight that patients suffering from chronic \nendometritis had lower Role-Emotional \nfunctioning capacities, greater anxiety, \nmental ill-being, lower health self-esteem \nand lower resistance to diseases, they as-\nsessed their treatment prospects skeptical-\nly, and all this undoubtedly meant life \nquality of these women was rather poor \n(comparison results are given in Table 4). \nTable 4 \nComparative characteristics of life quality between 2 groups \nParameters Group 1 (n=33) Me \n (25%-75%) \nGroup 2 (n=42) Me  \n(25%-75%) p-level \nPhysical functioning 65 (59–68)  44 (42–54)  <0,001* \nRole physical functioning 68 (67–71)  47 (44–49)  <0,001* \nBodily pain 71 (69–74)  43,5 (38–47)  <0,001* \nVitality 71 (70–73)  48 (45–51)  <0,001* \nSocial functioning 72 (70–75)  55 (48–56)  <0,001* \nRole emotional state 77 (74–79)  40,5 (37–45)  <0,001* \nMental health 80 (72–82)  42 (38–45)  <0,001* \nGeneral health 69 (60–72)  44,5 (43–55)  <0,001* \nNote: p<0.001* – means Mann-Whitney criterion allowed to reveal statistically significant discrepancies \nbetween 2 groups. \n\nE.G. Kobaidze, M.M. Padrul \nHealth Risk Analysis. 2017. no. 4 64\nConclusions. Health parameters of pa-\ntients suffering from chronic endometritis \ndiffer greatly from those of healthy women. \nHigh somatic pathology parameters and fer-\ntility issues can cause low scores of each life \nquality scale. Analysis of life quality which \npatients with this diseases have will allow to \ndevelop relevant recommendations aimed at \nits improvement and exerting positive influ-\nence on efficiency of the basic pathology \ntherapy. Allowing for poor health of women \nsuffering from chronic endometritis, we as-\nsume that doctors with all specialties should \npay greater attention to medical-preventive \nactivities, and prescribe health-preserving \ntreatment at all the stages when a woman \napplies for medical aid, and not only when \nshe is getting ready for a pregnancy. It is \nnecessary to apply individualized sets of \npharmaceuticals, physiotherapeutic and bal-\nneal techniques, as well as diet therapy, for \nthe recovery of basic metabolism types, anti-\noxidant processes, immunologic protection \nfactors and non-specific reactivity. Health-\npreserving treatment for not only gynecolog-\nical but also concomitant somatic patholo-\ngies can stimulate adaptation reserves recov-\nery in organs and systems, neuro-vegetative \nregulation, and, accordingly, hormonal ho-\nmeostasis recovery which becomes truly vi-\ntal for maintaining proper reproductive sys-\ntem functioning. \n \nReferences \n1. Demin A.V. Populyatsionnye pokazateli kachestva zhizni zhenshchin 65-74 let, \nprozhivayushchikh na Evropeiskom Severe Rossii [Population parameters of life quality charac-\nteristic for women aged 65-74 living in the Northern European part of Russia]. Molodoi uchenyi, \n2015, no. 21, pp. 261–269. Available at: https://moluch.ru/archive/101/22786/ (09.07.2017) (in \nRussian). \n2. Dolgikh O.V., Zaitseva N.V., Dianova D.G.  Analiz apoptoticheskoi aktivnosti \nlimfotsitov u zhenshchin fertil'nogo vozrasta v usloviyakh vozdeistviya reprotoksikantov [In \nwomen of childbearing age under the conditions of reprotoxicants exposure]. Rossiiskii immuno-\nlogicheskii zhurnal, 2015, vol. 9, no. 1, pp. 58 (in Russian). \n3. Loranskaya I.D.,  Rakitskaya L.G.,  Malakhova E.V., Mamedova L.D. Lechenie \nkhronicheskikh kholetsistitov [Chronic cholecystitis treatment]. Lechashchii vrach: meditsinskii \nnauchno-prakticheskii portal , 2006. Available at: https://www.lvrach.ru/2006/06/4534015/ \n(10.08.2017) (in Russian). \n4. Minasyan A. M., Dubrovskaya M. V. Beremennost' na fone khronicheskogo pielonefrita \n(obzor) [Pregnancy of a woman suffering from chronic pyelonephritis (a review)]. Saratovskii \nnauchno-meditsinskii zhurnal, 2012, vol. 8, no. 4, pp. 920–925 (in Russian). \n5. Orazmuradov A.A., Boltovskaya M.N., Shmel'kov A.V., Apresyan S.V., Nazimova S.V.,  \nTerent'eva S.L. Negativnoe vliyanie khronicheskogo pielonefrita na protsess gestatsii [Negative \nimpact of chronic pyelonephritis on the gestation]. Vestnik Rossiiskogo universiteta druzhby \nnarodov. Seriya: Meditsina, 2011, no. S5, pp. 14–18 (in Russian).   \n6. Ovchinnikov A.Yu., Slavskii A.N., Fetisov I.S. Khronicheskii tonzillit i sopryazhennye s \nnim zabolevaniya [Chronic tonsillitis and concomitant diseases]. Russkii meditsinskii zhurnal , \n1999, no. 7, pp. 31–36 (in Russian).   \n7. Bubnova O.A., Dolgikh O.V., Sinitsyna O.O., Krivtsov A.V., Bezruchenko N.V., Ma-\nzunina A.A., Gusel'nikov M.A., Otavina E.A. Polimorfizm genov semeistva ppars, gena esr1 u \nzhenshchin s nevynashivaniem beremennosti v usloviyakh aerogennoi ekspozitsii fenolami \n[Polymorphism of  ppars genes and esr1 gene in females with miscarriages under aerogenous \nexposure to phenols]. Okruzhayushchaya sreda i zdorov'e. Gigiena i ekologiya urbaniziro-\n\nHigh risks of somatic pathology in women with chronic  endometritis \nHealth Risk Analysis. 2017. no. 4                                                                                                                             65 \nvannykh territorii: materialy VI Vserossiiskoi nauchno-prakticheskoi konferentsii s mezhdu-\nnarodnym uchastiem molodykh uchenykh i spetsialistov, posvyashchennoi 85-letiyu FGBU NII \nECh i GOS im. A.N. Sysina Minzdrava Rossii [Environment and health. Hygiene and ecology on \nurbanized territories: materials of the VI Russian theory and practical conference with interna-\ntional participation of young scientists and experts dedicated to 85-th anniversary of Sytin's Sci-\nentific Research Institute for Human Ecology and Environmental Hygiene of the RF Public \nHealthcare Ministry]. In: Yu.A. Rakhmanin, ed. 2016, pp. 93–98 (in Russian).   \n8. Amirdzhanova V.N., Goryachev D.V., Korshunov N.I., Rebrov A.P., Sorotskaya V.N. \nPopulyatsionnye pokazateli kachestva zhizni po oprosniku SF-36 (rezul'taty mnogotsentrovogo \nissledovaniya kachestva zhizni «MIRAZh») [SF-36 questionnaire population quality of life in-\ndices Objective]. Nauchno-prakticheskaya revmatologiya, 2008, no. 1, pp. 36–48 (in Russian).   \n9. Radzinskii V.E. Reproduktivnaya infektologiya XXI veka [Reproductive infectology in \nthe XXI century]. StatusPraesens, 2013, no.16-5, pp. 33–36 (in Russian).   \n10. Fen I., Sidorova I.S., Stanoevich  I.V., Unanyan  A.L., Kudrina E.A. Sochetanie giper-\nplasticheskikh protsessov endometriya s khronicheskim endometritom [Combination of endo-\nmetrial hyperplastic processes with chronic endometritis]. Akusherstvo, ginekologiya i reproduk-\ntsiya, 2012, vol. 6, no. 1, pp. 31–33 (in Russian).    \n11. Motovilova T.M., Grechkanev G.O., Kachalina T.S., [et al.].  Sravnitel'naya kharakter-\nistika mikroflory polosti matki i nebnykh mindalin u patsientok s persistiruyushchim endometri-\ntom [Comparative characteristics of microflora of uterine cavity and palatal tonsils in the case of \nfemale patients having persistent endometritis]. Meditsinskii al'manakh , 2015, no. 4 (39), pp. \n105–107 (in Russian).   \n12. Sukhikh G.T., Shurshalina A.V. Khronicheskii endometrit [Chronic endometritis]. \nMoscow, GEOTAR-Mediya, Publ., 2010, 64 p. (in Russian).   \n13. Styazhkina S.N., Chernenkova M.L., Krivenko P.A., Gailyamova L.I. Techenie i iskho-\ndy beremennosti u zhenshchin s khronicheskim pielonefritom [The course of pregnancy and \noutcome of labor in women with chronic pyelonephritis]. Sovremennye problem nauki i obra-\nzovaniya: elektronnyi nauchnyi zhurnal , 2015, no. 1–1. Available at: https://www.science-\neducation.ru/ru/article/view?id=17394 (12.07.2017) (in Russian).   \n14. Tkachenko L.V., Sviridova N.I.  Prognosticheskie faktory riska razvitiya giperplastich-\neskikh protsessov endometriya v perimenopauzal'nom periode [Prognostic factors for the devel-\nopment of hyperplastic processes in perimenopause]. Volgogradskii nauchno-meditsinskii zhur-\nnal, 2013, no. 4, pp. 43–47 (in Russian).   \n15. Chereshnev V.A., Gusev E.Yu. Immunologiya vospaleniya: rol' tsitokinov [Immunolo-\ngy of Inflammation: The Role of Cytokines]. Meditsinskaya immunologiya, 2001, vol. 3, no. 3, \npp. 361–368 (in Russian).     \n16. Ware J.E., Snow K.K., Kosinski M., Gandek B. SF-36 Health Survey. Manual and in-\nterpretation guide. Boston, Mass: The Health Institute, New England Medical Center, 1993. \n17. Ware J.E., Kosinski M., Keller S.D. SF-36 Physical and Mental Health Summary \nScales: A User`s Manual. Boston, Mass: The Health Institute, New England Medical Center, \n1994. \n \nKobaidze E.G., Padrul M.M. High risks of somatic pathology in women with chronic  en-\ndometritis. Health Risk Analysis, 2017, no. 4, pp. 57–65. DOI: \n10.21668/health.risk/2017.4.06.eng \n \nReceived:  08.09.2017 \nAccepted: 11.12.2017 \nPublished: 30.12.2017","source_license":"CC0","license_restricted":false}