Effectiveness of complex pregravid preparation programs with the use of sodium chloride baths, electrical pulse therapy and manual therapy: a randomized clinical trial

Objective. To evaluate the effectiveness of complex pregravid preparation programs, including sodium chloride baths, electropulse therapy and manual therapy, and their impact on the endometrium, uterine blood flow parameters according to ultrasound and dopplerometry, as well as on the pregnancy rate in patients with chronic endometritis.

Materials and methods. The randomized study included 95 patients with chronic endometritis aged 28 to 45 years. 32 women of the main group received a complex of electropulse therapy procedures (10 procedures), sodium chloride baths (10 procedures) and manual therapy (5 sessions). 32 patients of the comparison group received treatment consisting of electropulse therapy and sodium chloride baths. In 31 patients of the control group, restorative treatment was used, including electrical impulse therapy and fresh baths.

Results. The value of the arterial perfusion index increased in the comparison group by 2.36 times (p<0.05), and in the main group by 2.6 times (p<0.05). In the control group, this indicator did not change significantly.

The systolic-diastolic ratio in the right uterine artery in the control group decreased by 6.18% (p<0.001), in the comparison group - by 9.18% (p<0.001), in the main group by 20.8% (p<0.001). 0.001). The indicator of systolic-diastolic ratio in the left uterine artery in the control group decreased by 7.44% (p<0.001), in the comparison group - by 9.27% (p<0.05), in the main group by 20.4% (p<0.001). The decrease in the systolic-diastolic ratio after treatment in the main group significantly exceeded similar indicators in the control group and the comparison group (p<0.001).

Conclusion. Sodium chloride baths and manual therapy as part of complex restorative treatment help to improve the structure of the endometrium and increase the volumetric blood flow of the uterus. Manual therapy reduces vascular resistance, which is manifested in a decrease in the systolic-diastolic ratio in the uterine arteries.