Blood flow signals uterine inflammation

The most common gynecological disease among women is uterine disease. Most of them will have diseases such as endometritis, uterine fibroids, adenomyosis, and uterine inflammation. Uterine inflammation is often manifested as blood flow signals, and the degree of blood flow signals can usually indicate the severity of uterine inflammation. Uterine diseases in women will affect their fertility. The uterus is the most important organ in the female body and diseases need to be avoided. But what does blood flow signal uterine inflammation?

The blood flow signal refers to the degree of blood flow richness, which can usually be divided into four levels: Level O is a mass with no blood flow signal; Level 1 is a small amount of blood flow signal; Level 2 is a moderate amount of blood flow signal; and Level 3 is an abundant blood flow signal. More than 4 blood flow dots or 2 blood vessels with clear walls can be seen in the mass. Generally speaking, malignant tumors have richer blood supply than benign tumors. Malignant tumors mostly have blood flow signals of level 2-3, while some benign tumors mostly have blood flow signals of level 0-1. Among some malignant tumors, the blood flow signals of level 2-3 can account for 90%, and the blood flow signals of level 1-2 can account for about 91.3%. Although the richness of blood flow is related to benign or malignant, it is also related to the size of the tumor. It is normal to detect blood flow signals in the uterus. If you want to determine whether it is benign or malignant and its nature, you must also make a judgment based on the amount and richness of the blood flow signals.

Uterine inflammation is a common infectious disease of the reproductive system, the most important of which is endometritis, which can be divided into chronic and acute types, and can also develop into intrauterine pyometra. Pathogens that cause uterine inflammation include Escherichia coli, Staphylococcus aureus, anaerobic bacteria, and hemolytic streptococci, and sexually transmitted pathogens include mycoplasma, chlamydia, and gonorrhea.

The pathogenesis of acute endometritis is closely related to pregnancy, including miscarriage, delivery, cesarean section, premature rupture of membranes, excessive prenatal and postpartum bleeding, obstetric surgery, maternal physical weakness, amniotic cavity infection and sexual intercourse in late pregnancy, which can all induce acute endometritis. In addition, acute endometritis can also be induced after curettage, intrauterine contraceptive device placement, long-term vaginal bleeding, chronic diseases, endometrioma, submucosal uterine fibroids and necrotic endometrial polyps.

When acute endometritis infects the basal layer of the endometrium, it can become a recurrence condition for chronic endometritis. Chronic endometritis can be caused by long-term placement of an intrauterine contraceptive device in women, incomplete restoration of the site of placental attachment, and residual placental tissue after miscarriage or delivery. Some women after menopause have low estrogen levels and thin endometrium, making them susceptible to bacterial infection and chronic endometritis.

Cervical obstruction caused by acute or chronic endometritis, such as poor drainage of the uterine cavity or inflammatory secretions that cannot be drained, can develop into intrauterine pyometra. Causes of cervical stenosis and obstruction include cervical laser, cone biopsy and electrocautery, or scar formation caused by more severe vaginitis, cervical injury and chronic cervicitis. Elderly women have a higher chance of developing pyometra. This is because their ability to resist infection decreases with age, causing the endometrium to be unable to shed periodically. In addition, the cervix is ​​narrow or closed, making it impossible to expel secretions from the uterine cavity, resulting in pyometra after infection.

1. Pathological examination of endometritis

There are many plasma cells and lymphocytes infiltrating in the intimal stroma. It is worth pointing out that the presence of more plasma cells is extremely important for diagnosis. In patients with prolonged inflammation, proliferation of fibroblasts and capillaries may be seen. Senile endometritis presents with thickening and hardening of the blood vessel walls, sometimes with calcification. When the lesion is severe, local ulcers may form. When the endometrial glands atrophy, the surface epithelium may undergo squamous metaplasia. When squamous metaplasia is extensive, large areas of squamous epithelium cover the entire inner wall of the uterine cavity, which is called uterine ichthyosis. In cases of endometritis after miscarriage, attention should be paid to the presence of villi and decidua. Especially if the miscarriage has been going on for a long time, the villi may be highly degenerated or even disappear, but scattered pieces of decidua tissue can often be found around the blood vessels.

2. Diagnostic curettage

It can identify the cause of the disease and rule out malignant lesions. Inflammation should be controlled for three days before surgery, and antibiotics should continue to be given after surgery to reduce inflammation. The operation should be gentle during the operation because the infected uterine wall is fragile and can easily cause uterine perforation. The endometrium of senile endometritis is thin, so more care should be taken when scraping it. Endometritis after miscarriage may leave residual embryonic tissue, which should be carefully and thoroughly scraped and examined, which can often also play a therapeutic role.