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Gravidary endometrium - bad or good?

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Every woman, without exception, at least once in her life faces the problems of the reproductive system. Gynecological diseases can have bright symptoms or go on stealthily. At the same time, asymptomatic diseases are usually more dangerous. They develop for a long time in the female body and are found already in the later stages.

That is why the medical community recommends that every woman be examined by a gynecologist at least once a year. Timely detection of diseases such as endometriosis, fibroids, erosion, dysplasia, etc., is the key to preserving reproductive health.

At the same time, gynecological diseases cannot be considered in isolation from diseases of the urinary system and such concomitant conditions as menopause, menstruation or pregnancy. A clear understanding of the relationship between these aspects of a woman’s life provides insight into the causes of diseases of the genitourinary system.

We collected, analyzed and structured all available information on women's health issues. And now with pleasure we share it with you.

Diagnostics

As already mentioned, it is possible to diagnose a gravidary endometrium by ultrasound. A more effective method of investigation will be transabdominal rather than transvaginal, because in this case it will be more informative.

Even if a woman has a delay of one day, then the changes in the endometrium will be clearly visible during the examination. And on the 5-8th day of the absence of menstruation, the presence or absence of the embryo should already be clearly visible. Coming out of this you can talk about pregnancy or miscarriage in the early stages.

By itself, the gravidary endometrium during pregnancy plays a very important role and is an integral part in the body, since it is the fetal egg that clings to it. That is why this condition of the endometrium is safe and completely acceptable. Also, there is no danger of a situation in which a miscarriage occurred, because after a time the hormone level returns to normal and the mucous layer becomes normal again. But still, doctors strongly recommend that you perform a control ultrasound scan in order to assess how fast the endometrium will return to normal and whether it will come at all.

The moment when there is no pregnancy is dangerous, and the mucous membrane is gravidary. Such a condition can cause a strong hormonal failure in a woman’s body, which in some cases can threaten with sterility. And in general, in such a state, it is problematic to become pregnant because the embryo will have a hard time fixing itself on such a layer of the endometrium. A similar situation can occur when taking oral contraceptives, if a woman forgot to take a pill on a schedule. Then it is recommended to drink only one pill, instead of the amount that was missed. Doctors in such a situation strongly recommend to resort to qualified treatment.

Do I need to treat?

Gravidary endometrium during pregnancy is normal and should not be treated. If there was a miscarriage or abortion, then after 30 days it is worth doing the last ultrasound, which would give a correct assessment of the condition of the uterine mucosa.

And if there was a hormonal failure, then the doctor should prescribe such hormonal drugs:

  • Containing progesterone,
  • Containing estrogen
  • Contraceptives that contain progesterone and estrogen,
  • Agonists containing gonadotropin-releasing hormone.

The specialist will prescribe an individual course of treatment based on the level of hormones in the body, the conclusion of an ultrasound and based on the age of the woman.

Definition

What does this mean? Gravidary endometrium can be detected by ultrasound. It has a different echogenicity than unchanged, and based on this, it is well visualized during such a procedure. At the same time, it can be detected both with transabdominal and transvaginal ultrasound. In the conclusion of the doctor and the description of the ultrasound results, this condition can also be referred to as the endometrial gravidatory reaction.

The process of such changes is always total, that is, such an endometrium is not formed focally, but immediately on the entire uterine cavity. Usually, its presence is accompanied by some changes in the ovaries.

The reason for this condition, like any other change in the structure of the endometrium, is hormonal changes and changes in the body. Gravidary endometrium appears when the hormonal level characteristic of pregnancy changes. That is, such a condition can appear only upon the occurrence of pregnancy, as a result of the mutual effects of progesterone and estrogen and changes in their content.

At the same time, at the initial stages the pregnancy itself by ultrasound examination can not be diagnosed. The mucous layer undergoes changes from the first day of conception. Therefore, with a delay of 1 day, its changes are already noticeable on the ultrasound, although the samoplodnoe egg is not yet visible - it is visualized much later. In this case, doctors usually recommend that patients take a venous blood test for the content of the hCG hormone in the body. This hormone begins to be produced immediately after the onset of pregnancy and its level helps to diagnose this condition with high accuracy.

Sometimes there are situations when the endometrium of the gravidary type is diagnosed, the fetal egg is not visualized, and the level of the hCG hormone is normal (for the absence of pregnancy) or borderline. In this case, doctors usually say that fertilization is likely to occur, resulting in mucosal changes that have begun. But the fertilized egg did not fixate initially or was fixed, but was immediately rejected, that is, there was a miscarriage at a very early time, unnoticed by the patient.

In some cases, the appearance of such an endometrium is possible as a result of a strong hormonal failure, up to a false pregnancy. In this case, hormonal treatment is required. But this happens very rarely.

Do I need to treat?

As mentioned above, the gravitational mucosa during pregnancy is considered normal and does not need treatment. After a miscarriage or abortion, it is desirable to conduct a control ultrasound after a month to determine whether the mucosa has normalized. But when hormonal failure treatment can occur several types of hormones:

  • Estrogen-progesterone combination oral contraceptives,
  • Gonadotropin-releasing hormone agonists,
  • Progesterone or estrogen separately.

The most suitable drug is chosen by the doctor based on the current hormonal status and age of the patient.

Gravid endometrium

No. 28 982 Gynecologist 01/25/2016

Good day! I have 18 day cycle, we plan the child. At the monitoring showed gravidary endometrium. Ovulation was on day 10 of the cycle. The first month after two stimulations. What it means: gravid endometrium

Hello! Today I was on the ultrasound. I ovulation occurred on the 8th. Sex acts were: August 2.4, 6.8
On the ultrasound they said that the endometrium is 6.7mm, the 21st day of the cycle today (10avg) in the 31 day cycle
Is pregnancy possible? I start drinking 1 tablet 2p per day right from today to drink duphaston. Tell me please, is there any chance of attaching to such an endometrium?

Hello, please tell me if the doctor's appointments are correct. I am getting ready for eco, today was at the fertility specialist, as a result, today is the 10th day of the cycle, 8th day of stimulation gonal-f 150, endometrium 8 mm, follicles from 12 to 16 mm in each ovary there are 8 of them, the doctor said to continue all 4 more days prick drove 150 and from tomorrow 3 days prick tsetrotid. I have a question: I will be stitching tsetrotid in the evenings, will a spontaneous ovulation occur until tomorrow evening? And is it time to carry out a puncture? After all.

Hello. I am going through a second cycle of ovulation stimulation. Day of cycle 12. Endometrium 9.1mm. Right ovary V = 17.57 cm3 The structure is not meas. Max. Follicle 19mm small 8.7, 6.6mm Left ovary V = 13.89cm3 follicle max 16mm small 10.9, 9.6, 6.5mm. The stimulation scheme was from 4-8 days clostilbegit 50mg t tab per day. On the 9th day, 1g divigel on day 12 was an injection of an ovitrel. Today, the 18th day of the cycle, I went to the ultrasound school 12, LA 10.5. Endometrium 8.5 mm. Free fluid in the inferior space in a small number of ve. But m.

Hello! I am 26 years old. Planning a pregnancy for more than a year. Before that, pregnancy never occurred. Tell me, please, on my problem. The previous cycle began on 30. 04, a whole month on the prescription of a doctor pricking the Ovarium Compositum after 2 days on the third (only 10 injections). The first injection is 30. 04, the last - 27. 05. In parallel, monitoring by ultrasound. There were no dominant follicles; on the 11th day of the cycle, the follicles stopped growing. On the 18th d. C. Descended to monitor the last p.

Good day monthly were 23. 12. 2015 to 26. 12. 2015, A positive test for ovulation showed on the 9th day of the cycle, on that day there was unprotected sexual intercourse. The next day, I already tested 1 ovulation test. I went and ultrasound folliculometry 05. 01. 2016 The doctor said ovulation has passed. The conclusion of the study 05. 01. 2016: Endometrium 10.6 mm, echostructure heterogeneous, three-layer. The cervical canal is enlarged. The corpus luteum is 14 mm, there is free liquid in the postomacine space (7-10ml) What are given.

Hello, I am 23 years old, I can not get pregnant for half a year. I observe several gynecologists at the same time, zppp and no infections, hormonal background is normal, endometrium is normal, I do ultrasound in dynamics, I track ovulation, on this day and in subsequent sexual acts. There is a yellow body, but there is no delay. The menstrual cycle is normal, except for the last two months (brown discharge appeared two days before the menstruation). The husband was also observed at the urologist, tests, semen in the standards.

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Endometrium gravidary type - medical consultation on the topic

Gravity-type endometrium appears during pregnancy, without the presence of the ovum, you most likely have not established a pregnancy (it was interrupted at an early period) - this is one of the options.
The second is that the doctor has not yet seen the fetal egg on the ultrasound, since it did not have time to attach to the uterus wall, but the changes inside the uterus have already begun, the body is preparing to take the fetal egg and carry the pregnancy.
I recommend that you donate blood on hCG with an interval of three to four days and later do a second ultrasound, observation of the dynamics will help to understand the situation.
All the best.

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Pathology of the corpus luteum

This type of disease is quite common. Pathology develops due to hormonal imbalance and is diagnosed in case of persistence of the corpus luteum. At the same time, the concentration of progesterone produced by him becomes significantly less. If it lasts a long period, then the pathological process begins.

The gravidary uterine layer is rejected and renewed significantly slower, since a considerable part of it is susceptible to reverse development. The size of the uterus increases, long periods go. Further necrosis of the tissues of the appendages affected by pathological changes is not excluded.

Abnormal pregnancy

Pathological condition often develops on the background of a broken pregnancy. As a rule, the process of reverse development of the endometrium does not begin immediately, but after a few weeks. Such changes may occur in the following cases:

  • incomplete spontaneous miscarriage,
  • incomplete removal of the ovum as a result of abortive activities,
  • embryo death shortly after conception.

The size and shape of the uterus changes accordingly. The mucous membranes of the reproductive organ cease to be decidual and go into a state of rest. As a result, the process of proliferation of the endometrium begins.

As a rule, it is possible to diagnose such changes after taking a scraping from the uterus, when the process of decomposition of the tissues of the deceased embryo has already begun.

Detection methods

Decidualization is a natural endometrial response to the attachment of the ovum. In the absence of pregnancy, the gravidary layer exfoliates at the end of the menstrual cycle, and after completion of the regulator begins to grow again.

It is possible to detect it by conducting an ultrasound examination. The most accurate results can be obtained using three-dimensional ultrasonography, which uses the Doppler. In addition, a blood test is prescribed for hCG.

If the fact of conception was not confirmed, then an additional angiography is performed. In this case, the uterine layer is estimated by the following parameters:

  • the number of blood vessels in the area being investigated,
  • blood velocity
  • ripple force.

Thanks to this, it is possible to determine how sensitive the endometrium is.

In conclusion, endometrial biopsy is performed, the taken tissues are sent for cytological examination.

During pregnancy

Immediately after successful fertilization, the fact of conception cannot be confirmed even by ultrasound. Changes in the endometrium occur from the very first days, so a transvaginal ultrasound (inside the vagina) will immediately show what the condition of the uterine layer is. Thus, pregnancy is diagnosed even in the earliest terms.

Accurately assess the state helps blood test for hCG. This hormone is produced in the female body immediately after successful fertilization.

Sometimes it happens that during the ultrasound study it is not possible to detect the fertilized egg, the analysis for hCG conception does not confirm the fact, but the transformation of the reproductive organ has occurred. In this case, all attention is paid to the condition of the mucous membranes of the uterus. It is possible that there was a spontaneous abortion, and it is extremely important to immediately identify the cause of the miscarriage. A similar clinical picture is observed after abortion. After a while, the endometrium will return to normal. This is the natural reaction of the uterine layer to the attachment of the ovum.

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Causes of decidualization

As mentioned above, the decidual tissue is an absolutely normal reaction of a healthy organism to conception. However, in rare cases, gravity endometrial cells are found in non-pregnant women. To find out whether this condition is a pathology, you need to know about the true causes of decidualization.

Regardless of whether the woman is planning a child and whether she has sex, immediately after ovulation, the body begins to prepare for a possible pregnancy. Preparation manifests itself in increased secretion of progesterone.

If conception occurs, the level of progesterone will continue to rise, and in the case of menstruation - will drop sharply. But if a woman takes a synthetic hormone, then the body can "be deceived" and decide that the conception has happened.

As a result, the stromal tissues of the endometrium of the non-pregnant uterus may begin to degenerate into gravidary. It is progesterone that helps intensify the process of vascularization. Due to the expanded vascular grid, the lining of the tissue becomes soft enough for successful implantation.

Why do you need gravid endometrium?

Pregnant women should not worry about the presence of decidual tissue: this means that the body is prepared to bear the child. In addition, an increased white blood cell count prevents the rejection of the embryo.

Since the fertilized egg contains the DNA of the father of the child, there is a risk that the body will perceive the fertilized egg as a hostile foreign body. It is decidual leukocytes that suppress the mother’s negative immune response to a cell with foreign DNA.

How is the decidualization process?

The decidualisation process begins in the first days after fertilization of the egg. The newly formed tissue is characterized by an increase in vascularization and the presence of a large number of polygonal and white blood cells (leukocytes).

Vascularization (the process of active proliferation of blood vessels) is the most significant change that can be easily detected using ultrasound.

Initially, thin endometrial arterioles undergo the process of endothelial proliferation (the walls of blood vessels thicken considerably, and the circulatory grid itself grows).

It is the arterioles that play the decisive role in the process of normal decidualization: without a sufficient amount of arterial blood, the endometrium cannot be reborn.

Important! In a healthy woman, the decidual endometrium cannot be focal, but must line the entire internal cavity of the uterus.

Conventionally, the decidualization process goes through the following stages:

  • After the implantation process begins (at the place of attachment of the fertilized egg), functional and morphological changes begin,
  • Измененные клетки посылают сигнал для начала изменения окружающих тканей,
  • Происходит накопление гликогена в тканях матки,
  • Primary “anchor” villi are formed, ensuring normal fixation of the zygote to the uterine wall.

The process of complete transformation of all endometrial stromal cells into decidual cells is completed in about 8-10 days.

Necrosis of the decidual tissue

Necrosis (or death) of the decidual tissue is an absolutely normal reaction of the body to the termination of pregnancy. In essence, this is the return of the endometrium to its normal state. Decidual necrosis usually develops after an abortion. Less commonly, dying off can be triggered by inflammatory infiltration.

If the dead tissue of the gravidary endometrium was detected during a routine cytological examination of a smear of a non-pregnant woman, it is recommended to urgently revise the dosage of oral contraceptives.

Contraceptive pills have a progestogenic effect on the endometrium, provoking the proliferation of the glandular membrane and stromal edema, followed by decidualization.

If the pathology is ignored, progressive atrophy of the lining of the uterus may develop. As a treatment, gonadotropin-releasing hormone agonists and estrogen-progesterone drugs are prescribed.

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