ARCHIVEOBSTETRICS AND GYNECOLOGY
ASSESSMENT OF THE EFFECTIVENESS OF ISTHMIC CERVICAL INCOMPETENCE CORRECTION WITH LASER DOPPLER FLOWMETRY
Kharkiv National Medical University, Ukraine
Cervical incompetence (CIN) is due to a pathological condition of the cervix. We developed a new method of correction of pregravid CIN consisting in the use of fillers, the main component of which is hyaluronic acid. To evaluate the effectiveness of various methods of correction of CIN we used a new method, Laser Doppler Flowmetry (LDF) technique based on non−invasive determination of blood perfusion of the tissue by measuring the Doppler shift that occurs when probing with the laser beam of red blood cells moving in the microvasculature. The study involved 90 patients who were divided into study and control groups. The control group consisted of 30 healthy women without abnormalities in the female reproductive system and history of miscarriage. The main group consisted of 60 women with the history of CIN. The analysis of the microvasculature with LDF in group 1 showed significant deterioration of microcirculation, possibly due to vasospastic effect in the area of the cervix. Group 2 also showed an increase in microcirculatory blood flow after the initial microvascular spasm. Obviously, these effects can be explained by the irritating action of the vaginal pessary on the cervical mucosa. In patients of group 3, after use of fillers based on hyaluronic acid, the microvasculature changes (expressed vasospasm) quickly returned to a normal level, corresponding the control group of patients. Thus, LDF allows to evaluate the processes of tissue perfusion by the blood, which is especially important in assessing the effectiveness and differentiated selection of therapy. Therapy using fillers does not violate the functional state of the microvasculature of the cervix, reduces the risk of complications after correction of CIN.
Key words: laser Doppler flowmetry, isthmic cervical incompetence, diagnosis of effectiveness of therapy, fillers.