Vol 63, No 2 (2014)

The aim of this study was to evaluate the efficacy of an agonist of gonadotropin-releasing hormone Buserilin in the treatment of patients with endometriosis in combination with endometrial hyperplasia. We conducted a clinical and laboratory examination and treatment of 108 patients aged 41 to 52 years old suffering from endometriosis varying degrees of prevalence in conjunction with endometrial hyperplasia. The results obtained suggest a scientifically sound complex treatment of patients with endometriosis on the background of endometrial hyperplasia with a GnRH agonist Buserilin-depo in the postoperative period, followed by the appointment of progestogens or combiened oral contraceptives as a long-term program management of patients to prevent relapse and re-operative treatment.

Obstetric haemorrhage remains a main cause of maternal morbidity and mortality. A hospital-based, individually randomized controlled study was proposed. 1095 women delivering vaginally in Kemerovo Perinatal Center were examined. Absence of controlled cord tractions hasn’t significant effect on amount of blood loss in the III stage, and frequency of PPH, in usage of additional uterotonics, postpartum hemoglobin levels, frequency of manual removal of placenta.

Purpose and tasks: to establish new prognostic criteria of date of prolongation of pregnancy with premature discharge of amniotic fluid on the basis of performance monitoring of cell immunity of mother in the dynamics of observation and the child at the time of completion childbirth. Material and methods. A clinical and laboratory examination of 50 pregnant women, the pregnancy of women was complicated by premature rupture of membranes at 22-34 weeks of gestation. The control group consisted of 40 women with normal pregnancy with the same time of gestation. The traditional methods of clinical and laboratory examination were used to assess the status of pregnant women. The study of peripheral blood was performed with hematological analyzer BC- 3000+. Subpopulations of peripheral blood lymphocytes was studied by cytometry using monoclonal antibodies (apparatus «FAC SCalibur» company «BectonDickinson», USA). Results. The development of leukocytosis with absolute and relative lymphopenia, reduction of CD16+56+lymphocytes and CD19 B lymphocytes were revealed in pregnant women with premature rupture of membranes. The failure of proliferative activity CD3+4+ T-helper cells, the increase of level of CD3+8+ cytotoxic T lymphocytes were revealed at the time of onset of labor after the prolongation of pregnancy. Prolongation of pregnancy at patients with premature rupture of membranes combined with the development of leukocytosis in the fetus, as well as the mother in the same period of observation. At the same time, unlike the parent organism, activation of B-lymphocyte proliferation and humoral immunity at fetus were occurred.

Tobacco is an urgent problem in Russia and in the world. Recent years have seen increased prevalence of smoking among the population. Tobacco dependence is included in the international classification of diseases, the American Psychiatric Association. From habit associated increase in the frequency of chronic diseases, mortality. In Russia smokes about 30 % of women and half of them continue to smoke during pregnancy. Proved that chronic nicotine intoxication has a negative effect on the pregnancy and fetus, worsens perinatal outcomes. It is also known that when tobacco smoking increases the level of homocysteine in the body, which in turn have toxic effects on vasculature. With many gestational hyperhomocysteinemia associated complications (gestoses, placental insufficiency, miscarriage and other). Already, there are methods of prevention and treatment of hyperhomocysteinemia. However, studies on folate metabolism in pregnant smoking a little. No clear approaches to the maintenance and inspection of this group of patients. I would like to draw attention to the state of folate metabolism in pregnant women with nicotine intoxication, reveal features of pregnancy, methods of prevention and treatment of gestational complications.

This review summarizes many of the published reports about the mechanisms of melatonin production and it’s role during pregnancy and labor. Melatonin seems to be of particular importance for the maintenance of the optimal course of pregnancy and fetus development. Sinergized actions of melatonin and oxytocin during labor were demonstrated. The individual prescription during labor pharmacological preparations which are physiological antagonists for melatonin is accentuated.

This article is dedicated to the surgeon A. A. Keeter (1813 -1879). He was one of the prominent students of N. I. Pirogov. He made a significant contribution to the science and clinical medicine. A. A. Keeter popularized new surgical techniques in gynecology and was the head of the first gynecological clinic in Russia. This clinic was opened in 1842 in Saint Petersburg State Medical Surgical Academy. He published the first detailed manual “Gynecologic diseases guidelines” in 1858. Moreover A.A. Keeter was the first surgeon in Russia who performed vaginal hysterectomy with successful result. Keeter was an outstanding scientist and founder of Russian surgical school.