Vol 63, No 5 (2014)

Analysis of ABCB4 gene in young women with cholelithiasis and relative story of gallstone disease was performed by NGS sequencing. The discovered “risk alleles” of this gene and their adverse haplotypes testify to ABCB4 participation in the development of cholelithiasis.

Aim. The aim of this study was to evaluate changes of vaginal microbiocenosis composition of pregnant women in first trimester after irrigation of the vagina with cavitated 0.05% solution of chlorhexidine and to find out if the following dotation of Lactobacillus spp. was needed. Materials and methods. 104 women planning induced termination of pregnancy in first trimester by vacuum aspiration were examined in order to estimate efficiency of vaginal microbiocenosis correction using irrigation of the vagina with cavitated 0.05% solution of chlorhexidine and to find out if the following dotation of Lactobacillus spp. was needed. All women had undergown irrigation of vagina and exocervix with 0.05% solution of chlorhexidine in order to prepare them for surgical abortion. Vaginal microbiocenosis before and after this procedure was evaluated by microscopy and real-time PCR (test Femoflor-16, DNA-Technology LLC, Moscow). Results. It was established that in patients with normocenosis the amount of Lactobacillus spp. decreased accordingly to the decrease of general bacterial load in the vagina at that the proportion of Lactobacillus spp. in microbiota stayed almost the same and was more than 90% in all examined women. In women with dysbiosis the decrease of general bacterial load in the vagina after irrigation with cavitated 0.05% solution of chlorhexidine happens mostly due to absolute and relative content of opportunistic microflora in microbiome. However initially low level of Lactobacillus does not allow reaching their optimal level after the first treatment stage. In these cases, the necessity of dotation of Lactobacillus spp. on the second stage of treatment is practically assured. Conclusions. The data demonstrated safety of use cavitated 0.05% solution of chlorhexidine for irrigation of the vagina in first trimester of pregnancy, that allow apply the method for prevention of infected complications before invasive procedure independently of primary composition of vaginal microbiota. Also this method demonstrated high effectiveness as approach for treatment of vaginal dysbiosis. However the continuing deficiency of lactobacilli requires their dotation on following stage.

The aim of our research was to identify clinical, morphological features of chronic endometritis among women of reproductive age with a hysteromyoma. 150 patients of reproductive age were surveyed. After which women were divided into three groups. The first group consisted of women at whom the hysteromyoma was combined with a chronic endometritis. The second group - chronic endometritis without hysteromyoma. The third group consisted of apparently healthy women who have addressed to the doctor with questions of contraception and pregnancy planning. It is established that the clinical and morphological picture of a chronic endometritis doesn’t depend on existence at such women of a hysteromyoma. At the women surveyed in both the first and second group almost equally often found inflammatory diseases of the pelvic organs, the bottom department of the genitals, hyperplastic process of endometrium, abnormal uterine bleeding. Special difference in activity of inflammatory process in an endometriya depending on the availability at these women hysteromyoma is not revealed. The combination of chronic endometritis with hysteromyoma is more common for women of late reproductive age, in the anamnesis whicht had childbirth, induced abortion.

The Background: Antimicrobial peptides are first line of defense for mucosa against viruses, bacteria, protozoa and fungi. Meanwhile, expression of antimicrobial peptides in postpartum period has not been studied. Objective: To estimate the expression of mRNA of antimicrobial peptides in epithelium of the cervix uteri after caesarean section and vaginal birth 3 or 4 days after delivery. Materials and methods: The data-sample consisted of 17 women after caesarean section and 46 women after vaginal delivery examined on days 3 or 4 of postpartum period. Quantitative reverse transcription PCR method was used to study mRNA expression of antimicrobial peptides. Statistical analysis was performed using Mann-Whitney criteria. Results: It was shown that higher level of expression of SLPI, HNP3, HD6 and HBD4 in the endocervix was present in women who delivered via caesarean section compared with those who had vaginal delivery. Conclusion: Women who underwent caesarean section exhibited increased expression of antimicrobial peptides compared to those who had vaginal birth. This increased expression can be attributed to multiple reasons such as differences in vaginal microflora restoration, different changes in hormone levels and also due to surgical trauma after operative delivery. The use of antimicrobial peptides can give new opportunities for prophylaxis and treatment of septic complications that occur in postpartum period.

Antimicrobial peptides (AMP) are cationic peptides of innate immune system with antiviral, antibacterial and antiprotozoal activity. AMP act as immunomodulators, promote bacterial opsonization, inhibit proteases activity, have anti-endotoxic and angiogenic effect. The review describes main types of AMPs, features of their expression in female reproductive tract depending from menstrual cycle and during pregnancy. Data about the role of AMPs in defending from sexually transmitted infections (HIV, genital herpes, HPV, gonorrhea), in pathogenesis of extrauterine pregnancy and preterm birth are described. Possibility of practical application of AMPs as alternative to antibiotics and as contraceptives is estimated.

This review presents the existing literature concerning repeated implantation failure in assisted reproductive technologies. There are also discussed the role of immune pathology in the occurrence of repeated implantation failure in assisted reproductive treatment and the prospects of improving implantation rates with intravenous immunoglobulin in women with different immune pathologies.