No 6 (2009)

The review gives data on the role of insulin resistance in the pathogenesis of various abnormalities (type 2 diabetes mellitus, arterial hypertension, atherosclerosis, obesity, gestational diabetes, etc.). It also discusses an association of the immunological link of insulin resistance regulation with the development of pregnancy and gestational complications. A role of tumor necrosis factor-б and insulin-like growth factor-binding protein is noted.

The review gives the data available in the literature on the use of xenon in anesthesiological care, including in obstetrics and gynecology. It considers the basic properties of the agent and its effect on different human systems of the body.

The objective of the study was to optimize lymphocyte immunotherapy (LIT) and to evaluate its efficiency in patients with habitual pregnancy loss of alloimmune genesis during their preparation for pregnancy and in its first trimester. The study was conducted in 64 women of reproductive age, of them 26 patients received LIT in amount of 50 million cells, 18 patients and 20 had LIT in amount of 100 million and 150 million cells, respectively. There were reductions in the level of CD3-56+16+ cells and CD4/CD8 cell ratio, increases in the levels of CD8+ cells and IgM, a decrease in the response of female lymphocytes to phytohemagglutinin, and rises in the levels of blocking factors and antiparental antileukocyte antibodies. The use of 100 million and 150 million cells has been found to be most effective in the preparation of married couples with habitual early pregnancy losses of alloimmune genesis for pregnancy. This makes it possible to increase the level of blocking factors and the generation of antiparental antibodies and to reduce the level of natural killer (CD3-56+16+) cells in peripheral blood.

The purpose of the investigation was to study nitric oxide (NO) in the genesis of preeclampsia (PE). Seventy-five pregnant women with preeclampsia, 23 with hypertensive disease, and 20 healthy pregnant women were examined. 24-hour blood pressure (BP) monitoring and an endothelium-dependent vasodilatation (EDVD) test were made; the levels of NO and dinitrazole complexes were determined. Inadequate NO release was ascertained to be one of the known causes of endothelial dysfunction. The ability of plasma to transfer NO becomes lower in preeclampsia, but it does not depend on its severity. NO release in the organs of pregnant animals with and without preeclampsia shows a circadian rhythm linked to diurnal BP variations and the decrease in the tissue content of NO in preeclamptic animals, as compared with healthy pregnant animals, points to the presence of vascular endothelial dysfunction. The correction of endothelial dysfunction is present in the spectrum of the pharmacological effects of nebivalol restoring an increment in the diameter of the brachial artery from 8.6 to 14.3% and the Ca antagonists nifedipine and amlodinine which increase the increment of EDVD to 12.4%.

Twenty-eight pregnant women with uterine myoma at 6 to 26 weeks gestational age were examined. The performed conservative myomectomy could preserve desired pregnancy in 24 women. Pregnancy was interrupted in 4 patients 12-22 days postoperatively at 11-25 weeks gestational age. No severe intra- and postoperative complications were observed. All the 24 women with preserved pregnancy carried it to term, which resulted in cesarean delivery. was made by cesarean delivery. Surgical intervention (conservative myomectomy) in pregnant women with uterine myoma is the last reserve of preserving the desired pregnancy. It should be based on clear and strict indications and performed in a highly specialized institution that has much experience in making such operations.

Three hundred and fifty-one elderly and senile patients were operated on for benign ovarian neoplasms. Laparoscopic and laparotomic accesses were used in 168 and 183 patients, respectively. Less traumaticity and shorter intervention and better postoperative period were observed in women who had undergone laparoscopy.

The thyrotropic-thyroid system was studied in full-term neonatal infants after physiological and complicated pregnancy. In mothers and neonates, the levels of thyroid-stimulating hormone, T3 and T4 were measured. The study was conducted in mothers with uncomplicated pregnancy (n = 94), varying gestosis (n = 76), hypothalamic syndrome (n = 60), and thyroid disease (n = 59). The findings suggest that the birth thyrotropic-thyroid system in full-term neonates after physiological and complicated pregnancy is functionally independent and ready to function in postnatality. However, maternal gestosis and endocrine pathology make some alterations in the formation of the thyrotropic-thyroid system in antenatality.

One hundred and twenty-four 12-to-18-year-old girls with uterine bleedings were examined. Strong family histories and perinatal complications were found. Examinations revealed a hyperestrogenic morphotype in 74% of cases and endometrial hyperplasia in 82%. In 64% of the teenagers, hypothalamo-pituitary-ovarian dysfunction was identified from EEG data and the levels of gonadotropic and sex hormones. Three-step therapy for uterine bleeding has been developed for pubertal girls.

Thirty-one women with lower genital infectious and inflammatory processes caused by mixed urogenital infection were examined. All the patients had varying clinical manifestations. The presence of pathogenic and/or opportunistic microorganisms in the clinically significant titers was verified in laboratory studies. The findings suggest that Safocid is highly effective.

In Russia, 54% of the population has overweight or obesity. Anovulatory infertility and menstrual dysfunction are common symptoms accompanying obesity in women. There has been recently growing interest in the concept of quality of life (QL) among physicians, including obstetricians and gynecologists. The paper presents the data of studying the time course of changes in QL indicators in women with obesity and anovulatory infertility when treating these diseases.