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No 5 (2010)

Articles

PERSPECTIVES FOR THE FORMATION OF NATIONAL LEGISLATION IN REPRODUCTIVEHEALTH IN THE RUSSIAN FEDERATION

sukhikh G.T., YuSUPOVA A.N., PAVLOVA Y.V., EROFEEVA L.V., Sukhikh G.T., Yusupova A.N., Pavlova Y.V., Yerofeyeva L.V.

Abstract

Репродуктивное здоровье является фактором, который формирует благоприятную демографическую перспективу страны. Концепция демографической политики Российской Федерации на период до 2025 года, утвержденная Указом Президента № 1351 от 09.10.2007, ставит одной из задач «укреплениерепродуктивного здоровья населения». Однако национальным законодательством не обеспечены в полной мере условия и возможности для сохранения репродуктивного здоровья населения. Поэтому особое место занимает формирование нормативной базы, регламентирующей сферу охраны репродуктивного здоровья граждан в РФ. Представляется необходимым установить в Законе «Об охране репродуктивного здоровья населения» основные принципы осуществления гражданами права на применение методов вспомогательных репродуктивных технологий, т.к. данное право является составной частью репродуктивных прав человека, реализуемых в целях охраны репродуктивного здоровья и лечения бесплодия. Нормативное закрепление права на охрану репродуктивного здоровья дало бы возможность получения целевого финансирования учреждений, оказывающих услуги по охране репродуктивного здоровья, создания сети центров по планированию семьи, укрепления базы подготовки специалистов в данной сфере, проведения научных исследований для создания соответствующих лекарственных средств.
Obstetrics and Gynecology. 2010;(5):3-5
pages 3-5 views

CLINICAL AND PHYSIOLOGICAL FEATURES OF THE DEVELOPMENT OF NEUROLOGICAL COMPLICATIONS OF ECLAMPSIA: A SYSTEMATIC OVERVIEW

ShIFMAN E.M., tikhova g.p., floka s.e., Shifman Y.M., Tikhova G.P., Floka S.Y.

Abstract

The cases of neurological complications of eclampsia, published in English-language medical journals in 1980 to 2008, are analyzed. The frequency characteristics of a sample of physiological and obstetric indicators are defined in patients with neurological complications of eclampsia; the specific features of frequency distributions of these indicators are revealed. The results of the study may suggest that the frequency of neurological complications of eclampsia is inversely related to age. The likelihood that a combination of young age and second labor confers the highest risk for neurological complications of eclampsia is high. The vast majority of women with neurological complications due to eclampsia have elevated diastolic blood pressure; however, the frequency distribution of systolic pressure does not give the same clear account. The analysis of the combined sample of cases of eclampsia with neurological complications permitted the areas and problems to be set off for such further investigations of this pathology.
Obstetrics and Gynecology. 2010;(5):6-14
pages 6-14 views

PLACENTAL MESENCHYMAL DYSPLASIA

PAVLOV K.A., DUBOVA E.A., ShchEGOLEV A.I., Pavlov K.A., Dubova E.A., Shchegolev A.I.

Abstract

The review gives information on a relatively rare anomaly of the placenta - its mesenchymal dysplasia. Placental mesenchymal dysplasia is concurrent with the Beckwith-Wiedemann syndrome in many cases. It is frequently misdiagnosed as hydatidiform mole because they have similar clinical and ultrasound signs and macroscopic pattern.
Obstetrics and Gynecology. 2010;(5):15-20
pages 15-20 views

MECHANICAL METHODS FOR PREVENTION OF THROMBOEMBOLIC COMPLICATIONSIN OBSTETRIC AND GYNECOLOGY

MURAShKO A.V., Murashko A.V.

Abstract

The review describes the efficiency of using the mechanical methods to prevent thromboembolic complications after surgical delivery via cesarean section.
Obstetrics and Gynecology. 2010;(5):21-24
pages 21-24 views

THE OVARIAN RESERVE IN SOME FORMS OF FUNCTIONAL INFERTILITY

ZhORDANIDZE D.O., NAZARENKO T.A., DURINYaN E.R., IVANETs T.Y., Zhordanidze D.O., Nazarenko T.A., Durinyan E.R., Ivanets T.Y.

Abstract

The paper presents the data available in the literature dealing with the studies of the ovarian reserve in some forms of reproductive dysfunction conducted in the past 10-15 years. It describes the status of the ovaries in patients with polycystic ovary syndrome, endometriosis, and idiopathic infertility.
Obstetrics and Gynecology. 2010;(5):25-31
pages 25-31 views

PRINTsIPY KOMPLEKSNOY OTsENKI I PODGOTOVKI ENDOMETRIYa U PATsIENTOK PROGRAMM VSPOMOGATEL'NYKh REPRODUKTIVNYKh TEKhNOLOGIY

KUZ'MIChEV L.N., SMOL'NIKOVA V.Y., KALININA E.A., DYuZhEVA E.V., Kuzmichev L.N., Smolnikova V.Y., Kalinina Y.A., Dyuzheva Y.V.

Abstract

The paper reviews the data available in the literature on the evaluation of the morphofunctional parameters and preparation of the endometrium in assisted reproductive technology programs. It considers noninvasive (ultrasonography, magnetic resonance imaging) and invasive (hysteroscopy, endometrial biopsy) techniques for the diagnosis of intrauterine pathology. Particular emphasis is placed on the parameters of endometrial receptivity assessment by an immunohistochemical study. A comprehensive approach, an important role in which is played by physical factors, to treating various abnormalities leading to endometrial deficiency is defined.
Obstetrics and Gynecology. 2010;(5):32-36
pages 32-36 views

PRESENT VIEWS OF THE PATHOGENESIS OF OVERACTIVE BLADDER

APOLIKhINA I.A., MUSLIMOVA S.Z., MAKhMEDZhANOVA F.N., Apolikhina I.A., Muslimova S.Z., Makhmedzhanova F.N.

Abstract

According to the data of large-scale epidemiological surveys conducted in European countries and the USA, the prevalence of overactive bladder (HB) averages 16-17%. The paper gives the main hypothesis for the causes of HB: an autonomous urinary bladder hypothesis, a myogenic hypothesis, and a neurogenic hypothesis. All three theories envisage that nervous degeneration is a common mechanism responsible for the development of HB, which points to the most important role of the nervous system in controlling the accumulating function of the bladder. This is confirmed by the data of recent studies, which suggest that there is an association between the symptoms of HB and the urinary level of nerve growth factor and its quantitative change during therapy with antimuscarinic agents and botulinum toxin A.
Obstetrics and Gynecology. 2010;(5):37-41
pages 37-41 views

THE THERAPEUTIC AND DIAGNOSTIC MANAGEMENT OF PREGNANT WOMEN WITH ARTERIAL HYPERTENSION IN RUSSIA: DIAGNOSIS AND CLASSIFICATION (RESULTS OF THE DIALOG II MULTICENTER EPIDEMIOLOGICAL STUDY)

OGANOV R.G., TKAChEVA O.N., Oganov R.G., Tkacheva O.N.

Abstract

The DIALOGUE II multicenter epidemiological study was conducted in 27 cities and towns of Russia; 2033 physicians managing pregnant women with arterial hypertension (AH) were interviewed by a questionnaire. Used terminology, diagnostic criteria, and a range of laboratory tests employed to specify the diagnosis of AH and to monitor the status of pregnant women with this condition were analyzed. The study has indicated that routine clinical practice does not properly use the generally accepted diagnostic criteria and uniform principles in the diagnosis of AH in pregnant women or a number of required laboratory tests.
Obstetrics and Gynecology. 2010;(5):42-48
pages 42-48 views

HEALTH OF BABIES BORN AFTER IN VITRO FERTILIZATION

SAVEL'EVA G.M., KURTsER M.A., KARAChUNSKAYa E.M., MLADOVA M.E., DRONOVA M.A., BUSLAEVA G.N., Savelyeva G.M., Kurtser M.A., Karachunskaya Y.M., Mladova M.Y., Dronova M.A., Buslayeva G.N.

Abstract

In the period 2004 to 2008, the authors studied the outcomes of 5386 labors after in vitro fertilization (IVF) at the Moscow maternity homes, Healthcare Department, of them 1726 labors at the Center of Family Planning and Reproduction (CFPR); 157 labors after controlled ovulation stimulation. The health status of 517 babies born at the CFPR in 2008was analyzed. That of 63 babies aged 1 year, who were treated at an intensive care unit after birth, was evaluated. The data available in the literature on higher perinatal mortality and perinatal morbidity rates in babies after IVF have been confirmed, which is largely determined by an increase in the incidence of multiple pregnancy by 15 times and preterm labor by more than 3 times as compared with that during spontaneous pregnancy. In premature babies, morbidity rates are 926.6 and 474,1%oo, respectively. After IVF, congenital malformations occur more frequently (6.6 versus 5,27%); there are no differences in chromosomal abnormality rates (0,28and 0,23%).
Obstetrics and Gynecology. 2010;(5):49-54
pages 49-54 views

PARTURIENT TRAUMAS AND FEMALE REPRODUCTIVE HEALTH

SELIKhOVA M.S., KOTOVSKAYa M.V., KUGUTOVA L.N., Selikhova M.S., Kotovskaya M.V., Kugutova L.N.

Abstract

In Russia, every 5 labors are now accompanied by soft tissue injuries in the generative passages. The high rates of episiotomy persist the rate of which does not tend to decrease. Traditional suture treatments fail to ensure adequate healing. The puerperium was comparatively analyzed when various suture treatment modes were applied: the sutures were traditionally treated in 47 patients; the novel Russian agent depantol as vaginal suppositories was used in 60 parturients with soft tissue injuries in the generative passages in the postpartum period. The results of the studies suggest that incorporation of depantol into a package of prophylactic measures to manage parturients with soft tissue injuries in the parturient canal causes a reduction in infectious complications and provides a better postpartum period.
Obstetrics and Gynecology. 2010;(5):55-58
pages 55-58 views

TREATMENT FOR ACUTE VULVOVAGINAL CANDIDIASIS: CURRENT TRENDS

SAVIChEVA A.M., Savicheva A.M.

Abstract

The paper deals with the present views of the etiology, pathogenesis, clinical picture, and treatments of acute vulvovaginal candidiasis (AVC). It gives data on the efficiency and safety of various AVC treatment regimens. The study conducted at the D. O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch (Saint Petersburg), has shown that livarol and sertaconazole vaginal suppositories are highly effective in treating AVC in nonpregnant women. The patients have been found to be highly loyal to the use of livarol due to its rapid abolition of the symptoms of Candida vaginitis and their adherence to its course therapy.
Obstetrics and Gynecology. 2010;(5):59-62
pages 59-62 views

OPYT ISPOL'ZOVANIYa MODIFITsIROVANNYKh SKhEM STIMULYaTsII YaIChNIKOV DLYa PREDOTVRAShchENIYa SINDROMA GIPERSTIMULYaTsII YaIChNIKOV V PROGRAMMAKh VSPOMOGATEL'NYKh REPRODUKTIVNYKh TEKhNOLOGIY

NAZARENKO T.A., DMITRIEV D.V., MAMEDOVA N.R., DURINYaN E.R., Nazarenko T.A., Dmitriyev D.V., Mamedova N.R., Durinyan E.R.

Abstract

Необходимость сочетать эффективность лечения методами ВРТ с его безопасностью не вызывает сомнения. В ряде случаев попытки снизить риск развития синдрома гиперстимуляции яичников (СГЯ) могут приводить к неэффективным циклам лечения. В работе проведен анализ эффективности и безопасности некоторых модифицированных схем стимуляции яичников. Показано, что развитие СГЯ определяется исходными характеристиками пациенток и использование «стандартных» протоколов стимуляции - «длинного» и с антагонистами гонадолиберина в равной степени может приводить к формированию данного синдрома у пациенток группы риска. Отсроченное на 48 ч и более от момента последнего введения гонадотропина назначение триггера овуляции не оптимизирует результаты лечения. При этом отсутствуют достоверные различия в частоте развития СГЯ. Замена триггера овуляции человеческого хорионического гонадотропина на агонист гонадолиберина не представляется целесообразной: хотя СГЯ у пациенток исследуемых групп не развился, беременность также не наступила.
Obstetrics and Gynecology. 2010;(5):63-67
pages 63-67 views

ASSESSMENT OF THE ACROSOME REACTION IN THE DIAGNOSIS OF INFERTILITY

NIKOLAEVA M.A., GOLUBEVA E.L., UShAKOVA I.V., VAN'KO L.V., BOZhEDOMOV V.A., SUKhIKh G.T., Nikolaeva M.A., Golubeva Y.L., Ushakova I.V., Vanko L.V., Bozhedomov V.A., Sukhikh G.T.

Abstract

Flow cytometric analysis of the sperm acrosome reaction enables one to effectively diagnose infertility caused by sperm dysfunctions in the presence of normal spermogram readings.
Obstetrics and Gynecology. 2010;(5):68-72
pages 68-72 views

MASTOPATHY: A GYNECOLOGIST'S NEW VIEW OF POINT OF THE OLD PROBLEM

PEKAREV O.G., VASIL'EV A.N., POPOVA S.P., PEKAREVA E.O., Pekarev O.G., Vasilyev A.N., Popova S.P., Pekareva Y.O.

Abstract

The paper gives the comparative results of a follow-up of 60 women with mastopathy. It shows the efficacy of a microdose monophasic gestodene-containing combined oral contraceptive used as a prolonged 63/7 regimen. The agent is safe, effective, and expedient in patients with diffuse fibrocystic breast disease. Clinical improvement could be achieved in 90% of cases just 6 months after the agent administration.
Obstetrics and Gynecology. 2010;(5):73-78
pages 73-78 views

PATHOGENETIC RATIONALE FOR IMMUNOMODULATORY THERAPY OF EXTERNAL GENITAL ENDOMETRIOSIS

YaRMOLINSKAYa M.I., SEL'KOV S.A., Yarmolinskaya M.I., Selkov S.A.

Abstract

The purpose of the investigation was to study the antiproliferative components of the immune system in patients with external genital endometriosis (EGE) and to develop pathogenetically warranted immunomodulatory therapy. The investigation was conducted at the D. O. Ott Research Institute of Obstetrics and Gynecology, North-Western Branch, Russian Academy of Medical Sciences (Saint Petersburg). The cytotoxic activity of natural killer (NK) cells and the parameters of the interferon (IFN) status in peripheral blood (PB) and peritoneal fluid (PF) were studied in relation to the extent of the disease. NK cell cytotoxicity index was determined by a cytotoxic test using as targets human erythromyeloid K-562 cells containing tritium-labeled uridine. The parameters of the IFN status in PB were estimated by a bioassay using as a test culture lung carcinoma L-41 cell lines susceptive to vesicular stomatitis virus. Induction of IFN-a/в by PB leukocytes was carried out by Newcastle disease virus; IFN-y production was induced by phytohemagglutinin or staphylococcal enterotoxin. The significant reduction was found in the cytotoxic activity of NK cells in PB and PF, which was negatively correlated with the extent of the disease (r=-0.46; p < 0.01). Analysis of the parameters of the IFN status in patients with EGE revealed higher total serum IFN levels than those in the control group; there was a significant decrease in the ability of PB leukocytes to produce IFN-a/в and IFN-y, which was most evident in grade IV EGE (the capacity for IFN-a/в production in EGE was 84.2±7.8 IU/ml; that in the control was 288.3+18.7 IU/ml; p < 0.001); the capacity for IFN-y secretion was 21.3+1.6 and 172.6+8.6 IU/ ml, respectively; p < 0.001). Immunomodulatory therapy is pathogenetically warranted by the obtained results. The use of an acridone IFN inductor was ascertained to cause a significant increase in NK cell cytotoxic activity and a rise in the ability of PB leukocytes to produce IFN-a/в and IFN-y. The stimulation coefficient that reflected an increment in the capacity of lymphoid cells for IFN production was highest in grades I and II genital endometriosis for IFN-a/в (256.2+21.7 and 89.2+6.8%, respectively) and in grades III and IV for IFN-y (47.6+4.2 and 396.5+33.2%, respectively).
Obstetrics and Gynecology. 2010;(5):79-83
pages 79-83 views

REGIONAL ASPECTS OF PERINATAL MORTALITY

FROLOVA O.G., GUDIMOVA V.V., SALAMADINA G.E., YuSUPOVA A.N., Frolova O.G., Gudimova V.V., Salamadina G.Y., Yusupova A.N.

Abstract

The paper presents the results of studying the regional aspects of perinatal mortality from its rates and causes as a basis for elaborating measures to reduce perinatal losses. The 2007-2008 official statistical data of the Russian Federation (RF) and its areas were the material of the study. Its method was to divide an aggregate of areas by death rates, by applying the percentile distribution. The findings indicated that perinatal mortality rates were as high as 7,2% in 26,5% of the RF areas, 10,0% in 57,8%, 12,8% in 14,5%, and 15,6% in one area. Area distribution data were also obtained from the death rates by the federal districts. The perinatal mortality of as high as 7,2% was recorded in 11,1% of the areas of the Far Eastern Federal District (FEFD) and in 66,7% of those of the Ural Federal District (UFD). The perinatal mortality of as high as 10,0% was observed in 33,3% of the areas of UFD and in 72,2% of those of the Central Federal District (CFD), in 71,4% of those of the Volga Federal District, and in 66,7% of those of FEED. The number of third-level areas (with the perinatal mortality of as high as 12,8%) was smaller: 16,7% in CFD, 23,1% in the South Federal District, and 22,2% in FEED. Each of the other districts had one area with this death rate; this was not notified in CFD. The trend in the causes of perinatal death in the fetus and mother and their specif ic features are given in relation to the rate. When elaborating the measures to reduce perinatal mortality, one should use experience in organizing obstetric and neonatal services of the areas with the low rate achieved, by decreasing the proportion of causes, such as birth injury, birth asphyxia, and congenital malformations.
Obstetrics and Gynecology. 2010;(5):84-87
pages 84-87 views

INTERNATIONAL EXPERIENCE AND ANALYSIS OF VARIOUS ORGANIZATIONAL MODELS OF CARE DURING DELIVERY AND NURSING OF EXTREMELY LOW BIRTH WEIGHT INFANTS

SOROKINA Z.K., Sorokina Z.K.

Abstract

Various organizational, normative and ethic approaches to delivery, resuscitation, and nursing of extremely low birth weight neonates are comparatively analyzed, by taking into account the prognosis of their later development and social adaptation. The indicators that determine the mode and possible scope of perinatal care are given with correction for each week of gestation. The paper provides the current prognosis-oriented practice-based medical care standards that have been developed and introduced in a number of countries for medical care delivered during delivery, resuscitation, and intensive care in extremely preterm gestation.
Obstetrics and Gynecology. 2010;(5):88-93
pages 88-93 views

A NEW WORD IN THE PHARMACOTHERAPY AND PREVENTION OF PLACENTAL INSUFFICIENCY UNDER THREAT OF PRETERM LABOR

STEPANYaN A.V., DZhOBAVA E.M., ARTIZANOVA D.P., SUDAKOVA G.Y., LYuBANSKAYa S.V., ESKIS P.M., PANAYOTIDI D.A., DOBROKhOTOVA Y.E., Stepanyan A.V., Dzhobava E.M., Artizanova D.P., Sudakova G.Y., Lyubanskaya S.V., Eskis P.M., Panaiotidi D.A., Dobrokhotova Y.E.

Abstract

The course of pregnancy and the outcomes of labor were prospectively analyzed in 45 pregnant women with placental insufficiency under threat of preterm labor. Different aspects of complex therapy for pregnancy complications are considered; ways of enhancing the efficiency of therapy and feasibilities for its monitoring are proposed.
Obstetrics and Gynecology. 2010;(5):94-97
pages 94-97 views

ALTERNATIVE TREATMENT FOR CLIMACTERIC SYNDROME

TsVETKOVA T.P., SMIRNOVA L.V., Tsvetkova T.P., Smirnova L.V.

Abstract

The paper considers the prevalence, diagnosis, and treatments of climacteric syndrome. It gives the results of an open-labeled comparative study of the eff iciency and safety of sagenit tablets 0.1 g used to treat patients with severe climacteric syndrome. The study enrolled 71 women. Later on all the examinees were divided into 2 groups: 1) 38 patients with severe manifestations of climacteric syndrome who were given sagenit (a study group) and 2) 33 apparently healthy women without clinical manifestations of climacteric syndrome (a control group). Positive results were obtained in relieving the symptoms of climacteric syndrome in the study group women just following a month of therapy; and after 3-month therapy the modified menopausal index was 30.9±1.70 scores in 98.3% of the study group women, which corresponded to the values in the control group.
Obstetrics and Gynecology. 2010;(5):98-101
pages 98-101 views

CORRECTION OF VAGINAL MICROFLORA ABNORMALITIES IN BACTERIAL VAGINOSISAND NONSPECIFIC VAGINITIS

ZAKhAROVA T.V., VOLKOV V.G., ZAKHAROVA T.V., VOLKOV V.G.

Abstract

A comprehensive examination was made in 63 women with pathological vaginal discharge, including 32 with bacterial vaginosis and 31 with vaginitis. All the patients received anti-inflammatory antibacterial therapy at stage I and vaginal ecofemin as a capsule twice daily for 6 days at stage II. Ecofemin was found to be an effective agent to correct vaginal microbiocenosis in patients with bacterial vaginosis and vaginitis.
Obstetrics and Gynecology. 2010;(5):102-106
pages 102-106 views

IMMUNOMODULATORY THERAPY FOR INFLAMMATORY DISEASES OF THE LOWERFEMALE SPHERE

MEDYaNNIKOVA I.V., KRAVChENKO E.N., MEDYANNIKOVA I.V., KRAVCHENKO Y.N.

Abstract

One hundred female patients with nonspecific inflammatory diseases of genitals were examined. Immunomodulation in the complex traditional therapy was ascertained to be effective. Monotherapy with the immunomodulator lavomax® (Nizhfarm, Russia) provides a steady-state positive effect in the inflammatory processes characterized by a chronic slowly progressive and recurrent course, which generally occur in the presence of secondary immunodeficiency.
Obstetrics and Gynecology. 2010;(5):107-110
pages 107-110 views

TRANSCRANIAL PHYSICAL METHODS IN THE CORRECTION OF REPRODUCTIVE SYSTEM DISORDERS IN ADOLESCENT GIRLS WITH OBESITY

SALOV I.A., BOLOTOVA N.V., LAZEBNIKOVA S.V., ChIChEVA G.V., RAYGORODSKIY Y.M., Salov I.A., Bolotova N.V., Lazebnikova S.V., Chicheva G.V., Raigorodsky Y.M.

Abstract

The study was undertaken to evaluate and optimize various modes of transcranial physiotherapy for reproductive system disorders in puberty girls with obesity. Combined use of transcranial magnetic therapy (TMT) and transcranial electrostimulation (TES) was substantiated by a study of the hormonal status, lipid and carbohydrate metabolism, anthropometric and clinical data, and the results of ultrasonography and electroencephalography. The application of an AMO-ATOC-Э apparatus for this purpose could normalize a menstrual cycle in 86.3% of the girls, by reducing body weight by an average of 9.26±4.28 kg for 3 months. This method was shown to ensure effective prevention of polycystic ovary syndrome. Analysis of electroencephalograms indicates a baseline impairment of brain bioelectrogenesis in adolescent girls with reproductive system disorders and their correction with TMT and TES therapy.
Obstetrics and Gynecology. 2010;(5):111-116
pages 111-116 views

COMBINED THERAPY FOR BENIGN DISEASES OF THE CERVIX UTERI

VAGANOVA S.E., Vaganova S.Y.

Abstract

The results of treatment were comparatively analyzed in 290 women aged 19 to 48 years who had human papillomavirus-associated non-tumor diseases of the cervix uteri. The use of Epigen intim spray in the traditional cryotherapy for benign pathology of the cervix uteri was found to cause a significant reduction in the time of epithelization, an increase in the percentage of cured patients after one cryoexposure session, and a decrease in the number of recurrences.
Obstetrics and Gynecology. 2010;(5):116-120
pages 116-120 views

THE SPECIFIC FEATURES OF SEPTIC SHOCK IN OBSTETRICS

KULIKOV A.V., Kulikov A.V.

Abstract

The paper considers the issues of initial intensive therapy for septic shock in obstetrics. This protocol is based on the current guidelines of the leading Russian (the Russian Association of Surgical Infection Specialists) and foreign (SSC) organizations. The specific traits of a pregnant woman are discussed in relation to the infectious process, as well as the etiology and risk factors, the current diagnostic criteria for severe sepsis and septic shock are discussed. Attention is given to the fact that the systemic manifestations of the septic process are considerably ahead of the local manifestations of a uterine purulent process and that it is necessary to be oriented to the current markers and criteria when making a decision to sanitize a primary focus of infection. The present-day initial intensive care protocol for septic shock, which gives not only the currently available treatments, but also states the time of their performance, is presented. The basic principles in the reduction of maternal mortality associated with pyoseptic diseases are defined.
Obstetrics and Gynecology. 2010;(5):121-125
pages 121-125 views

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