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No 1 (2010)


Glucocorticoids in obstetric care: pro and con

Sidelnikova V.M.


The paper presents the data available in the literature on the effects of glucocorticoids used during pregnancy on the maternal and fetal status. Particular emphasis is laid on their use in the prevention of respiratory distress syndrome during preterm labor.
Obstetrics and Gynecology. 2010;(1):3-6
pages 3-6 views

Role of T regulatory cells in pregnancy

Veryasov V.N., Vanko L.V., Sukhikh G.T.


The paper gives the data available in the literature on the basic interaction modes between T regulatory cells and dendritic cells and other immunocytes, on the ways of their involvement in decidual tissue, and the basic mechanisms of regulation of local immunosuppression.
Obstetrics and Gynecology. 2010;(1):6-11
pages 6-11 views

Pathophysiological bases of ultrasound monitoring of the fetus in its growth retardation syndrome

Kovalev V.V., Tsyvyan P.B.


The paper provides the data available in the literature on fetal-placental blood flow and the fetal cardiovascular system and biophysical profile. Attention is drawn on the sequence of development of fetal heart failure and on the assessment of the so-called cardiac rhythm variability.
Obstetrics and Gynecology. 2010;(1):11-15
pages 11-15 views

Autoplasma donation and normovolemic hemodilution during abdominal delivery

Sheikina T.V., Puchko T.K., Rogachevsky O.V.


The review of literature deals with the concurrent use of autoplasma donation and acute normovolemic hemodilution during surgical delivery. The paper gives the data of the researches that have been made in this area and could produce significant positive changes in the prevention and treatment of obstetric hemorrhages. The advantages and disadvantages of the procedure are analyzed in detail. A rationale is provided for the efficiency of concurrent use of these techniques in reducing intraoperative blood loss during surgical delivery.
Obstetrics and Gynecology. 2010;(1):15-19
pages 15-19 views

Clinical, laboratory, and ultrasonic evaluation and pregnancy management tactics in different forms of chorionic pathology in the first trimester

Kiryushchenkov P.A., Belousov D.M., Aleksandrina O.S., Alekseyeva M.S.


The clinical, ultrasonic, bacteriological, virological, hormonal, immunological, molecular biological, and hemostasiological parameters were retrospectively analyzed in 30 pregnant women with chorionic maldevelopment as subchoreal (n = 20) and subamniotic (n = 10) hematomas (a study group). A control group comprised 38 healthy primagravidas. Subchoreal hematomas have been ascertained to be more common than subamniotic ones. They are diagnosed at an average of 8.3±0.4 weeks gestation; their mean volume is 1.32±0.25 cm3. In subamniotic hematomas, these are l2.1±0.5 weeks and 17.7±6.0 cm3, respectively. Subchoreal hematomas generally develop in the presence of thrombophilic states, immunological disorders, and HLA Class II compatibility in a married couple. Subamniotic hematomas more frequently occur in the presence of chronic bacterial and viral infections. Subchoreal hepatomas accompany chorionic hypoplasia and they are attended by uterine hemodynamic disorders. In addition to the conventional therapy, it is necessary to use hemostatic therapy in combination with microcirculation-improving agents in this type of hematomas and hemostatic agents, antibacterial and immunomodulating therapies in subamniotic hematomas.
Obstetrics and Gynecology. 2010;(1):19-23
pages 19-23 views

Early diagnosis of fetal chromosomal anomaly by the OSCAR program

Gnetestskaya V.A., Kurtser M.A., Malmberg O.L., Belkovskaya M.E., Panina N.G., Dubrovina Y.V.


The purpose of the study was to evaluate the efficiency of the One Stop Clinic for Assessment of Risk (OSCAR) program for the early detection of fetal chromosomal anormaly. The study group included 618 patients at 11-14 weeks gestational age. The comprehensive study comprised medicogenetic counseling, ultrasonography, and determination of the blood levels of biochemical markers. The individual risk for birth of a baby with trisomy 21, 18, or 13, monosomy X, and polyploidy was calculated using a computer Life Cycle program. Chorionic biopsy was made in patients at increased risk for chromosomal anomaly for fetal karyotyping. The prospective study suggests that the OSCAR program is highly effective. The sensitivity of combined prenatal screening for fetal chromosomal diseases in the first trimester, by taking into account the age of a pregnant woman, ultrasound markers of chromosomal anomaly, and the level of biochemical markers, was 97.6% with 7.5% frequency of false-positive results.
Obstetrics and Gynecology. 2010;(1):24-28
pages 24-28 views

Value of embryonic cells isolated from the cervical canal in early noninvasive prenatal diagnosis

Fedorova N.I., Tetruashvili N.K., Demura T.A., Sidelnikova V.M., Sukhikh G.T.


The authors identify the basic lines in the noninvasive prenatal diagnosis, which have yielded certain results (determination of fetal rhesus D gene, fetal sex, diagnosis of gene point mutations, aneuploidies, prediction of pregnancy complications.
Obstetrics and Gynecology. 2010;(1):28-31
pages 28-31 views

Congenital adrenal hypoplasia caused by 21-hydroxylase deficiency in patients undergoing an assisted reproductive technology programs

Glinkina Z.I., Kuzmichev L.N., Bakharev V.A., Dzenis I.G., Azizova G.D., Mikayelyan V.G., Ikonnikov M.V.


One hundred and eight patients included into the assisted reproductive technology (ART) program were examined. Heterozygous carriage of CYP21B gene mutation was revealed in 41 (38%) patients (26 females and 15 males). CYP21B gene deletion and duplication were 70.7 and 24.4%, respectively. HLA Class I antigens was shown to play an important role in the diagnosis of heterozygous carriage of this disease. When the markers of HLA B 14 and B 35 were available, CYP21B gene mutation was found in 68% of cases. Six cases had CYP21B gene mutation in a married couple. Awareness of the heterozygous carriage of the mutant CYP21B gene will assist one to make a necessary correction of treatment, thus enhancing the efficiency of an in vitro fertilization program and promoting the birth of healthy baby without adrenal hypoplasia within the framework of the ART program.
Obstetrics and Gynecology. 2010;(1):31-33
pages 31-33 views

Immunological parameters in pregnant women in the early prognosis of development of fetoplacental insufficiency

Ostanin A.A., Kustov S.M., Tyrinova T.V., Tikhonova M.A., Khonina N.A., Pasman N.M., Chernykh Y.R.


The authors studied cell subpopulations (CD4+CD25+ and CD4+CD25highT-reg; CD56+CD16- and CD56+CD16+NK cells; CD56+CD3+NKT cells) by flow cytofluorimetry and determined the biological (suppressor) activity of serum factors and the spontaneous production of cytokines (IFN-г, TNF-б, GM-CSF, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13) in 24-hour whole blood cultures by multiplex proteomic analysis in 19 women in whom the course of pregnancy was complicated by the development with fetoplacental insufficiency (FPI) and in 13 women with physiological pregnancy, who were matched for age (30.2±0.8 and 32.3±0.6 years) and gestational age (10.8±0.7 and 10.3±0.5 weeks). The development of FPI was ascertained to be associated with immune dysfunctions detectable just in early pregnancy as lower natural regulatory CD4+CD25+ and CD4+CD25highT cells and impaired cytokine balance due to enhanced TNF-б along with the decreased production of IL-10 and IL-13 (higher TNF-б/IL-10 and TNF-б/IL-13 ratios), as well as the reduced suppressor activity of serum factors. These immunological parameters may be used as additional criteria in the early prediction of FPI development.
Obstetrics and Gynecology. 2010;(1):33-38
pages 33-38 views

Plasmapheresis and immunoglobulin therapy in the complex treatment of rhesus sensitization

Fedorova T.A., Mitrya I.V.


One hundred and forty-seven pregnant women with rhesus sensitization with a rhesus antibody titer of higher than 1:32 were examined. A study group comprised 87 women who received complex therapy involving plasmaferesis (PA) and immunoglobulin therapy. A control group included 60 pregnant women with rhesus sensitization. The study indicated that a course of medium-volume PA followed by immunoglobulin therapy resulted in reduced and stabilized rhesus antibody titers, which reduced the number of preterm labors by 2.6 times, the rate of birth of babies with the moderate and severe forms of neonatal hemolytic disease by 2.5 times, the duration of phototherapy by 1.4 times, thus lowering prenatal morbidity rates. The complex treatment of rhesus sensitization, by using PA and immunoglobulin therapy, was found to be an effective method for the prevention of fetal and neonatal hemolytic disease.
Obstetrics and Gynecology. 2010;(1):38-42
pages 38-42 views

Implication of viral infection in the pathogenesis of uterine myoma

Posiseyeva L.V., Malyshkina A.I., Sotnikova N.Y., Antsiferova Y.S., Peretyatko L.P.


Three hundred and thirty-five women with uterine myoma and 102 apparently healthy women (a control group) were examined. Herpesvirus infection has been found to be of vital importance in the pathogenesis of uterine myoma, which acts as one of the triggers for the formation of a myomatous nodule and for rapid growth of a tumor. Herpesvirus infection shows its impact through the enhanced elaboration of epidermal growth factor at both the systemic and local level, which determines not only the growth rate of uterine myoma, but also its morphological type. Thus, the use of antiviral drugs in combination with immunomodulators may be considered as an element of pathogenetic therapy for uterine myoma in reproductive-aged and perimenopausal women.
Obstetrics and Gynecology. 2010;(1):42-45
pages 42-45 views

The Delivery Certificate program: results and prospects

Guseva Y.V., Filippov O.S., Chumakova O.V., Shirokova V.I.


The on-line data on how the Delivery Certificate program as part of the national health care project is being carried out in 85 subjects of the Russian Federation are analyzed. The introduction of the program has aided in upgrading the quality of female health care and strengthening the material-and-technical basis of obstetric care facilities. The execution of the Delivery Certificate program has improved the quality of a follow-up of pregnant women in maternity welfare centers and reduced the frequency of pregnancy and labor complications and maternal and infant mortality rates. It is necessary to continue implementing the Delivery Certificate program in order to further upgrade the quality of health care to women during pregnancy and labor and to neonatal infants.
Obstetrics and Gynecology. 2010;(1):46-50
pages 46-50 views

The problem of Candida vulvovaginitis in women and the current approaches to its treatment

Kuzmin V.N.


The paper presents data on the problem of Candida vulvovaginitis in women. It discusses the variants of clinical and laboratory manifestations of the disease and the modes of clinical use of fluconazole in the treatment of various variants of its recurrent forms.
Obstetrics and Gynecology. 2010;(1):50-52
pages 50-52 views

Efficiency of therapies for bacterial vaginosis in nonpregnant women (results of a multicenter study)

Uvarova Y.V., Ankirskaya A.S., Grigorenko Y.P., Kumykova Z.K.


The authors give the results of a multicenter study of the treatment of bacterial vaginosis (BV) in nonpregnant women of reproductive age. They have evaluated the clinical and microbiological efficiency of the diagnosis and treatment of BV in 2505 patients from 14 cities and towns of Russia, by using the unified procedure. The combined treatment for BV with oral trichopol in a dose of 250 mg twice daily for 5 days and intravaginal clindamycin cream on days 1 to 3 of trichopol use have been found to be highly effective (clinical and bacteriological effectiveness being 87.3 and 97.4%), by causing adverse reactions in a few cases (4.1%). Candida vaginitis as a treatment complication was detected in 0.8-1.2% of the women. This treatment regimen for BV is recommended for clinical practice.
Obstetrics and Gynecology. 2010;(1):52-56
pages 52-56 views

Bacterial vaginosis and local antimicrobial activity in pregnant women

Karapetyan T.E., Arzumanyan V.G., Komissarova L.M., Malbakhova Y.T., Serdyuk O.A., Rumyantseva L.V.


The authors studied the antimicrobial activity of vaginal discharge (VD) in varying bacterial vaginosis (BV) and the pH value of the vaginal contents, and the parameters of the obligate and facultative microflora. Forty-four pregnant women with BV and 9 without signs of this disease were examined. The severity of BV was found to correlate directly with the abundant bacterial microflora (correlation coefficient 0.883) and pH (0.871) and inversely with glucose concentrations (-0.961), the obligate microflora (-0.889), and antimicrobial activity (-0.936). With severer BV, there were reductions in the VD concentrations of lysozyme, calprotectin, and defensins. The authors do not rule out that the decreased VD antimicrobial activity caused by the presence of antimicrobial peptides results in the occurrence of VD.
Obstetrics and Gynecology. 2010;(1):57-59
pages 57-59 views

The specific features of therapy for chronic recurrent vulvovaginal candidiasis

Torchinov A.M., Mazurkevich M.V., Murachayeva L.K.


The paper presents the results of clinical trials of Livarol used in the treatment of chronic vulvovaginal candidiasis (VVC), including that in the second and third trimesters of pregnancy. In terms of the broad antimycotic spectrum of action, Livarol used to treat chronic VVC caused by non-albicans Candida spp. has been found to be highly effective. Due to the absence of its systemic action and its low adsorption, the agent is safe when vaginally used in pregnant women.
Obstetrics and Gynecology. 2010;(1):60-62
pages 60-62 views

The abilities of interferons in the treatment of inflammatory diseases of small pelvic ORGANS

Maltseva L.I., Minnullina F.F., Tseretelli I.K., Fattakhova A.R., Osadchaya D.I.


The new interferon inductor tiloron (Lavomax, Nizhfarm) was used to treat women with endometritis, salpingoophoritis complicated by tubal pregnancy or ovarian apoplexy. There was a high contamination rate of the endometrium, endosalpinx, and ovaries with herpes viruses, Chlamydia, and other specific and nonspecific opportunistic microorganisms. Lavomax was used in a total dose of 2.5 g per course in the treatment of 68 patients. Elimination of the specific and nonspecific microbial flora was achieved in all the patients and in 70% of the Lavomax-untreated women. Transformation of chronic inflammatory diseases to urgent states (tubal pregnancy and ovarian apoplexy) requires the use of the currently available interferon inductors for effective treatment.
Obstetrics and Gynecology. 2010;(1):62-64
pages 62-64 views

Serum activity of the matrix metalloproteinases MMP-2 and MMP-9 in perimenopausal patients with endometrial hyperplasia

Strizhova N.V., Soboleva G.M., Ibragimov A.I., Reisner Y.A.


The serum activity of the matrix metalloproteinases (MMP) 2 and 9 was determined in 60 patients with endometrial hyperplasia and in 10 healthy women. In the study group, about a half the female patients were found to have an increase in MMP-2 and MMP-9 activities up to 2+ and 3+. In all healthy women, the activity of MMP was 1+.
Obstetrics and Gynecology. 2010;(1):65-66
pages 65-66 views

Urinary bladder extrophy and pregnancy

Yemelyanova A.I., Adamyan L.V., Ordzhonikidze N.V., Kozachenko A.V.


The authors give their data on the specific features, complications, and outcomes of pregnancy in 7 women with urinary bladder extrophy. With preserved renal function and no renal failure, there may be birth of a viable fetus. Corporeal cesarean section is a method of delivery.
Obstetrics and Gynecology. 2010;(1):66-69
pages 66-69 views

E. M. Vikhlyaeva. Postmenopauzal'naya terapiya

Radzinskiy V.E., Panova E.A.
Obstetrics and Gynecology. 2010;(1):69-70
pages 69-70 views

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