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No 2 (2011)

Articles

SAFETY PROBLEMS OF DRUG USE DURING PREGNANCY AND BREASTFEEDING

USHKALOVA E.A., TKACHEVA O.N., CHUKHAREVA N.A.

Abstract

The effects of drugs on the course of pregnancy remain little studied and the opinions about the safety of their use are ambiguous. To study drug safety during pregnancy is presently considered to be a priority of pharmacoviligance in the USA and European Union. In Russia, health care facilities and pharmaceutical companies may enter reports on the negative effect of drugs on the course and outcome of pregnancy just into the pharmacoviligance database at the Roszdravnadzor website and physicians may send them to the regional or federal drug safety monitoring center. Along with pregnancy drug safety testing during the physicians’ level of knowledge in this area should be increased.
Obstetrics and Gynecology. 2011;(2):4-7
pages 4-7 views

HOMOCYSTEINE, MTHFR GENE POLYMORPHISMS, AND PREGNANCY COMPLICATIONS

TRIFONOVA E.A., GABIDULINA T.V., AGARKOVA T.A., GABITOVA N.A., STEPANOV V.A.

Abstract

The review discusses the current views on the role of polymorphic variants of the MTHFR gene in the development of obstetric diseases in the light of the contradictory results of studies revealing the associations of markers of this locus with complicated pregnancy.
Obstetrics and Gynecology. 2011;(2):8-15
pages 8-15 views

PHARMACOLOGICAL CORRECTION OF ADMA-ENOS-ASSOCIATED TARGETS IN PREECLAMPSIA

POKROVSKY M.V., POKROVSKAYA T.G., GUREYEV V.V., BARSUK A.A., PROSKURYAKOVA E.V., KOROKIN M.V., BELOUS A.S., KOROKINA L.V., RAGULINA V.A., GUDYREV O.S., LEVASHOVA O.V., KOROLEV A.E., MALTSEVA N.V., POLYANSKAYA O.S., TEREKHOVA E.G., BABKO A.V., NOVIKOV O.O., ZHILYAKOVA E.T., SOROKOPUDOV V.N., KOLESNIK I.M.

Abstract

Methylated L-arginine analogues, such as asymmetric dimetylarginine (ADMA) and monomethylarginine (L-NMMA), are endogenous inhibitors of endothelial nitric oxide (e-NOS). It has been recently established that the maternal plasma concentrations of ADMA are higher in women with preeclampsia and the elevated ADMA concentrations are a predictor of preeclampsia. The previously presented studies showed that L-arginine on an ADMA-like model of L-NAME-induced endothelial dysfunction was effective in increasing the activity of endothelial NO synthase and the generation of nitric oxide. The eNOS activator resveratrol, antioxidants, potentiated polyclonal antibodies against eNOS, etc. were effective on this model. Investigations of endothelium-protective activity have been under way on other ADMA-eNOS-associated experimental models of metabolic syndrome X, homocysteine-, hypoestrogenism-, and sepsis-induced endothelial dysfunction and endothelial dysfunction in reactive postvaccination vasculitis.
Obstetrics and Gynecology. 2011;(2):16-20
pages 16-20 views

ROLE OF GESTAGENS IN THE TREATMENT OF INFERTILITY AND MISCARRIAGE

KRASNOPOLSKAYA K.V., GORSKAYA O.S., KABANOVA D.I., KRSTICH E.V.

Abstract

The paper presents the data available in the literature on the mechanism of action of progesterone in a woman’s body and those on the role of gestagens in the treatment of infertility and miscarriage.
Obstetrics and Gynecology. 2011;(2):21-23
pages 21-23 views

MENOPAUSAL METABOLIC SYNDROME AND HORMONE REPLACEMENT THERAPY

SALOV I.A., TOLSTOV S.N., MYCHKA V.B., KIRILLOVA M.Y., VOICHENKO N.A., ZHERNAKOVA Y.V., KUZNETSOVA I.V.

Abstract

The review presents the current view of the cardiovascular aspects of menopause and the existing methods of hormone replacement therapy (HRT). It considers the relationship of estrogen deficiency in early postmenopausal women to the development of metabolic syndrome (MS), essential hypertension, and atherosclerosis and evaluates the impact of combination HRT on the cardiovascular system. HRT is a first-line pathogenetic therapy for menopausal symptoms. Particular emphasis is laid on a combination of estradiol and drosperinone as preferential for postmenopausal women with MS. Angelik provides a new alternative approach to managing postmenopausal women with MS and, due to additional therapeutic benefits, is superior to other drugs used for HRT.
Obstetrics and Gynecology. 2011;(2):24-31
pages 24-31 views

OVERACTIVE, BLADDER: A NEW VIEW ON THE PROBLEM

ERMAKOVA E.I., BALAN V.E.

Abstract

The paper gives the present view on the etiology, pathogenesis, diagnosis, and treatment of overactive bladder in women.
Obstetrics and Gynecology. 2011;(2):32-35
pages 32-35 views

QUADRIVALENT ANTI-HPV VACCINE: THE PREVENTION OF CANCER AND GENITAL CONDYLOMAS

ROGOVSKAYA S.I., PODZOLKOVA N.M.

Abstract

The paper reviews the data available in the literature on the primary prevention of cancer of the cervix uteri and other diseases associated with human papillomavirus (HPV). It gives update on clinical trials of a quadrivalent anti-HPV vaccine, covers its introduction in different countries, and shows the clinical and economic benefits of its use.
Obstetrics and Gynecology. 2011;(2):36-41
pages 36-41 views

TIME COURSE OF CHANGES IN THE SOLUBLE FORMS OF CELL ADHESION, MOLECULES IN PREECLAMPSIA

ZIGANSHINA M.M., KRECHETOVA L.V., VANKO L.V., KULTERBAYEVA M.A., SOKOLYAN A.V., SUKHIKH G.T.

Abstract

Objective. To study the time course of changes in the soluble forms of cell adhesion molecules (CAM), such as sICAM- 1, sVCAM-1, sL-selectin, and sE-selectin, in the sera of women during physiological and varying preeclampsia-complicated pregnancy. Subjects and methods. Fifty-three patients at 8 to 41 weeks of gestation with complications and 73 women with physiological pregnancy and labor, who were matched for age, parity, and deliveries in the history, were followed up. The soluble forms of CAM (sE-selectin, sL-selectin, and sVCAM-1) were determined in the sera of pregnant women by enzyme-linked immunosorbent assay (ELISA) using the test systems (Bender MedSystems GmbH, Austria). Results. There is a pronounced imbalance in CAM levels in preeclampsia. In patients at high risk for preeclampsia, deviations in the blood content of sICAM-1 and sVCAM-1 may be a marker for the prediction of preeclampsia throughout their pregnancy and deviations in sL-selectin levels may be a marker in the early periods. Conclusion. The sensitivity and specificity of these tests suffice to predict the development of preeclampsia just during early pregnancy. When the blood level of CAM is in excess of its certain threshold concentrations, the highrisk group patients may be presumed to have an 80% chance of developing preeclampsia. When the preeclampsia worsens, blood tests for the above CAM forms, along with other specific assays, will allow the risk of perinatal complications to be predicted.
Obstetrics and Gynecology. 2011;(2):42-48
pages 42-48 views

PREGNANCY IN WOMEN WITH ACQUIRED HEART DISEASE: COURSE AND OUTCOMES

BUKHONKINA Y.M., CHIZHOVA G.V., STRYUK R.I.

Abstract

Objective. To analyze the course and outcomes of pregnancy in women with acquired heart diseases (AHD). Materials and methods. The medical cards and delivery records of 40 pregnant women with AHD were analyzed. The results were statistically processed with a package of Biostatistics Version 4.03 programs, by applying the standard methods of variation statistics and Student’s test. Results. In a group of women with corrected AHD, the latter was revealed later than that in a group of those with uncorrected AHD; these pregnant women were more frequently found to have functional class (FC) II heart failure. The pregnant women with ADH showed chronic intrauterine hypoxia and chronic fetal growth retardation. In the pregnant women with corrected AHD, delivery at term occurred significantly more frequently than in those with uncorrected AHD. In the patients with corrected AHD, their neonates’ body weight was significantly higher than the babies born to those with uncorrected AHD, FC II circulatory insufficiency, or pulmonary hypertension. Healthy neonatal infants were 14.3 and 8.3% in the corrected and uncorrected AHD groups, respectively. Both groups were comparable with respect to the rate of cerebral ischemia (more than 70%). Hyperexcitability and motor disorders were more common in the uncorrected AHD group. Autonomic visceral dysfunctions, incomplete pregnancy, and fetal growth retardation were predominant in the corrected AHD group. Conclusion. Heart failure developing by the end of pregnancy caused chronic intrauterine hypoxia and chronic fetoplacental insufficiency in the pregnant women with AHD. As a result, preterm labor occurred in 80% of cases in the corrected AHD group. Cesarean section as a delivery mode was prevalent, which was due to both cardiac and obstetric diseases. The proportion of healthy newborn infants born to patients with AHD was small (nearly 10%). Different types of neonatal central nervous system diseases were recorded at a high frequency.
Obstetrics and Gynecology. 2011;(2):49-52
pages 49-52 views

THE FREQUENCY OF HEMORRHAGIC MANIFESTATIONS IN EXTREMELY PREMATURE INFANTS

ALIEVA L.B., ANTONOV A.G., BURKOVA A.S., LENYUSHKINA A.A.

Abstract

Objective. To define the frequency of hemorrhagic complications in extremely premature infants and their relationship to body weight and gestational age and to assess the role of these complications in tanatogenesis in case of fatal outcomes. Materials and methods. Five hundred and seven case histories of extremely premature infants admitted to the neonatal intensive care unit in 1997 to 2009 were analyzed retrospectively and prospectively. Three hundred and forty-two case histories were analyzed after 165 patients were excluded from the study due to the fact that they did not meet the inclusion criteria for the purpose in hand. Results. The authors established the frequency of hemorrhagic complications, their relationship, a correlation between hemorrhagic complications and birth weight and gestational age, as well as the role of individual nosological entities in tanatogenesis. Conclusion. Our study has provided evidence that infants of 24-26 weeks gestation are susceptible to hemorrhagic manifestations. The found correlations between hemorrhagic complications of various sites and disseminated intravascular coagulation (DIC) suggest that the complications are of considerable importance in manifesting DIC. A significant predominance of hemorrhagic syndrome in dead versus surviving patients permits the assumption of the important role of these manifestations in tanatogenesis.
Obstetrics and Gynecology. 2011;(2):53-57
pages 53-57 views

THE FMR1 GENE: NEW POSSIBILITIES OF ASSESSING THE OVARIAN RESERVE

SHAMILOVA N.N., MARCHENKO L.A.

Abstract

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, Moscow Objective. To reveal the ranging number of CGG repeats in patients with premature ovarian failure (POF) and their associations with the level of anti-Müllerian hormone (AMH). Subjects and methods. At the first stage of the study, the patients were divided into 3 groups (A, B, and C) according to the number of CGG repeats in the alleles (allele 1 with a smaller number of repeats and 2 with their larger number). At the second stage, these were classified into 3 groups according to the found zygosity in the fragile X mental retardation (FMR1) gene. Group 1 included women with both alleles being in the normal range of repeats, i.e. 26-34 repeats; Group 2 comprised the heterozygous carriers of the abnormal number of repeats, i.e. one allele was in the normal range, the other was outside this range; Group 3 consisted of women having the alleles outside the normal range of CGG repeats (26>CGG>34). A statistical correlation was determined between the number of repeats and the parameters of the ovarian reserve. Results. In the patients with POF, the frequency of both normal and abnormal lengths of CGG repeats in the FMR1 gene was practically equal (45 versus 55%). The group with the normal number of repeats (Group B) showed a statistically significant increase in the level of AMH as compared to the short (Group A) and long (Group C) number of repeats (0.49±1.13, 0.1±0.14, and 0.09±0.15 pg/ml, respectively; p < 0.05). The patients with a drastically diminished ovarian reserve were more typified by shorter CGG repeat lengths than their extension (34 versus 11%), which was slightly different from the conventional viewpoint given in the literature. Most authors previously pointed out that longer CGG repeat lengths in the grey (41-50) and permutation (51-200) zones were of diagnostic value. Comparative analysis revealed a direct moderate correlation between the number of CGG repeats in the FMR1 gene and the level of AMH in Group A (r = 0.358; p < 0.05). At the same time, Group C exhibited an inverse moderate correlation between the number of repeats and the concentration of AMH (r = -0.3174; p < 0.05). No correlation was found between the level of AMH and age in the group with the normal number of repeats. The content of AMH was moderately inversely proportional to age in the groups with the homozygous and heterozygous carriage of abnormal CGG repeat lengths. Conclusion. The length of CGG repeats in the FMR1 gene may be certainly one of the early objective predictors of POF and serve as a new test for the prediction of ovarian functional activity.
Obstetrics and Gynecology. 2011;(2):58-64
pages 58-64 views

COMPARATIVE ANALYSIS OF FOLLITROPIN ALPHA OVULATION STIMULATION IN THE USE OF GONADOTROPIN-RELEASING HORMONE AGONISTS OR HIGH-DOSE ETHINYL ESTRADIOL IN PATIENTS WITH PREMATURE OVARIAN FAILURE

MARCHENKO L.A., ZHAKHUR N.A., BUTAREVA L.B., KUZMICHEV L.N., MIKAELYAN V.G.

Abstract

Objective. To comparatively analyze two ovulation stimulation schemes in patients with premature ovarian failure. Subjects and methods. The study enrolled 35 patients aged 22 to 40 years with premature ovarian failure; in 18 of them the ovaries were stimulated with follitropin alpha after pituitary pre-desensitization with gonadotropin-releasing hormone agonists (Group 1) and in 17 this was done with the same agent in the use of high-dose ethinyl estradiol (Group 2). Clinical, laboratory, and ultrasound studies were performed and the hormonal profile was evaluated. Results. A positive effect was achieved in 4 and 2 patients in Groups 1 and 2, respectively (p > 0.05). Pregnancy occurred in none case. The estrogenic scheme contributed to a more physiological response of the ovaries; however, it caused a significantly larger number of adverse reactions. Conclusion. Today the use of donor oocytes remains the only highly effective method to treat infertility in this contingent of patients, which may be extensively employed in day-to-day clinical practice.
Obstetrics and Gynecology. 2011;(2):65-69
pages 65-69 views

ENDOCRINE AND METABOLIC CHARACTERISTICS OF PATIENTS WITH DIFFERENT PHENOTYPES OF POLYCYSTIC OVARY SYNDROME

CHERNUKHA G.E., BLINOVA I.V., KUPRASHVILI M.I.

Abstract

Objective. To study the endocrine and metabolic characteristics of different phenotypes of polycystic ovary syndrome (PCOS). Subjects and methods. A complete clinical and laboratory study was made in 155 reproductive-age women, including 135 patients with PCOS and 20 healthy individuals. Results. The complete phenotype of PCOS was identified in 63%; its incomplete phenotypes were determined in the other cases; among them, both androgenic and non-androgenic phenotypes were encountered with nearly equal frequency. The patients with the androgenic phenotypes of PCOS, particularly with its complete form, besides hyperandrogenemia, were more frequently found to have elevated luteinizing hormone levels and more significant metabolic disorders than those with the non-androgenic phenotype and with carbohydrate metabolic disturbances being uncharacteristic of them; dyslipoproteinemia was 1.5 times less common and hyperinsulinemia and metabolic syndrome were observed 2 times less frequently. Conclusion. The women with ovulation and hyperandrogenemia have a higher risk for the metabolic disturbances similar to the earlier known phenotypes of PCOS whereas the risks for metabolic syndrome associated with type 2 diabetes mellitus and cardiovascular diseases are low in women having anovulation with hyperandrogenism.
Obstetrics and Gynecology. 2011;(2):70-76
pages 70-76 views

PREVALENCE OF OBESITY, ABNORMAL WEIGHT GAIN, AND METABOLIC SYNDROME IN PREGNANT WOMEN OF THE FAR NORTH

SUPLOTOVA L.A., SMETANINA S.A., NOVAKOVSKAYA N.A.

Abstract

Objective. To assess the prevalence of obesity, abnormal weight gain, and metabolic syndrome during pregnancy. Subjects and methods. Five hundred and twenty-one women living in the Far North. Results. Obesity, abnormal weight gain, and carbohydrate metabolic disturbances were found to be encountered in nonindigenous pregnant women more frequently than in native ones. Metabolic syndrome is extremely rare during pregnancy and comprises not more than three components. Reproductive-age women with obesity make up a group at risk for metabolic disturbances in this period. Conclusion. For the prevention of metabolic disturbances and reproductive losses, it is necessary to implement measures to reduce weight in women before pregnancy occurs.
Obstetrics and Gynecology. 2011;(2):77-81
pages 77-81 views

THE CAPACITIES OF ECHOGRAPHY IN PATIENTS WITH TUBOPERITONEAL INFERTILITY DURING SURGICAL INTERVENTIONS

NANAGYULYAN G.V., KHACHATRYAN A.K.

Abstract

Objective. To improve the echographic diagnosis of a commissural process in the small pelvis to optimize surgical treatment policy in the achievement of pregnancy in women with tuboperitoneal infertility. Subjects and methods. Fifty-two women with infertility, including 30 patients with a diagnosed commissural process in the small pelvis and 22 patients with no commissural process being found at preoperative transvaginal echography. Physical examinations and echographic, X-ray, and endoscopic studies were performed. Results. Laparoscophic echography (LE) offers a means of examining the uterine tubes all the way to the uterine angle and defining the site of the fimbrial part, which cannot be frequently done at pre- and intraoperative transvaginal echography. In a significant commissural process and hydrosalpinx, LE makes it possible to accurately determine the fimbrial part of the uterine tubes and to perform the adequate surgical intervention — salpingostomy. LE in combination with endoscopic imaging can well define the borders of a space-occupying lesion and its adjacent organs in the manifest commissural process, thus preventing traumatization of the latter and finishing the operation through endoscopic access. In tuboperitoneal infertility concurrent with gynecological diseases, LE can differentiate small-sized functional masses from benign tumors and tumor-like masses of the ovary and, if any, accurately define the site of a tumor in the ovary, avoid extra incisions and coagulation of the ovarian surface, thus preserving the ovarian reserve in women with unrealized reproductive function and old reproductive-age women. Conclusion. There is evidence for the diagnostic value of intraoperative echography and LE in hydrosalpinx, liquid tumorlike and inflammatory diseases of the appendages concurrent with significant commissures and with the involvement of adjacent organs into the commissural conglomerate, which can define the scope of surgical intervention well, assure its safety, and preserve the appendages in young women with unrealized reproductive potential.
Obstetrics and Gynecology. 2011;(2):82-85
pages 82-85 views

PREVENTION OF MATERNAL DEATHS: MONITORING DURING PREGNANCY AND LABOR

BASHMAKOVA N.V., KOVALEV V.V., TATAREVA S.V., ZILBER N.A., KAYUMOVA A.V., DAVYDENKO N.B., VARTAPETOVA N.V.

Abstract

Objective. To make a stepwise medical and statistical analysis of maternal mortality rates in the Sverdlovsk Region. Subjects and methods. Stage 1 established the cause-and-effect relations of pregnancy, labor, and postpartum deaths, by analyzing the paired cases in the comparison groups: maternal losses and near miss cases. To determine the reserves of improving perinatal care to women living in the Sverdlovsk Region, the authors made an epidemiological analysis of main health indicators, the timeliness and quality of medical care to patients within the framework of the Internet system «Monitoring of risk-group pregnant women in the Sverdlovsk Region». Results. Diagnostic and tactical errors were found and maternal death risk groups were formed. Continuous monitoring of pregnant women was ascertained to be an effectively operating tool to assess the quality of a follow-up in the primary care facilities and to promote the regionalization of care to the region’s pregnant women. Conclusion. Overall, the optimized organization of an obstetric service in the Sverdlovsk Region could achieve a maternal mortality rate of 21.2 per 100000 live births.
Obstetrics and Gynecology. 2011;(2):86-92
pages 86-92 views

THE TRAINING OF AN OBSTETRIAN/GYNECOLOGIST, A NEONATOLOGIST, AND A RESUSCITATION SPECIALIST IN THE PERINATAL CENTERS OF THE RUSSIAN FEDERATION AND IN THE ACADEMICIAN V. I. KULAKOV RESEARCH CENTER OF OBSTETRICS, GYNECOLOGY AND PERINATOLOGY

PROTOPOPOVA T.A., VOLGINA V.F., SHUVALOVA M.P.

Abstract

The main goal of training an obstetrician/gynecologist, a neonatologist, and a resuscitation specialist is to further improve their knowledge, skills, and practical experience in specialized quality care. The quality of training of a physician is assessed by professionals. The perinatal centers of Russia and the Academician V. I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, are in full conformity with the present-day requirements for postgraduate education: they have teaching licenses, use the current educational methods (nanotechnologies) in the teaching process, and attract qualified teachers. Great attention is given to on-site thematic improvement cycles and teaching narrow specialization issues in an amount of 72—288 academic hours. Further improvement of the postgraduate training of a physician promotes better main quality indicators of obstetric/gynecological and neonatal services in the regions.
Obstetrics and Gynecology. 2011;(2):93-96
pages 93-96 views

TRENDS IN METABOLIC PARAMETERS DURING ANTIHYPOXIC THERAPY FOR OBSTETRIC SEPSIS

YAKOVLEV A.Y., ZAITSEV R.M., ZUBEYEV P.S., MOKROV K.V., BALANDINA A.V., KUCHERENKO V.E.

Abstract

Objective. To estimate the contribution of succinate-containing infusion agent reamberin to the correction of blood metabolic parameters in patients with obstetric sepsis in the postpartum period. Subjects and methods. Trends in blood metabolic parameters (lactate, pyruvate, glucose, lactate/pyruvate and glucose/lactate ratios) and nitrogen balance were studied when reamberin (800 ml/day during 8 days of intensive care) was infused in 43 patients with postpartum obstetric sepsis. Results. Baseline metabolic decompensation was found in the early postoperative period in patients with postpartum obstetric sepsis, which was resistant to antibacterial, infusion therapy, and nutritional support. The administration of amberin can reduce the time of decompensation of metabolic disturbances — on day 8, the study metabolic parameters decreased to the upper limit of the reference range. In the f irst 2 days of infusion, 800 ml of reamberin is insufficient for rapid correction of the baseline metabolic disturbances. Conclusion. Reamberin was ascertained to have a beneficial effect on baseline metabolic disturbances, by enhancing the efficiency of nutritional therapy. The magnitude of metabolic disturbances requires that the antihypoxic properties of postoperative intensive therapy be potentiated.
Obstetrics and Gynecology. 2011;(2):97-101
pages 97-101 views

USE OF A HERBAL ANTISEPTIC TO TREAT INFLAMMATORY DISEASES OF THE CERVIX UTERI

BALAYEV T.A., BADYUGINA I.B., MOLDAVER B.L., ASLANYAN T.A., BELYAEVA O.M.

Abstract

Objective. To study the efficacy of galenophyllipt in the treatment of inflammatory diseases of the cervix uteri. Material and methods. The antimicrobial activity of the agent was experimentally studied on a model of localized staphylococcus infection in the skin-muscle wound of albino mice. The efficacy of galenophyllipt was investigated in albino mice with burn erosion of the cervix uteri. Results. The use of galenophyllipt promotes faster cleansing of deep wound layers from the microbes, limitation of granulation tissue inflammation focus, and abolishment of the inflammatory process in the tissues of the vagina and cervix uteri. Conclusion. The proven potent antimicrobial activity and stimulating effect on regenerative and reparative processes allow one to recommend galenophyllipt for the treatment of inflammatory diseases of the cervix uteri.
Obstetrics and Gynecology. 2011;(2):102-105
pages 102-105 views

USE OF HORMONAL CONTRACEPTIVES IN A REHABILITATION PROGRAM AFTER PRIOR EXACERBATION OF CHRONIC SALPINGOOPHORITIS

SHATUNOVA E.P., STEPANOVA Y.V.

Abstract

Objective. To assess a role of combination oral contraceptives with different progestagen components in a package of rehabilitative measures after prior exacerbation of chronic salpingoophoritis. Subjects and methods. One hundred and eight women treated at hospital for exacerbation of chronic salpingoophoritis were examined and divided into 3 groups: 1) 42 patients who were given a drospirenone-containing combination oral contraceptive (COC); 2) 35 patients who took desogestrel-containing COC; 3) 31 patients who received no hormonal contraceptives. Results. Comparison of the pattern of genital diseases in women using drospirenone- and desogestrel-containing COC revealed no statistically significant differences: both agents ensurd a good control of the menstrual cycle, a reduction in the degree of dysmenorrheal symptoms, the absence of functional ovarian cysts and endometrial hyperplasia, a decrease in the rate of exacerbations of chronic salpingoophoritis. However, the women receiving drospirenone-containing COC showed a better tolerability profile, a lower frequency of side effects, including no action on weight and blood pressure, as well as no peripheral edemas. Conclusion. The high efficacy of drospirenone with the lower frequency of adverse reactions allows this agent to be recommended in the package of rehabilitative measures in patients with chronic salpingoophoritis.
Obstetrics and Gynecology. 2011;(2):106-110
pages 106-110 views

PREGNANCY AND LABOR IN MULTIPLE SYSTEM ATROPHY

KHODZHAYEVA Z.S., SHIFMAN E.M., SOKOLOGORSKY S.V., FLOKA S.E.

Abstract

The paper describes a clinical observation of the course of pregnancy and combined spinal and epidural anesthesia used during cesarean section in a female patient with multiple system atrophy.
Obstetrics and Gynecology. 2011;(2):111-113
pages 111-113 views

THE REPRODUCTIVE HEALTH OF NATIVE GIRLS IN THE REPUBLIC OF TYVA

GRITSINSKAYA V.L.

Abstract

Objective. To study the reproductive health in the native girls of the Republic of Tyva (RT). Material and methods. The 1999-2008 reports of the Federal State Statistics Service in the RT and in the Ministry of Health of RT were analyzed. Randomized study was made in 785 Tuvan girls aged 10 to 18 years. The results were statistically processed according to the requirements for sample surveys, by applying a Statistica version 6.0 software package © Statsoft, USA. Results. The development of the reproductive system in the native girls of Tyva under the present conditions is characterized by a high rate of dyshormonic physical development, underdevelopment of secondary sex characteristics, a high rate of menstrual irregularities, and a high prevalence of gynecological diseases. Conclusion. Reproductive impairments develop in the girls under a complex of the sociomedical and ecogeographic factors characteristic of the republic. They determine reproductive abnormalities and inadequate reproductive behavior in the girls and may negatively affect the realization of reproductive function.
Obstetrics and Gynecology. 2011;(2):114-117
pages 114-117 views

GONADOBLASTOMA IN A PATIENT WITH 46,XY GONADAL DYSGENESIS

ADAMYAN L.V., KOGAN E.A., MAKIYAN Z.N., KISELEVA I.A.

Abstract

The paper describes a case of gonadoblastoma in a female patient with 46,XY (mixed) gonadal dysgenesis. The uterus, vagina, and bisexual development of external genitals were observed in the patient.
Obstetrics and Gynecology. 2011;(2):118-120
pages 118-120 views

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