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No 8 (2011)

Articles

STAGES OF FORMATION OF THE MOTHER-PLACENTA-FETUS SYSTEM

ALEKSANDROVA N.V., BAYEV EARLY O.R.

Abstract

The review gives the data available in the literature on the early stages of formation of the mother-placenta-fetus system; a special role is assigned to mechanisms for cytotrophoblast invasion. It also describes a role of local, immune, and hormonal factors involved in implantation and further placentation, as well as in the development of obstetric pathology.
Obstetrics and Gynecology. 2011;(8):4-10
pages 4-10 views

ROLE OF LEUKOCYTES AND CYTOKINES IN THE DEVELOPMENT AND REGULATION OF LABOR ACTIVITY AT TERM BIRTH

RUMYANTSEVA V.P., BAYEV O.R., VERYASOV V.N.

Abstract

The review gives data available in the literature on the relationship of the occurrence of labor activity to a local inflammatory response developing in the uterine-placental unit. Its main components are leukocyte infiltration, as well as the increasing synthesis of proinflammatory cytokines in the cervix uteri, myometrium, placenta, and fetal membranes. In addition, different mechanisms of the interaction between the cytokines and the major known modulators of uterine contractility were revealed.
Obstetrics and Gynecology. 2011;(8):11-15
pages 11-15 views

TEST OF BLOOD FROM THE PRESENTING PART OF THE FETUS IN THE EVALUATION OF ITS STATUS DURING LABOR

EREMINA O.V., SHIFMAN E.M., BAYEV O.R., ALEKSANDROVA N.V.

Abstract

The paper provides a current review of the Russian and foreign literature on invasive procedures for evaluating the fetal status during labor. It considers different invasive methods for the diagnosis of the fetal status and compares their efficiency, the frequency of side effects, and reproducibility. Separate emphasis is laid on pathophysiological and biochemical rationales for a procedure for measuring blood lactate from the skin of the fetal head. The paper analyzes and compares the measurements of pH and lactate from the blood of the fetal presenting part during labor.
Obstetrics and Gynecology. 2011;(8):16-20
pages 16-20 views

CURRENT TRENDS IN THE TREATMENT OF OVERACTIVE BLADDER IN WOMEN

APOLIKHINA I.A., MAKHMEDZHANOVA F.N., MUSLIMOVA S.Z.

Abstract

The overactive bladder (OAB) is a symptom complex that is accompanied by urgency with and without urgency urinary incontinence, by more frequent daytime urination, and nocturia. Despite the fact that this condition poses no threat to life, OAB exerts a significant impact on quality of life. The total prevalence of OAB symptoms is 12-22%. Muscarinic antagonists (M-choline blockers), ß-adrenoblocker agonists, potassium channel modulators, and other drugs are now used to treat OAB. M-choline blockers are, in terms of evidence-based medicine, first-line agents (Level 1 evidence and Grade A recommendation) with a low side-effectprofile.
Obstetrics and Gynecology. 2011;(8):21-26
pages 21-26 views

BRONCHOPULMONARY DYSPLASIA: FROM NORTHWAY TO OUR DAYS

OVSYANNIKOV D.Y.

Abstract

The review gives information on the pathomorphism of bronchopulmonary dysplasia originally described as iatrogenia in extremely premature babies who have been on mechanical ventilation. It provides a comparative characterization of the classical and new forms of the disease. Therapy with an exogenous surfactant (poractant alpha) is shown to affect the frequency and course of bronchopulmonary dysplasia and late outcomes in babies and infants are described.
Obstetrics and Gynecology. 2011;(8):27-31
pages 27-31 views

RECOMBINANT ERYTHROPOIETIN TREATMENT FOR SEVERE ANEMIA IN PREGNANT KIDNEY TRANSPLANT RECIPIENTS

MURASHKO L.E., KANDIDOVA I.E., KRAVCHENKO N.F.

Abstract

Objective. To develop a treatment with recombinant erythropoietin (rEPO) for severe anemia in pregnant kidney transplant women receiving iron-containing agents. Subjects and methods. Sixty-eight pregnant kidney transplant patients were followed up; of whom 19 (27.9%) women were found to have anemia with a hemoglobin (Hb) level of 490 g/l. The women’s mean age was 25.9±3.8 years. Primiparas and multiparas constituted 21 and 79%, respectively. Administration of rEPO was started at an Hb of 490 g/l with a dose of 2000 IU subcutaneously thrice weekly in the use of parenteral iron preparations (iron saccharate). After Hb increased by at least 5 g/l, maintenance therapy with rEPO was continued in a subcutaneous dose of 2000 IU once weekly in the oral use of iron preparations in a therapeutic dose (one tablet twice daily). Results. Gestational age at the start of therapy was 26.8±.3.5 weeks; the mean Hb concentration was 86.14±4.9 g/l; red blood cells, 2.86±0.28x10 12/l. The duration of rEPO therapy did not exceed 2 weeks; that of maintenance therapy ranged from 4 to 8 weeks. At delivery, the mean Hb concentration reached 104±3.14 g/l; red blood cells were 3.42±0.1x10 12/l. The gestational age at delivery was 35.2±1.2 weeks; the birth weight was 2543±244 g and the height was 45.8±3.5 cm. All the patients were delivered via caesarean section. The postoperative bed days averaged 11 days. No postpartum infectious and inflammatory diseases were observed. Conclusion. Treatment with rEPO for anemia in pregnant kidney transplant recipients can substantially improve therapeutic effectiveness for its severe forms, decrease inpatient treatment time, improve fetoplacental unit function, and reduce the frequency of postoperative infectious complications.
Obstetrics and Gynecology. 2011;(8):32-35
pages 32-35 views

IMPACT OF COMBINATION PATHOGENETIC THERAPY FOR PREECLAMPSIA ON THE OUTCOMES AND PROLONGATION DURATION OF PREGNANCY

TCHAI V.B., GRICAN G.V., GRICAN A.I., POTILICINA N.G., EREMEEV D.P., POLSTYANOY A.M., KOVALEVA E.A.

Abstract

Objective. To evaluate the efficiency of anticoagulant therapy and plasmapheresis (PA) as the components of combination therapy for preeclampsia, which contribute to better treatment results and prolonged pregnancy. Material and methods. Thirty-f ive cases of pregnancy prolongation in gestosis at 31.5±0.42 weeks’ gestation were prospectively analyzed. The course of therapeutic PA consisted of 4—6 sessions with 654 to 876 ml of autoplasma per session. Central hemodynamic changes and the time course of changes in the hemocoagulation system, blood biochemical parameters, and C-reactive protein were estimated before and after PA. Results. The use of therapeutic PA in varying gestosis, regardless of the baseline type of blood circulation, could prolong pregnancy by an average of 16.5±1.6 days and prevent gestosis progression and health worsening in 74% of cases. The combined use of a course of therapeutic PA and anticoagulant therapy in pregnant women with gestosis resulted in elimination of chronometric hypercoagulation, its statistically significant reduction as compared to the baseline level of the soluble fibrin monomer complex, platelet aggregation, and fibrin degradation products and in a considerable decrease in the level of C-reactive protein by an average of 18.4±1.7 to 2.2±1.1 mg. Conclusion. Hemodynamic correction based on the individual choice of antihypertensive drugs, PA, and continuous anticoagulant therapy in pregnant women with preeclampsia could ensure stable hemodynamics, maintain electrolyte balance, the hemic component of blood oxygen-transporting function, prolong pregnancy, make prophylaxis of neonatal respiratory distress, and, in all cases, have live babies.
Obstetrics and Gynecology. 2011;(8):36-41
pages 36-41 views

MEDICAL POLICY FOR INTRAUTERINE INFECTIONS

TIRSKAYA Y.I., BELKOVA T.N., RUDAKOVA E.B., DOLGIKH T.I., SHAKINA I.A.

Abstract

Objective. To reveal diagnostic and prognostic criteria for intrauterine infection (IUI). Subjects and methods. The authors made a retrospective analysis of labor histories in 302 patients and neonates and a prospective study in 49 mother-newborn pairs at risk for IUI to elaborate a prognostic model and in 53 pairs to evaluate the efficiency of the developed algorithm. The diagnosis of IUI was verified or ruled out from the results of additional neonatal examination on postpartum day 1. Results. Clinicoanamnestic criteria for IUI development were revealed by taking into account their diagnostic value; a 92%-accuracy IUI risk table was compiled. A scheme for management of pregnant women at risk for IUI was proposed in accordance with the developed risk table. Conclusion. In IUI without a well-defined etiological agent, the irregular use of etiotropic agents is not preferable to nonspecific therapy aimed at improving uterine-placenta unit function.
Obstetrics and Gynecology. 2011;(8):42-47
pages 42-47 views

THE SPECIFIC FEATURES OF THE THIRD TRIMESTER OF PREGNANCY AND LABOR IN OBESE PATIENTS

MAKAROV I.O., BOROVIKOVA E.I., BAIRAMOVA M.A., RYKUNOVA O.V., DUBOVA E.A., PAVLOV K.A., SHCHEGOLEV A.I.

Abstract

Objective. To study the specific features of the third trimester of pregnancy and labor and placental morphological changes in obese patients. Subjects and methods. A prospective cohort study was made in 100 patients in 2009 to 2011, who were divided into 3 groups according to the degree of obesity. Results. Irrespective of the degree of obesity, all the women developed metabolic syndrome. Regardless of the magnitude of obesity in the third trimester, every two pregnant women developed preeclampsia; every three women were at risk for preterm labor. As compared to first-degree obesity women, third-degree obesity patients were diagnosed as having chronic fetal hypoxia, amniotic fluid aspiration, and hypoxically ischemic lesion of the fetal central nervous system 3.5, 6, and 13 times more frequently, respectively. Placental histological study showed a preponderance of angiogenesis without vascular branching, as well as more evident vascular endothelial growth factor expression in the villous capillary endothelium and extravillous trophoblast.
Obstetrics and Gynecology. 2011;(8):48-53
pages 48-53 views

CLINICAL VALUE OF THE IMPAIRED CIRCADIAN BLOOD PRESSURE PROFILE IN PREGNANT WOMEN; POSSIBILITIES FOR DRUG PREVENTION OF GESTATIONAL HYPERTENSIVE COMPLICATIONS

RUNIKHINA N.K., SHARASHKINA N.V., BART B.Y., TKACHEVA O.N.

Abstract

Objective: to ascertain the clinical value of the impaired circadian blood pressure (BP) prof ile and to determine the possibilities of drug prevention of hypertensive complications in pregnant women. Subjects and methods. The trial enrolled 377 pregnant women aged 18 to 42 years (mean 28 years) with different forms of arterial hypertension (AH), who were allocated to 4 groups: pregnant women with chronic AH (CAH); those with baseline normal BP, who developed gestational AH (GAH) or preeclampsia (PE) after 20 weeks’ gestation; and those in whom the signs of PE were added to CAH (CAH+PE). At the end of the first trimester, in the second (20—22 weeks) and third (30—32 weeks) ones, the pregnant women underwent clinical and laboratory studies, 24-hour BP monitoring, and echocardiography. The outcomes of pregnancy and labor were retrospectively analyzed. Results. Gestational hypertensive complications develop gradually after the stage of autonomic and metabolic abnormalities, endothelial dysfunction, and vasodilatation deficiency, which manifest themselves as the higher values of peripheral vascular resistance and diastolic pressure, and impaired circadian rhythm of BP with its insufficient nocturnal lowering. Conclusion. The detection of the early markers of GAH and PE makes it possible to use the period of preclinical changes in the regulation of the cardiovascular system to implement measures for their correction. By taking into account the data on the specific features of the micro- and macroelement status in pregnant women and on magnesium deficiency before hypertensive complications, magnesium preparations (magnerot) can be regarded as possible therapy at this stage.
Obstetrics and Gynecology. 2011;(8):54-60
pages 54-60 views

CLINICAL AND PATHOGENETIC RATIONALE FOR A STUDY OF THE SECRETION OF ANGIOGENIC FACTORS IN THE LUTEAL PHASE OF THE MENSTRUAL CYCLE IN WOMEN WITH A HISTORY OF REPEATED EARLY PREGNANCY LOSSES

KHODZHAYEVA Z.S., MUSIYENKO E.V.

Abstract

Objective. To analyze the serum level of vascular endothelial growth factor (VEGF) in patients with a history of recurrent miscarriage (RM). Subjects and methods. This was a prospective cohort study. Sixty-two women with a history of early pregnancy losses and 32 healthy puerperas underwent an examination of the immune status and pro- and antiangiogenic factors and ultrasonography with Doppler study of uterine vessels in the secretory phase of the menstrual cycle. Pregravid preparation was used after randomization. Results. In the secretory phase of the menstrual cycle, the women with a history of RM were found to have a large number of cells with CD56+ phenotype and impaired uterine hemodynamics along with the low level of the proangiogenic factor VEGF with the normal values of antiangiogenic factors. Methylprednisolone, as compared to imunofan, considerably enhanced VEGF secretion at the preimplantation stage. There was a correlation of VEGF with endometrial thickness, uterine hemodynamics, and cytotoxic cell levels with CD56+ phenotype. Conclusion. Peripheral blood VEGF level should be measured in women with recurrent first-trimester pregnancy losses, immune status imbalance, and impaired uterine hemodynamics in the secretory phase of the menstrual cycle. When the VEGF level is low, it is expedient to administer methylpredlisolone methylprednisolone 8 mg/day from day 1 to day 25 of the menstrual cycle as part of combination pregestational preparation.
Obstetrics and Gynecology. 2011;(8):61-65
pages 61-65 views

HEMOSTATIC STATUS IN DRUG-INDUCED ABORTION

NEMANOVA S.B., SHLAGANOVA I.A., ILYINA G.E., FOMINA I.A., VOROBYEVA N.A., BARANOV A.N.

Abstract

Objective. To evaluate the safety of using the analogues of mifepristone and misoprostol for the interruption of early pregnancy, by def ining the combined effects of the drugs on the hemostatic system. Subjects and methods. Questioning, general clinical examination, dynamic biochemical and hematological studies, and determination of basic vascular and thrombocytic, coagulant, antiacoagulant, and fibrinolytic parameters of the hemostatic system were done in 65 women who had undergone drug-induced abortion. Results. The patients with drug-induced abortion have the changes in blood parameters in the reference range, which are indicative of the higher activity of hepatic enzyme systems and the compensatory enhancement of the blood clotting potential, and impairments in platelet disaggregation processes. Blood anticoagulant and fibrinolytic activities tend to reduce slightly in the reference range of the mean activity values for AT II and protein C and to prolong the spontaneous lysis of euglobulin clots 3—4 days after abortion. Most blood parameters are normalized by day 10 postabortion. Conclusion. Pharmacological abortion in early pregnancy exerts a sparing effect on the hemostatic system with the reserve abilities being preserved.
Obstetrics and Gynecology. 2011;(8):66-71
pages 66-71 views

CHANGES IN THE CYTOKINE PROFILE AND CELLULAR IMMUNITY PARAMETERS IN PATIENTS WITH UTERINE CERVICAL DYSPLASIA INDUCED BY PAPILLOMAVIRUSES

LAZARENKO L.N., LIGIRDA N.F., VOROBYEVA L.I., POTEBNYA G.P., DEMCHENKO O.N., SPIVAK N.Y.

Abstract

Objective. To study the production of interferon-а and interferon-y and other pro- and anti-inflammatory cytokines and the subpopulational composition of peripheral blood lymphocytes in patients with human papillomavirus (HPV)-induced uterine cervical dysplasia. Subjects and methods. Fifty-four patients with HPV-induced cervical dysplasia of different grades (CIN I, CIN II, CIN III, and cancer in situ) and a control group of 10 clinically healthy women were examined. Their cervical specimens were tested for HPV DNA and specific cytomorphological, histological, and colposcopic markers in HPV-affected tissues by polymerase chain reaction. The peripheral blood serum levels of IFN-y, IFN-а, IL-1ß, IL-2, IL-4, IL-10, and TNF-а and the count of T lymphocytes and their individual subpopulations were measured. Results. In HPV-induced cervical dysplasia, the serum samples were found to have decreased IFN-а and IFN-y concentrations with a simultaneous increase in the levels of the proinflammatory cytokines TNF-а and IL-1ß, as well as the Th2-type cytokine IL-4. The concentration of the anti-inflammatory cytokine IL-10 was reduced. In CIN III and cancer in situ, there were abnormal cellular immunity parameters, as confirmed by the decreased peripheral blood count of CD3+/HLA-DR+ Т lymphocytes and the lower immunoregulatory index CD4/CD8. In patients with CIN III and cancer in situ, the serum concentration of IFN-y was lower than that in those with CIN I and CIN II. Conclusion. The findings are of great importance in predicting the nature of development of an immune response in HPV-induced cervical dysplasia.
Obstetrics and Gynecology. 2011;(8):72-76
pages 72-76 views

CLINICAL AND EPIDEMIOLOGICAL MONITORING OF MEASLES IN PREGNANT WOMEN IN THE ALTAI TERRITORY

SAFYANOVA T.V., ORLOV V.I., LUKYANENKO N.V., STOLYAROVA E.A.

Abstract

Objective. To analyze the results of clinical and epidemiological monitoring of measles in pregnant women in the Altai Territory to define their value during epidemiological surveillance over measles infection as a whole. Material and methods. The authors made a retrospective analysis of the incidence of measles over 18 years (1992—2010) and an analysis of measles vaccination coverage in the Altai Territory in 2005—2010. Along with clinical studies, the package of diagnostic methods for measles comprised quantification of specific IgG and IgM to its virus, estimation of the avidity index for specific IgG, and identification of measles virus RNA. Results. A system for clinical and epidemiological monitoring of measles in pregnant women was developed and introduced. Examination of pregnant women indicated a diverse spectrum of immunity to measles virus. The majority (98.0%) of the study group pregnant women had high-avidity antibodies in the protective titer, which resulted from prior infection or prior vaccination. There was a further decline in the incidence of measles in the Altai territory; all cases of acute measles were confirmed by laboratory tests. Conclusion. The measles infection monitoring system developed and introduced in the Altai territory may serve as a model of epidemiological surveillance and control over intrauterine infections as a whole.
Obstetrics and Gynecology. 2011;(8):77-80
pages 77-80 views

SOCIOMEDICAL CHARACTERISTICS OF ADOLESCENT FEMALES WITH PREMENSTRUAL SYNDROME

BASOVA O.N., VOLKOV V.G.

Abstract

Objective. To identify the sociomedical risk factors and course of premenstrual syndrome (PMS) in adolescent females. Subjects and methods. A questionnaire was used to get information in 520 female respondents aged 15—18 years. A study group comprised 96 adolescent females with PMS; a control group consisted of 424 girls. Mathematical methods for data processing included statistical, correlation analysis, and estimation of odds ratios (OR) in confidence intervals (CI) at the chosen significance of 95%. Results. A sociomedical characterization was compiled for adolescent females with PMS and risk factors for this pathology were identif ied. The neuropsychic and endocrine-exchange forms of PMS with a preponderance of its mild form were most common in the adolescents. Conclusion. The foregoing is a rationale for optimizing the early prediction and diagnosis of PMS just in adolescence in order to timely render medical care to adolescent females.
Obstetrics and Gynecology. 2011;(8):81-85
pages 81-85 views

EXPERIENCE WITH ORGAN-SPARING SURGERY FOR PLACENTA ACCRETA

KURTSER M.A., BRESLAV I.Y., LUKASHINA M.V., SHTABNITSKY A.M., PANIN A.V., ALEKSEYEVA T.V., PLATITSIN I.V.

Abstract

Objective. To generalize the experience of managing patients with true placenta accrete, by ligating the internal iliac arteries and embolizing the uterine arteries, and to determine whether organ-sparing surgery can be performed in placenta accreta. Subjects and methods. Thirty case histories were analyzed in patients with placenta previa and accreta. The diagnosis was established from the data of Doppler ultrasound study and confirmed by magnetic resonance imaging. For hemostasis, the internal iliac arteries were ligated in 15 patients (Group 1); the fetus was extracted through incision into the fundus of the uterus, followed by embolization of the uterine arteries, in 15 patients (Group 2). Results. When the uterine arteries were embolized, in the vast majority of patients, blood loss was less than that when the internal arteries were ligated. Conclusion. The data given suggest that organ-sparing surgery can be performed in true placenta accrete.
Obstetrics and Gynecology. 2011;(8):86-90
pages 86-90 views

PROGNOSTIC FACTORS FOR THE EFFICACY OF MIFEPRISTONE IN PREPARATION FOR LABOR

BAYEV O.R., RUMYANTSEVA V.P., BURDULI G.M., POLYANCHIKOVA O.L., RUBTSOVA S.V.

Abstract

Objective. To study the clinical and ultrasound criteria that are of prognostic importance in defining the efficiency of labor preinduction and induction with mifepristone. Subjects and methods. Eighty-two women in whom the cervix uteri was prepared for labor with mifepristone in a dose of 200 mg twice at a 24-hour interval were examined. The following prognostic factors, such as maternal age, parity, weight, and uterine cervical length measured by transvaginal ultrasonography (USG), were studied. Results. Age over 30 years was found to be a prognostic factor to reduce the efficiency of preparation of the cervix uteri for labor. There is also a relationship between parity and the outcome of mifepristone preinduction that is characterized by the higher rate of delivery in primiparas than in multiparas. A cervical length of 26 mm during transvaginal USG is a statistically significant factor to reduce the likelihood of delivery after preinduction. The mifepristone dosage to patient weight ratio is of great prognostic value for the maturation of the cervix uteri and for the course of an act of delivery. Mifepristone preinduction at 41 weeks’ or more gestation is accompanied by the higher rate of cesarean delivery than that at 40—41 weeks’ gestation.
Obstetrics and Gynecology. 2011;(8):91-94
pages 91-94 views

EXPERIENCE WITH COMBINATION TREATMENT FOR GENITAL HERPES IN WOMEN

UDZHUKHU V.Y.

Abstract

Objective. To analyze the clinical efficacy of lavomax in combination therapy for genital herpes (GH) with emphasis on its impact on the body’s nonspecific resistance. Subjects and methods. Forty-nine women with GH were followed up. Its diagnosis was verified by enzyme immunoassay and polymerase chain reaction. Results. Immunological studies revealed impairments in the phagocytic component of immunity. The findings suggest that lavomax used in the combination therapy of GH is pathogenetically grounded and effective. Conclusion. Combination therapy using lavomax has a normalizing impact on the body’s natural resistance and rapidly eliminates the clinical manifestations of herpesvirus infection, and achieves a stable clinical resolution.
Obstetrics and Gynecology. 2011;(8):95-97
pages 95-97 views

TREATMENT FOR HEMORRHOIDS IN PREGNANT WOMEN AND PUERPERAS

KRASNOVA N.A., GRACHYOVA T.I.

Abstract

Hemorrhoids are observed in about 50% of women during pregnancy in its any period, but more frequently in the third trimester and postpartum. Choice of a drug is limited to the maternal and fetal safety framework. The paper gives data on the drugs of choice (Relief group medications) in treating hemorrhoids in pregnant women and puerperas, which have the most balanced composition, a high therapeutic activity, a good tolerability, and no side effects.
Obstetrics and Gynecology. 2011;(8):98-101
pages 98-101 views

ETIOLOGICAL FACTORS OF RECURRENT MISCARRIAGE

AIRAPETOV D.Y.

Abstract

The paper describes different causes of early reproductive losses; preferential attention is given to immunological and immunogenetic aspects.
Obstetrics and Gynecology. 2011;(8):102-106
pages 102-106 views

MANAGEMENT OF INDUCED PREGNANCY OCCURRING IN THE PRESENCE OF SEVERE OVARIAN OVERSTIMULATION SYNDROME

SAROYAN T.T., KORNEYEVA I.E.

Abstract

The paper briefly outlines the current pathogenetic mechanisms of the development of severe ovarian overstimulation syndrome, the clinical and laboratory characteristics of pregnant women during the manifestation of the syndrome, and the course and management of induced pregnancy occurring in the presence of severe ovarian overstimulation syndrome.
Obstetrics and Gynecology. 2011;(8):107-111
pages 107-111 views

FLUORESCENCE DIAGNOSIS AND PHOTODYNAMIC THERAPY FOR VULVAR CONDYLOMATA ACUMINATA

DENISOVA E.D., APOLIKHINA I.A., BULGAKOVA N.N.

Abstract

Objective. To study the efficiency of the fluorescence diagnosis (FD) and photodynamic therapy (PDT) of vulvar condylomata acuminata (CA), by using the endogenous photosensitizer protoporphyrin IX, the synthesis of which occurs in the use of oral and topical 5-aminolevulinic acid (5-ALA). Subjects and methods. Eighty-six patients with vulvar CA were examined and treated. For FD and PDT, the authors used alasens that contained the standard substance of 5-ALA. Results. During FD, the red fluorescence of protoporphyrin IX was recorded not only in CA, but also in the hidden, invisible in white light, foci of human papillomavirus infection, which further developed to the clinical form of papillomavirus infection. The FD and PDT of vulvar CA were shown to result in a clinical resolution in 70—73% of cases and to reduce the number of recurrences by 5-fold as compared to chemical destruction. Conclusion. FD and PDT can be regarded as an alternative method for the diagnosis and treatment of vulvar CA.
Obstetrics and Gynecology. 2011;(8):112-116
pages 112-116 views

DRUG THERAPY FOR PREMENSTRUAL SYNDROME

POZDNYAK A.O.

Abstract

The paper describes basic hypotheses of the pathogenesis of premenstrual syndrome. It covers the major abnormalities to be differentiated from premenstrual syndrome. Main medicinal approaches to correcting this syndrome are given. Drospirenone-containing combined oral contraceptives are shown to play a role in the treatment of premenstrual syndrome.
Obstetrics and Gynecology. 2011;(8):117-120
pages 117-120 views

PATHOGENETIC TREATMENT FOR BACTERIAL DYSBIOSES

TKACHENKO L.V., BOGATYREVA L.N.

Abstract

Objective. To establish the eff iciency of two-step treatment in women with new-onset and recurrent bacterial vaginosis. Subjects and methods. The study included 70 patients aged 35 to 45 years with bacterial vaginosis. Its diagnosis was made on the basis of clinical data, Amsel’s diagnostic criteria, the results of vaginal smear microscopy and vaginal discharge culture study. All the studies were conducted before and after two-step treatment with fluomizin and gynoflor E. Results. Gardnerella vaginalis that had been found in none patient in Group 1 and preserved in 2 (7.1%) patients in Group 2 proved to be most susceptible to the drugs. Anaerobic cocci and enterococci were isolated in the low titer of 10 2—10 3 CFU/ml in 7.1 and 11.9% of Group 1 women, respectively, which was 5 times less than those prior to treatment. The drug was highly effective against Escherichia coli and staphylococci. The colonization exceeded 103 CFU/ml only in 4 out of 42 women. The drug also exerted a considerable inhibitory effect on the growth of Candida fungi; the latter were not detected in Group 1 women posttreatment, but were only in 1 (3.5%) in Group 2. There was a posttreatment preponderance of lactobacteria in the vaginal discharge in 95.2 and 92.8% in Groups 1 and 2 women, respectively. Conclusion. The study demonstrated the efficiency of the first step of treatment with the antiseptic fluomizin and that of the second step that recovered biocenosis with gynoflor E that contained viable lactobacteria and a microdose of estriol.
Obstetrics and Gynecology. 2011;(8):121-124
pages 121-124 views

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