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No 1 (2012)

Articles

PLACE OF ABDOMINAL AND VAGINAL SURGICAL DELIVERY IN MODERN OBSTETRICS. REALITY AND PROSPECTS

KRASNOPOLSKY V.I., LOGUTOVA L.S., PETRUKHIN V.A., BUYANOVA S.N., POPOV A.A., CHECHNEVA M.A., AKHVLEDIANI K.N., TSIVTSIVADZE E.B., MELNIKOV A.P.

Abstract

The paper deals with the topical problem of modern obstetrics — surgical delivery. The reasons for the increasing annual rate of cesarean section and indications for abdominal delivery under the present-day conditions are analyzed. The authors propose alternative delivery methods, such as vaginal surgical delivery, for pregnant women with extragenital diseases and delivery per vias naturalis for those with a uterine scar after cesarean section. They give an objective assessment of these deliveries and their advantages over cesarean section for mother and fetus.
Obstetrics and Gynecology. 2012;(1):4-8
pages 4-8 views

IMPACT OF MATERNAL MAGNESIUM SULFATE THERAPY FOR PREECLAMPSIA/ECLAMPSIA ON A NEWBORN INFANT (CLINICAL OUTCOMES): META-ANALYSIS

SHIFMAN E.M., BAIBARINA E.N., KRYUCHKO D.S., TIKHOVA G.P.

Abstract

Objective. To evaluate the impact of magnesium sulfate therapy (MST) on a newborn infant (perinatal mortality; neonatal hypotension; 1-minute Apgar scores less than 7; 5-minute Apgar scores less than 7; a need for tracheal intubation in a delivery room; a need for neonatal transfer from a delivery room to an intensive care unit (ICU); ICU treatment for more than 7 days). Materials and methods. The results of 13 randomized clinical trials published in English-language medical journals and in the reports of the Cochrane Society over 1990—2010 were analyzed, which met the following requirements: a prospective study; randomization; the presence of a control group; information hiding from an investigator/an analyst; a study of at least one of the clinical outcomes given in the objective of the study; a statistical description of an effect in terms of a relative risk with a 95% confidence interval. Results. MST in a mother with preeclampsia/eclampsia does not increase the rate of neonatal outcomes, such as the rate of fatal outcomes, Apgar scores less than 7 at 1 and 5 minutes, a need for tracheal intubation in a delivery room; a need for neonatal transfer from a delivery room to an ICU; neonatal ICU stay for more than 7 days. Evaluation of the efficacy of magnesium sulfate versus phenytoin has shown the statistically significant advantage of the former. Conclusion. Magnesium sulfate is not an independent additional risk factor for developing the poor outcomes described in the objective of the study. However, it should be noted that this study deals with the neonatal infants, the most of whom are full-term and have no obvious intrauterine developmental abnormalities or serious perinatal pathology.
Obstetrics and Gynecology. 2012;(1):9-16
pages 9-16 views

VASCULAR CHANGES IN THE OPHTHALMIC ARTERY BASIN IN PREGNANT WOMEN WITH PREECLAMPSIA

KHRAMCHENKO N.V., SHIFMAN E.M., GUS A.I.

Abstract

The data of a study of blood flow in the ophthalmic basin vessels in pregnancy complicated by preeclampsia and eclampsia are given as an analytical review. The latter presents the results of examining hemodynamic parameters in the direct sinus and basal veins of Rosenthal in arterial hypertension. It is concluded that Doppler ultrasound studies can assist in determining the stage of preeclampsia, predicting its course, and evaluating the therapeutic action of medicaments.
Obstetrics and Gynecology. 2012;(1):17-22
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SYSTEMIC INFLAMMATORY RESPONSE SYNDROME AND PREGNANCY (A REVIEW OF LITERATURE)

LOMOVA N.A., ORDZHONIKIDZE N.V., VANKO L.V.

Abstract

The paper sets forth current ideas on the mechanisms to develop a systemic inflammatory response during pregnancy. It considers different factors of innate immunity, which are involved in the development of complications, such as recurrent miscarriage, intrauterine growth retardation, preeclampsia, placental insufficiency syndrome, and intrauterine infection. The role of neutrophils and cytokines in the development of an inflammatory response is covered. Understanding of the pathophysiological mechanisms acting in the maternal-placental-fetal unit will make it possible to improve diagnostic methods and to perform pathogenetically sound therapy for obstetric complications.
Obstetrics and Gynecology. 2012;(1):23-27
pages 23-27 views

ROLE OF GENETIC FACTORS IN THE GENESIS OF POSTMENOPAUSAL OSTEOPOROSIS

BORDAKOVA E.V., DONNIKOV A.E., YAKUSHEVSKAYA O.V., YURENEVA S.V.

Abstract

This paper considers the major components of the gene network of osteoporosis. As of now, the conventional study of the risk factors for postmenopausal osteoporosis (PMO) deals with a search for the gene mutations associated with bone mineral density (BMD) and PMO. Papers on the association between VDR, LRP-5, RANK, RANKL, ОPG, ESR1, and ESR2 gene polymorphisms and decreased BMD and fractures are analyzed. The given analysis of the data available in the literature suggests that the complex analysis considering the pathomorphological, pathophysioloical, and phenotypic changes in bone tissue with the allelic features of the genes associated with BMD and PMO, the combined effect of a few polymorphisms, gene-gene interactions, and population peculiarities must be a promising area of a genetic study.
Obstetrics and Gynecology. 2012;(1):28-34
pages 28-34 views

THE PREDICTION AND DIAGNOSIS OF THE SEVERE FORMS OF PLACENTAL INSUFFICIENCY

TEZIKOV Y.V., LIPATOV I.S.

Abstract

Objective. To estimate the prognostic and diagnostic possibilities of markers of endothelial dysfunction, decidualization, apoptosis, and cellular proliferation to identify the severe forms of placental insufficiency (PI). Subjects and methods. One hundred and fifty-four women at high risk for the severe forms of PI and a control group of 30 healthy pregnant women were examined over time during their second and third trimesters of pregnancy. Clinical, immunological, and instrumental studies were used. Results. In the second trimester, the prognostically significant criteria for decompensated PI are increases in the antiendothelial antibody cytotoxicity index up to 36.9±4.2%, total immunoglobulin E up to 351±18 ng/ml, placental a1-microglobulin up to 74.4±6.5 ng/ml, Fas/APO-1/CD 95-receptor-expressing lymphocytes up to 48.3±3.2%, and tumor necrosis factor-a up to 202±18 pkg/ml and a reduction in serum placental growth factor concentrations to 248±13 pkg/ml. Conclusion. The prediction and early diagnosis of the severe forms of PI can be made, by mon itoring the blood levels of endothelial dysfunction markers, maternal placental membrane proteins, apoptosis, and cellular proliferation
Obstetrics and Gynecology. 2012;(1):35-42
pages 35-42 views

DIAGNOSIS AND TREATMENT OF HEMOLYTIC DISEASE OF THE FETUS

MAKAGON A.V., ANDRYUSHINA I.V.

Abstract

Objective. To analyze the authors’ results obtained over 10 years and to evaluate the efficiency of the introduced current methods for the prenatal diagnosis and treatment of hemolytic disease (HD) of the fetus. Subjects and methods. The study enrolled 358 pregnant women who were divided into 4 groups according to treatment policy: conservative management and intrauterine blood transfusion (IUBT) to the fetus, as well as to the used algorithm (in 1999—2005 when their medical history, antibodies, the presence of fetal dropsy were kept in mind and in 2006—2009 when the maximal blood flow velocity (MBFV) in the middle cerebral artery (MCA) becomes the basis of mon itoring. Results. Introduction of fetal monitoring based on MCA MBFV measurements could optimize obstetric tactics and significantly reduce the number of invasive diagnostic interventions (p < 0.001). There was evidence that IUBT was highly effective in the treatment of the severest edematous form of HD of the fetus. Isoserological examination using gel technologies makes it possible to diagnose rare forms of conflicts and to select a donor on an individual basis. Conclusion. Fetal MCA MBFV measurements permit fetal anemia to be predicted. The edematous form of fetal HD is a curable condition that calls for fetal emergency care: IUBT is an effective treatment for fetal HD. The gel method is optimal in performing an isoserological study.
Obstetrics and Gynecology. 2012;(1):43-48
pages 43-48 views

DURATION OF NORMAL LABOR UNDER PRESENT CONDITIONS

BAYEV O.R., RUBTSOVA S.V., VASILCHENKO O.N., RUMYANTSEVA V.P., ALEKSANDROVA N.V.

Abstract

Objective. To study the impact of current management of spontaneous labor on its duration to elaborate criteria for its normal course. Subjects and methods. Four hundred and forty-two cases of labors with good maternal and perinatal outcomes were analyzed. Of them, 339 labor histories were retrospectively analyzed and 103 women formed a prospective management group. The study included parturients with full-term singleton pregnancy and fetal cephalic presentation without severe somatic and gynecological diseases. Results. The duration of latent and active phases does not greatly differ in primiparas. In secundiparas, the reduction in total labor duration is determined by the rapider course of the active phase in the first period and to a lesser extent in the second one. When employing epidural analgesia (EA), there was a significant increase in total labor duration in both primiparas and secundiparas due to the f irst period; a prolonged waterless interval; the higher frequency of cases of powerless labor in primiparas; acute fetal hypoxia was more common. Conclusion. Parity remains a leading natural factor that influences labor duration. The latter is significantly affected by obstetric tactics in a low-risk group.
Obstetrics and Gynecology. 2012;(1):49-54
pages 49-54 views

ROLE OF TOLL-LIKE RECEPTORS IN THE PATHOGENESIS OF POSTPARTUM ENDOMETRITIS

LEBEDEVA O.P., SAMBORSKAYA N.I., PAKHOMOV S.P., CHURNOSOV M.I., POPOV V.N., KALUTSKY P.V., IVASHOVA O.N., RUDYKH N.A., POLYAKOVA I.N.

Abstract

Objective. To establish the role of toll-like receptors (TLR) 1, 2, 4, and 5 in the pathogenesis of postpartum endometritis. Subjects and methods. Forty-eight patients with signs of postpartum endometritis and 56 women with a normal postpartum period were examined. Epithelial cells taken from the cervical canal at 3—4 days postpartum were the material to be estimated for TLR expression. The latter was assessed using the quantitative polymerase chain reaction (PCR). Results. The patients with postpartum endometritis showed a significant reduction in the levels of TLR4 and TLR5, as well as the TLR signaling pathway proteins MyD88 and NF-kB. The expression of TLR1 and TLR2 did not significantly change. Lower NF-kB expression resulted in a reduction in the elaboration of proinflammatory cytokines and antimicrobial peptides onto the mucosal surface, which may promote the invasion of a pathogen even if the latter was modest. Conclusion. The reduced expression of TLR4 and TLR5 in the female genital tract epithelium may play a considerable role in the pathogenesis of postpartum endometritis as this favors the activation of the opportunistic flora due to diminished local immunological responsiveness.
Obstetrics and Gynecology. 2012;(1):55-59
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THE OVARIAN RESERVE IN WOMEN WITH INFERTILITY AND AUTOIMMUNE THYROIDITIS

PERMINOVA S.G.

Abstract

Objective. To assess ovarian reserve patterns in women with infertility and thyroid autoimmunity. Subjects and methods. Ovarian reserve parameters (FSH, AMH, ovarian volume, number of antral follicles) were assessed in 67 women with tubo-peritoneal infertility without operative interventions on the ovaries, aged from 29.3± 0.9 years including 31 women with thyroid autoimmunity (TAI) (main group) and 36 women without thyroid pathology (controls). Results. There is obvious evidence that women with AIT have a diminished ovarian reserve: higher FSH and lower AMH in young and middle-aged women, decreased ovarian volume, and a smaller number of antral follicles, which is likely to be associated with the autoimmune genesis of this pathology. Conclusion. Infertile women with TAI are a risk group for ovarian reserve decrease that demands highly efficient methods of restoration of reproductive function within minimum time limits
Obstetrics and Gynecology. 2012;(1):60-63
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CLINICAL MANIFESTATIONS OF POLYCYSTIC OVARY SYNDROME AT A LATE REPRODUCTIVE AGE AND IN POSTMENOPAUSE

CHEBOTNIKOVA T.V., DAVYDOVA G.N., KHOLODOVA Z.L., ILYIN A.V., GONCHAROV N.P., DEDOV I.I., MELNICHENKO G.A.

Abstract

Objective. To def ine age-related changes in the clinical picture of polycystic ovary syndrome (POS). Subjects and methods. The study enrolled 60 POS patients aged over 40 years (38 patients at a late reproductive age and 22 in postmenopause). A control group comprised 197 women (mean age 52.8±7.2 years). All the patients underwent a clinical laboratory examination involving hormonal and biochemical (lipid fractions) studies and an oral glucose tolerance test. Results. TThe POS patients over aged 40 years were not found to have biochemical hyperandrogenism both at a late reproductive age and in menopause; type 2 diabetes mellitus (type 2 DM) and glucose tolerance were detected in a third (n=18) and every five (n=13) of patients, respectively; which is substantially higher than that in the comparison group stratified by body mass index and age. Obesity in POS makes an additional contribution, by increasing the risk of type 2 DM: odds ratio 5.58 (95% confidence interval 1.33-32.69). Conclusion. POS may be considered to be a powerful risk factor for carbohydrate metabolic disturbances. Obesity in POS is an additional risk factor and generally aggravates the course of the disease.
Obstetrics and Gynecology. 2012;(1):64-69
pages 64-69 views

MONITORING PATIENTS UNDERGOING CONIZATION OF THE CERVIX UTERI FOR CERVICAL INTRAEPITHELIAL NEOPLASIA (THE CLINICAL, MORPHOLOGICAL, AND MOLECULAR BIOLOGICAL ASPECTS OF THE PROBLEM)

KOGAN E.A., FAIZULLINA N.M., ISRAILOVA A.K., KOZACHENKO A.V., DEMURA T.A., TEMISHEVA Y.A., EKIMOV A.N., DONNIKOV A.E.

Abstract

Objective. To study of the importance of a complex of clinicomorphological studies and molecular testing of human papillomavirus (HPV) in the cervical canal epithelium when monitoring patients undergoing conization for cervical intraepithelial neoplasia (CIN). Material and methods. A retrospective clinicomorphological and molecular biological study was made using the material obtained from 167 women who had undergone knife conization for CIN II-III, CIN-III. A comparison group comprised 30 women with an HPV history and the signs of uterine cervicitis. Results. Cytological and immunocytochemical monitoring was made in 197 women, by using the markers p16 and Ki-67 and molecular testing of DNA of HPV of 21 types. A recurrence was found in 6 (3.6%) patients. Conclusion. A complex of clinicomorphological studies and molecular testing of HPV in the cervical canal epithelium is recommended to monitor patients who have undergone knife conization for CIN. Conclusion. A complex of clinicomorphological studies and molecular testing of HPV in the cervical canal epithelium is recommended to monitor patients who have undergone knife conization for CIN.
Obstetrics and Gynecology. 2012;(1):70-74
pages 70-74 views

PREMENSTRUAL SYNDROME: POSSIBILITIES OF NON-HORMONAL TREATMENT

LEDINA A.V., PRILEPSKAYA V.N.

Abstract

Objective. To study the efficacy and tolerance of an extract from the plant Vitex agnus castus in the treatment of moderate and severe premenstrual syndrome (PMS) in reproductive-aged women. Subjects and methods. One hundred and twenty-one women with PMS were followed up for 6 months, during which the patients f illed out their health assessment diaries every day and also the tested psychological questionnaire thrice. They took agnucaston (cyclodynon) that contained 40 mg of the Vitex agnus castus extract as one tablet daily immediately after awakening during 3 menstrual cycles. Results. A significant improvement occurred in 67.8% of the patients (according to the diary entries) and in 59.3% of the women (according to the questionnaire data). A subjective improvement was reported by 86.4 and 96.2% of the women according to the data of their diaries and questionnaires, respectively. The side effects associated with the use of the drug were noted in 13 (10.7%) women. Serious adverse reactions occurred in none patient. Conclusion. Agnucaston is an effective and acceptable drug to treat PMS.
Obstetrics and Gynecology. 2012;(1):75-79
pages 75-79 views

STUDY OF THE HORMONAL PROFILE IN PATIENTS AFTER GYNECOLOGICAL OPERATIONS

TORCHINOV A.M., UMAKHANOVA M.M., BOKLAGOVA Y.V.

Abstract

Objective. To study the hormonal profile in patients after different gynecological operations. Subjects and methods. Examinations were made in 106 patients who had undergone surgery for tubal pregnancy, ovarian (endometrioid, follicular, corpus luteal) cysts, uterine myoma; of them 35 patients were operated for tubectomy, 40 for ovarian resection, and 31 for conservative myomectomy). The hypothalamic-pituitary system of the patients was studied via enzyme immunoassay of the secretion of gonadotropic and ovarian hormones. The study was conducted before and 1, 3, and 7 days and 1 month following surgery. The patients received combined oral contraceptives (Novynette, Regulon, and Lindynette) from the seventh day. Results. All the patients were observed to have impaired hormonal homeostasis at the level of both pituitary and steroid hormones in the first (1—7) days after surgical treatment. There were no considerable preoperative hormonal changes. Only 20% of the patients operated for tubectomy had normal hormonal homeostastic parameters one month after surgical operations. The most significant changes were seen in a group of patients after ovarian resection — the hormonal homeostatic parameters were in the normal range only in 10% of the patients one month following surgery. Slight changes in the content of the hormones were noted in patients with uterine myoma before and after surgery. Conclusion. By taking into account the degree of hormonal disorders, there is a need for rehabilitation measures, by obligatorily using combined oral contraceptives.
Obstetrics and Gynecology. 2012;(1):80-87
pages 80-87 views

MACROAND MICRORHEOLOGICAL PROPERTIES OF BLOOD IN PREGNANT WOMEN WITH PLACENTAL INSUFFICIENCY AFTER IN VITRO FERTILIZATION

BURANOVA F.B., FEDOROVA T.A., ERSHOVA L.I.

Abstract

Objective. To evaluate the macro- and microrheological properties of blood in pregnant women with placental insuff iciency (PI) after in vitro fertilization (IVF) and embryo transfer (ET). Subjects and methods. Clinical laboratory tests were carried out in 47 patients who were divided into 3 groups. A study group comprised 14 pregnant women after IVF and ET. A comparison group included 18 patients with chronic PI, in whom pregnancy occurred spontaneously. A control group consisted of 15 women with physiological pregnancy. Blood rheological parameters were estimated by macrorheological (asymptomatic blood viscosity, plasma viscosity, packed cell volume, and plasma total fibrinogen concentration) and microrheologic (spontaneous red blood cell aggregation and disaggregation) parameters. Results. After IVF, the pregnant women with PI were found to have blood macro- and microrheological changes; among other things, there were impairments in red blood cell aggregation and disaggregation processes and deformation. In PI, hyperaggregation and impaired blood rheology after IVF were ascertained to be mainly associated with the increased rate of formation of linear aggregates of red blood cells, their enhanced rigidity and lowered deformation. Conclusion. After IVF, the mechanism of hyperaggregation in PI is associated with considerable blood rheological changes which consist in the decreased disaggregation rate of large aggregates, the higher rigidity index of red blood cells, and their reduced deformation capacity. This requires timely diagnosis, correction of blood rheological parameters, and development of treatment regimens to improve the gas transport function of red blood cells in the microcirculatory bed of the fetoplacental unit, which positively affects perinatal outcomes.
Obstetrics and Gynecology. 2012;(1):88-93
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RESULTS OF THE WORK OF YAROSLAVL OBSTETRIC SERVICE IN ACCORDANCE WITH THE PRINCIPLES OF EVIDENCE-BASED MEDICINE

OKHAPKIN M.B., KHITROV M.V., GURIEV D.L.

Abstract

The paper presents the results of the work of Yaroslavl obstetric service over 10 years (1998 to 2007). It proposes to optimize indications for cesarean section in order to reduce its frequency and to extend the use of fetal vacuum extraction and discusses the principles of management in pregnant women with arterial hypertension. It is concluded that to follow the current scientific principles requires no additional material costs and financing, but substantially enhances the efficiency of the work of obstetric service.
Obstetrics and Gynecology. 2012;(1):94-97
pages 94-97 views

PERINATAL OUTCOMES OF MULTIPLE BIRTHS

BARANOV I.I., TOKOVA Z.Z., TADEVOSYAN A.A.

Abstract

Objective. To study perinatal outcomes in women with multiple pregnancy achieved by different methods. Subjects and methods. A retrospective continuous clinicostatistical analysis of primary medical records was made in 94 puerperas with multiple births (including 5 triple ones) given in the obstetric departments of the Center in 2008. According to the multiple pregnancy-achieving methods, the women were divided into 3 groups: 1) 34 (36.2%) women with spontaneous pregnancy, 2) 50 (53.2%) with pregnancy achieved by assisted reproductive technologies; 3) 10 (10.6%) with pregnancy due to ovulation induction. Results. Statistically significant differences were found between the groups in a number of gynecological diseases: infertility, oligomenorrhea, endometriosis, or polycystic ovary syndrome. The leading obstetric complications were threatening miscarriage, isthmic-cervical insufficiency, early toxicosis, and preeclampsia. Abdominal delivery occurred in 76.5, 98.0, and 80.0% in Groups 1, 2, and 3, respectively. The group rate of preterm labors was 55.9, 64.0, and 70%, respectively. There were 184 (96.3%) and 9 (4.7%) live and still births, respectively, including 58 (61.7%) and 36 (38.3%) same- and different-sex twin pairs, respectively, among the twin births and 2 and 3 same- and different-sex triple pairs among the triple births. Mild, moderate, and severe asphyxia was noted in 49.2, 9.3, and 7.8%, respectively. Stillbirth rates were 26.3%; early neonatal and perinatal mortality rates were 5.4% and 31.7%, respectively. Conclusion. The main cause of fetal and neonatal deaths is extreme immaturity and intragatric hemorrhages. The high rates of perinatal mortality and its components are associated with preterm labor and prematurity. The onrush of neonatal intensive care in the past decade has determined the substantial reduction of early neonatal mortality.
Obstetrics and Gynecology. 2012;(1):98-102
pages 98-102 views

PREDICTION OF PRETERM LABOR FROM THE IDENTIFICATION OF THE MOST SIGNIFICANT RISK FACTORS

MARTYNENKO P.G., VOLKOV V.G.

Abstract

Objective. To develop and introduce a new preterm labor-predicting system that is based on the identification of the most significant risk factors. Subjects and methods. The labor histories of 25297 puerperas who had given live births in the obstetric facilities of the Tula Region in 2006 to 2008 were retrospectively analyzed. Groups 1a and 1b comprised 149 and 1243 puerperas whose delivery occurred at 22—31 and 32-36 weeks gestation, respectively; Group 2 (control) included 23905 women who had full-term pregnancy. The pregnant women who had been registered at 20—24 weeks gestation in the maternity consulting centers of the Tula Region and whose pregnancy ended in delivery in 2009 were prospectively examined. Results. Most risk factors increase the probability of preterm labor (PL) after 32 weeks gestation. Medical risk factors have a stronger influence on early PL than on late ones. The major risk factors of early PL are multiple pregnancy (75.8%) and isthmic-cervical insufficiency (54.9%). A significantly increased risk is observed when the cervical canal is 25 mm or less in length in combination with V- and U-shaped form of the internal pharynx. PL with preterm rupture of fetal membranes occurred irrespective of the state of the cervix uteri. Conclusion. The main direct cause of PL in the Tula Region is the spontaneous onset of labor, the leading risk factors of which were multiple pregnancy and incompetence of the cervix uteri. A pathological change in the (V- and U-shaped) form of the internal pharynx in combination with the shortening of the cervical canal to 25 mm or less is a prognostically poor ultrasound criterion for PL.
Obstetrics and Gynecology. 2012;(1):103-107
pages 103-107 views

ROLE OF LACTULOSE IN THE COMBINATION TREATMENT OF INFLAMMATORY DISEASES OF THE URINARY TRACT IN PREGNANT WOMEN

MOZGOVAYA E.E., TALALEVA N.E., DEDUL A.G., OPARINA T.I., PROKOPENKO V.M.

Abstract

Objective. To optimize the results of treatment for urinary tract infections (UTI) in pregnant women, by using lactose (normaze) in their combination therapy. Subjects and methods. A study group consisted of 50 pregnant women with UTI who received normaze in addition to conventional therapy; a comparison group included 30 pregnant women with this condition who did not take normaze; a control group comprised 25 pregnant women without UTI. The magnitude of subjective questionnaire complaints was estimated; bacteriological study of the urogenital tract was conducted; ultrasonography of the pubic symphysis was performed in patients with symphysiopathy. The blood levels of magnesium and total and ionized calcium and the daily urinary excretion of magnesium and calcium were estimated. Results. There was a considerable improvement in stools, alleviated symptoms of mineral metabolic disturbances in pregnant women with UTI and a more significant correction of genital tract biocenosis in the patients receiving lactulose as part of combination treatment. Conclusion. Incorporation of normaze into the algorithm of treatment for pregnant women with UTI substantially affects the efficiency of the performed therapy due to its many-sided pathogenetic action on the symptom complex peculiar to patients with UTI during pregnancy.
Obstetrics and Gynecology. 2012;(1):108-112
pages 108-112 views

RESULTS OF A COMPARATIVE STUDY OF THE EFFICIENCY OF THERAPY AND PREVENTION OF COMPLICATIONS WITH COMPRESSION PRODUCTS IN PREGNANT WOMEN WITH CHRONIC VENOUS INSUFFICIENCY

MURASHKO A.V., BASHMAKOVA N.V., DANKOVA I.V., KRASIKOV N.V.

Abstract

Objective. To compare the efficiency of therapy and prevention of thromboembolic events with VENOTEKS compression knitwear and elastic bandages, their safety, and patient compliance. Subjects and methods. A multicenter, open-label comparative randomized prospective clinical trial was conducted in 75 pregnant women with chronic venous insufficiency (CVI). Clinical, laboratory, and instrumental studies were performed. Results. The trial revealed the high efficacy of VENOTEKS compression knitwear as a means of the treatment and prevention of CVI progression during pregnancy. As compared with elastic bandages, the compression knitwear resulted in a more pronounced reduction in subjective symptoms and in the clinical class of CVI. There was no evidence for the impact of the compression knitwear on the hemostasis or there were no differences between he groups in the hemodynamic changes in the venous system of the lower extremity. There was a higher patient compliance with compression knitwear. The trial failed to record thrombotic or thromboembolic events and to establish individual intolerance and the negative impact of compression knitwear. Conclusion. Class II compression and Venoteks anti-embolism knitwear may be recommended as an effective, safe, and comfortable means for treating and preventing complications due to CVI in pregnancy and postpartum and for preventing thromboembolic events in the use of different methods for delivering a baby.
Obstetrics and Gynecology. 2012;(1):113-118
pages 113-118 views

A RARE CASE OF THE ECHOGRAPHIC DIAGNOSIS OF DUODENAL ATRESIA LOCATED IN CONGENITAL DIAPHRAGMATIC HERNIA IN A FETUS

DEMIDOV V.N., MASHINETS N.V.

Abstract

The paper describes an ultrasound case of congenital diaphragmatic hernia concurrent with duodenal atresia in a fetus at 25 weeks. Fetal chest scanning determined heart displacement to the right, left lung hypoplasia due to the dislocation of the intestine, stomach, and spleen to the chest, as well as dilated duodenum, enlarged stomach, and polyhydramnios. In this term, the fetal stomach was located in the chest and its duodenum was in the abdomen. Reexamination of the fetus at 36 weeks showed a shift of the duodenum to the chest. Surgical treatment of diaphragmatic hernia and duodenal atresia was performed after birth. The diagnosis was intraoperatively verified.
Obstetrics and Gynecology. 2012;(1):119-121
pages 119-121 views

THE CURRENT TNM CLASSIFICATION OF FEMALE GENITAL TUMORS

SHCHEGOLEV A.I., DUBOVA E.A., PAVLOV K.A., NOSOV V.B.

Abstract

The paper characterizes T, N, and M categories and determines the stages of tumors of the vulva, vagina, corpus and cervix uteri in accordance to the TNM Classification of Malignant Tumors, 7th Edition (2009). The differences of this classif ication of the previous sixth edition (2002) are emphasized.
Obstetrics and Gynecology. 2012;(1):122-127
pages 122-127 views

IMMUNE FACTORS IN THE ETIOLOGY AND PATHOGENESIS OF PREGNANCY COMPLICATIONS

SUKHIKH G.T., VANKO L.V.

Abstract

The paper gives current views of the role of immune mechanisms, particularly innate immunity factors that contribute to the formation and development of normal pregnancy and participate in the pathogenesis of pregnancy complications. Based on the data available in the literature and their own studies, the authors consider the immunological aspects of pregnancy complications, such as recurrent miscarriage and preeclampsia, and those associated with infectious and autoimmune processes. Whether immunological assays can be used to diagnose and predict impairments in normal pregnancy is analyzed.
Obstetrics and Gynecology. 2012;(1):128-136
pages 128-136 views

IRON-DEFICIENCY STATES IN PREGNANT WOMEN AND PUERPERAS

KONOVODOVA E.N., BURLEV V.A.

Abstract

The paper characterizes iron-deficiency states in pregnant women and puerperas and presents update on the etiology and pathogenesis of these conditions. It also describes the clinical picture of and main diagnostic criteria for iron-def iciency states, their medical correction and main preventive procedures.
Obstetrics and Gynecology. 2012;(1):137-142
pages 137-142 views

IMPAIRED URINATION DURING PREGNANCY AND POSTPARTUM

KOVALEVA L.A., APOLIKHINA I.A., BALAN V.E., TETERINA T.A.

Abstract

Pregnancy and labor are leading risk factors for developing the symptoms of female urinary incontinence. Great attention is now given to elective cesarean section in women at risk for developing the symptoms of impaired urination. Only behavioral therapy among the methods for treating and preventing urinary incontinence during pregnancy can be used.
Obstetrics and Gynecology. 2012;(1):143-147
pages 143-147 views

Strizhakov Aleksandr Nikolayevich

- -.
Obstetrics and Gynecology. 2012;(1):148-149
pages 148-149 views

In memory of Boris Lvovich Gurtovoy

- -.
Obstetrics and Gynecology. 2012;(1):150-150
pages 150-150 views

In memory of Nina Vladimirovna Strizhova

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Obstetrics and Gynecology. 2012;(1):151-151
pages 151-151 views

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