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No 4-1 (2012)

Articles

PROAND ANTIANGIOGENIC FACTORS IN THE PATHOGENESIS OF EARLY PREGNANCY LOSSES. PART 2. RATIO OF PRO-AND ANTIANGIOGENIC SERUM FACTORS IN EARLY PREGNANCY

ZIGANSHINA M.M., KRECHETOVA L.V., VANKO L.V., KHODZHAYEVA Z.S., MUSIYENKO E.V., SUKHIKH G.T.

Abstract

Objective. To analyze early pregnancy changes in the ratio of pro- and antiangiogenic factors in the serum of women with a history of m iscarriage. Subjects and methods. Sixty-six patients with early pregnancy were examined. The soluble forms of VEGF, sVEGF-R1(sFlt-1), sVEGF-R2 (sKDR), MMP-2, MMP-9, TIMP-1, TIMP-2, and PLGF were determined in their sera by enzyme immunoassay, by using the standard test systems (Bender MedSystems GmbH (Austria) and R&D Systems (USA)). The f indings were used to calculate the ratios of pro- and antiangiogenic factors. Results. The findings suggest that analysis of ligand/receptor pairs may be used to characterize the processes of angiogenesis in early pregnancy. Moreover, the VEGF/VEGF-R1, VEGF/VEGF-R2, and MMP-9/TIMP-1 ratios are of the greatest informative value. The nature of intragroup changes in the VEGF/VEGF-R1 and VEGF/VEGF-R2 ratios in the examined pregnancy periods proposes that there is a unified mechanism that regulates relationships between VEGF and its receptors VEGF-R1 and VEGF-R2. The PLGF/VEGF-R1 and MMP-2/TIMP-2 ratios are of low informative value. Conclusion. The difference found in this study for the ratio of factors regulating gestational angiogenesis between the successful and unsuccessful perinatal outcome groups may be suggestive of its specif ic features and, in the non-developing pregnancy group, of impaired angiogenesis in the placental and embryonic vascular system in early pregnancy.
Obstetrics and Gynecology. 2012;(4-1):4-9
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SPREAD OF GENETIC POLYMORPHISMS ASSOCIATED WITH GESTATIONAL THROMBOHEMORRHAGIC AND VASCULAR COMPLICATIONS IN A COHORT OF PREGNANT WOMEN FROM THE RUSSIAN POPULATION

MEDYANNIKOVA I.V., GUDINOV Z.V.

Abstract

Objective. To study hemostasiological relations in the pathogenesis of gestational complications, to devise methods for more effective diagnosis and optimization of medical and preventive measures against late obstetric complications. Subjects and methods. Pregnant women were genotyped for four prothrombotic polymorphisms within the framework of a cohort prospective study in Omsk. Results. There was a high level of polymorphism of the plasminogen activator inhibitor-I(PAI-I) (62%) and methyltetrahydrofolate reductase - MTHFR (36%) and a low prevalence of polymorphic loci for the blood coagulation factors II and V genes in the plasma — F2 (3%) and F5 (2%). No great differences were found in the frequency of F2 and F5 polymorphisms between the examined women with gestational complications or those with physiological pregnancy. Conclusion. Carriage of the rare MTHFR allele doubles a risk for poor pregnancy outcomes. Among PAI-1 polymorphisms, there was a preponderance of heterozygous carriers in the study group, by considerably increasing the risk of obstetric complications. PAI-1 homozygous genotypes, including the major mutation, were unassociated with the risk in question and were more common among good pregnancy outcomes.
Obstetrics and Gynecology. 2012;(4-1):10-15
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SIGNIFICANCE OF AUTOANTIBODIES IN THE PATHOGENESIS OF PREECLAMPSIA

MAKAROV O.V., BOGATYREV Y.A., OSIPOVA N.A.

Abstract

Objective. To define the clinical significance of a study of a number of natural autoantibodies (AAb) for the valid timely diagnosis of preeclampsia and to make a differential diagnosis of preeclampsia and chronic arterial hypertension (CAH). Subjects and methods. Seventy-six pregnant women were examined. Eighteen pregnant women were noted to have preeclampsia (Group 1 (a study group); 36 pregnant women with CAH formed a comparison group (Group 2); of them there were Subgroup 2B patients (n=10) whose pregnancy was complicated by preeclampsia; the latter was absent in Subgroup 2A (n=26). A control group (Group 3) included healthy pregnant women (n=22). Enzyme immunoassay was used to measure the serum level of AAbs to IgG class anti-double-stranded DNA, two platelet membrane antigens (TrM-001-15, TrM-015-12), two kidney antigens (KiM-05-300, KiS-07-120), and hepatic mitochondrial antigen (HMMP) in all the pregnant women. Results. The most characteristic feature of pregnant women with preeclampsia is an obvious reduction in the serum levels of all examined AAbs; those of the latter to DNA and the proteins Trm-0.01 and Kis-07-12 were especially low. There was an imbalance in AAb levels in Subgroups 2A and 2B. In mixed forms of gestosis and in Subgroup 2A, the levels of platelet antibodies may be normal, near- or above-normal. Reduced markers for kidney pathology were revealed in 100% in Subgroup 2B and only in 33.3% in the pregnant women from Subgroup 2A, which may be indubitably used for differential diagnosis. Conclusion. The study of a number of natural AAbs ensures optimization of the differential diagnosis of preeclampsia and chronic hypertensive states in pregnant women at 24—40 weeks’ gestation and serves to predict with a high probability the development and severity of gestosis 2—4 weeks before the appearance of the first clinical symptoms of this pathology, which improves perinatal outcomes and substantially reduces maternal and infant morbidity and mortality.
Obstetrics and Gynecology. 2012;(4-1):16-21
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LEVELS OF HOMOCYSTEINE, FOLATES, AND VITAMIN B 12 IN THE BLOOD OF PREGNANT WOMEN WITH PREECLAMPSIA

MURASHKO L.E., FAIZULLIN L.Z., BADOYEVA F.S.

Abstract

Objective. To study a relationship between the blood levels of folates and vitamin B 12 to the plasma concentrations of homocysteine in pregnant women with preeclampsia (PE). Subjects and methods. Seventy-nine pregnant women at 28—35 weeks’ gestation were examined; out of them 29 women with normal pregnancy formed a control group, 32 and 18 had moderate and severe PE, respectively. Plasma homocysteine levels were measured using an IMx polarized fluorescence immunoanalyzer and IMx Homocysteine assay kits (Abbott Laboratories). The red blood cell and plasma levels of folic acid and vitamin B 12 were measured by a competitive chemoluminescence technique (Immulite 2000-BIODPC, USA). Results. As compared to the control group, the pregnant women with PE were shown to have much higher blood homocysteine levels. At this time, there was a direct relationship between homocysteine concentrations and PE severity. Conversely, the latter was found to depend inversely on the plasma and red blood cell levels of folates. The concentration of vitamin B 12 showed a similar trend. There was an inverse relationship between homocysteine and folate levels. At the same time the greatest folate reduction was seen in pregnant women having homocysteine concentrations more than 7μmol/l. Conclusion. It was shown that there was a direct correlation between the blood homocysteine levels in the pregnant women and the severity of PE. Moreover, there was an inverse correlation between the blood concentrations of homocysteine and B-group vitamin.
Obstetrics and Gynecology. 2012;(4-1):22-25
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NONINVASIVE SCREENING OF PREGNANT WOMEN

BAKHAREV V.A., KARETNIKOVA N.A., STYGAR A.M., IVANETS T.Y.

Abstract

Objective. To define the diagnostic value of a prenatal diagnosis program, by using noninvasive and invasive studies of the most common chromosomal abnormalities (such as Down syndrome and Edwards syndrome) and some multifactorial embryonic/fetal malformations (neural tube defects) in different periods of normal or threatened miscarriage-complicated singleton and multiple pregnancies. Subjects and methods. A total of 2022 women were examined during their first or second trimesters of normal or threatened miscarriage-complicated singleton and multiple pregnancies, who received hormonal therapy. The authors used noninvasive (ultrasonography, biochemical screening, software support to assess risks for fetal pathology (computer-assisted analysis) and invasive (transabdominal choriocentesis or transcervical chorion biopsy in the first trimester of pregnancy, placentocentesis, amniocentesis, cordocentesis in the second trimester to determine embryonic/fetal karyotypes) studies. The data obtained were statistically processed applying the Excel computer program. Results. According to the results of noninvasive prenatal diagnosis, all the women were allocated to 2 groups: those at low and high risk of a baby to be born with chromosomal abnormality. The high risk of the latter (1:130—1:5) was due to the enlarged embryonic collar of area. Multiple pregnancy showed no correlation between the values of serum markers, the high risk of chromosomal disorders in accordance with the computer program, and karyotypic abnormalities. Conclusion. Based on the findings, the authors have stated some propositions that pregnant women should be examined using screening programs. The main propositions are that ultrasound markers have a dominant role in the formation of a group at risk for a baby to be born with a chromosomal abnormality and neural tube defects; invasive diagnosis plays a crucial role in the detection of an embryonic/fetal chromosomal abnormality.
Obstetrics and Gynecology. 2012;(4-1):26-31
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EVALUATION OF ARTERIAL BLOOD FLOW IN PREGNANT WOMEN FROM THEIR SPHYGMOGRAM READINGS

ABRAMOVA R.M., BARANOV A.N., ISTOMINA N.G.

Abstract

Subjects and methods. Sphygmographic parameters were examined in 814 women at 8—10, 20—22, and 30—32 weeks’ gestational age; they formed 2 groups: 1) 240 women with physiological pregnancy; 2) 80 pregnant women with PE. Results. It was found that with a longer physiological pregnancy period, the index peripheral pulse-wave characterizing peripheral resistance decreased and the dicrotic wave determining diastolic blood flow increased. In pregnant women with further development of PE, the changes in sphygmographic parameters are indicative of peripheral vascular spasm and diminished diastolic blood flow. Conclusion. The main patterns of the changes in sphygmogram readings were established for physiological and PE-complicated pregnancy depending on gestational age, which may be used to predict the development of gestational complications.
Obstetrics and Gynecology. 2012;(4-1):32-37
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PREDICTION OF POWERLESS LABOR, BY USING CARDIOINTERVALOGRAPHY

DMITRIYEVA S.L., KHLYBOVA S.V., TSIRKIN V.I., KHODYREV G.N.

Abstract

Objective. To estimate the sensitivity and specificity of the authors’ method to predict powerless labor (PL) in pregnant women before labor and/or in the latent phase of its first period, by using cardiointervalography (CIG). Subjects and methods. A Neuron-Spectrum diagnostic system (Neurosoft, Ivanovo) was employed to make CIG and to estimate heart rate variability (HRV) in 302 women 1—5 days before term labor and in the latent phase of its first period. To analyze the results of the study retrospectively, all the women were divided into 2 groups. Group 1 consisted of 242 women, whose delivery was uncomplicated; Group 2 included 60 women whose delivery was complicated by PL. Results. A method was proposed to predict PL in pregnant women before labor and/or in the latent phase of its first period, which was based on the score rating of 11 indices, including 8 indicators characterizing HRV, as evidenced by CIG. The sensitivity of this method used before labor or in the latent phase of its first period was 96 and 96%, and its specificity was 98 and 97%, respectively. Conclusion. The proposed method shows promise for use as it permits the timely prevention of PL in high-risk women.
Obstetrics and Gynecology. 2012;(4-1):38-41
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ABNORMAL PREGRAVID UTERINE BLOOD FLOW IN PATIENTS WITH A HISTORY OF PRETERM BIRTH

SAVELYEVA G.M., BUGERENKO E.Y., PANINA O.B.

Abstract

Objective. To reveal the specific features of uterine circulation in patients with a history of preterm birth and their relationships to the concomitant factors favoring the development of endothelial dysfunction. Subjects and methods. The study covered 204 patients with a history of preterm birth who were planning their subsequent pregnancy. In addition to preterm birth, 128 of them had complicated last pregnancy, including fetal growth retardation, gestosis, placental abruption, and antenatal fetal death. Clinical and laboratory studies were conducted in all the patients and revealed hereditary hemostatic defects. Uterine artery blood flow was examined by transvaginal scanning on days 7-8 after ovulation. Results. Uterine circulatory disorders (UCD) were found in 40% of the patients with a history of preterm birth and in 8.3% of the control patients. There was an association between the uterine circulation, the time of the manifestations of and nature of gestational complications accompanying a previous pregnancy, the periods of delivery, the blood coagulation system, the diseases contributing to the development of endothelial dysfunction, and the number of years elapsed since labor. Conclusion. Late postgravid UCD in patients with a history of obstetric diseases points to the fact that gestational complications may recur in subsequent pregnancies. Therefore such patients need their uterine system to be rehabilitated before planning their further pregnancy.
Obstetrics and Gynecology. 2012;(4-1):42-47
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OBSTETRIC ASPECTS OF IMPAIRED URINATION IN WOMEN

KOVALEVA L.A., BALAN V.E., APOLIKHINA I.A., AMIROVA Z.S.

Abstract

Objective. To study the rate of impaired urination during pregnancy, to determine the importance of risk factors, and to elaborate an optimal algorithm for examination and treatment. Subjects and methods. A detailed clinical and laboratory examination was made in 140 women with impaired urination at 20 and 32 weeks’ gestational age and 4 months after labor. Group 1 (a study group) comprised 70 patients who received complex behavioral therapy; Group 2 (a comparison group) included 70patients who dismissed behavioral therapy. A control group consisted of 30 healthy pregnant women matched for main parameters. The authors interviewed using a specially designed questionnaire (518 women), used a clinicoanamnestic method, assessed urination diaries, conducted an objective examination including serum relaxin measurements, uroflowmetry, ultrasonography estimating the urethral sphincter area and the urethrovesical angle (alpha angle), and applied statistical methods. Results. During pregnancy, the rate of impaired urination substantially increases; the risk factors are the preexisting disease before current pregnancy; patient age; a history of pregnancies and vaginal deliveries;previous deliveries of relatively higher birthweight neonates, and body mass index. The optimal method for correction of any type of impaired urination during pregnancy is behavioral therapy that reduces its symptoms during pregnancy and after labor by 3 and 1.9 times, respectively. Conclusion. Evaluation of impaired urination in pregnant women is extraordinarily important and allows high risk-group identification. The detailed clinical and laboratory examination of risk group patients makes it possible to reveal the type and degree of impaired urination and to determine its prognosis. Complex behavioral therapy is an optimal method to treat and prevent impaired urination during pregnancy.
Obstetrics and Gynecology. 2012;(4-1):48-53
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USE OF PREIMPLANTATION DIAGNOSIS WITHIN THE FRAMEWORK OF AN ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAM FOR MARRIED COUPLES WITH A COMBINATION OF MUTATIONS AT THE AZF LOCUS OF THE Y CHROMOSOME AND CFTR GENE POLYMORPHISM IN HUSBANDS

BELYAEVA N.A., GLINKINA Z.I., SOKUR S.A., GUBAYEVA Z.M., DOLGUSHINA N.V., KALININIA E.A.

Abstract

Objective. To study the prevalence and pattern of gene disorders in patients with pathozoospermia; to examine the level and pattern of chromosomal abnormalities in the embryos of married couples with simultaneous mutation at the AZF locus of the Y chromosome and CFTR gene polymorphism in the husbands. Subjects and methods. Three hundred and eighty married couples with a male infertility factor who needed an in-vitro fertilization/intracytoplasmic sperm injection (ICSI) program were examined. All the men underwent a spermiological test of their ejaculates and molecular genetic analysis to detect gene disorders. In two married couples with primary infertility, whose husbands were found to have azoospermia and asthenoteratozoospermia and simultaneous mutation at the AZF locus of the Y chromosome and CFTR gene (5T allele) polymorphism, preimplantation diagnosis (PID) was made by the FISH technique, by choosing the sex of embryos. The FISH study of embryonic blastomere nuclei applied Abbott probes to the X, Y, 13, 18, and 21 chromosomes. Results. In the men with pathoazoospermia, mutations and CFTR gene polymorphism were detected in 12.6%; of them the 5T allele was 79% of cases; microdeletions at the AZF locus of the Y chromosome were found in 14.2%; out of them, microdeletion in the AZTc—del sY 1192 subregion was 59.6% of cases. PID of the embryos from married couples with simultaneous mutation at the AZF locus of the Y chromosome and CFTR gene polymorphism in the husbands indicated that 41.2% of the embryos examined had aneuploidy for sex chromosomes and 36.4% of the embryos had aneuploidy for autosomes 13, 18, and 21 (in one or a few chromosomes). Conclusion. The men with pathozoospermia are observed to have a high rate of gene disorders; these patients form a group at risk of birth of a sick baby. The men with pathozoospermia and simultaneous mutation at the AZF locus of the Y chromosome and CFTR gene polymorphism can transmit the existing mutations to their offspring and form a group at risk for birth of a baby with aneuploidy for different chromosomes.
Obstetrics and Gynecology. 2012;(4-1):54-58
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PREVENTION OF BIRTH OF A SICK BABY IN PATIENTS WITH INFERTILITY AND ROBERTSONIAN TRANSLOCATION IN THE KARYOTYPE

GLINKINA Z.I., ALIYEVA K.U., BUGAI T.V., BELYAEVA N.A., GUBAYEVA Z.M., SOKUR S.A., KALININA E.A.

Abstract

The paper describes a clinical observation of a married couple with infertility, heterozygous CYP 21B gene mutation in the wife and Robertsonian translocation in the husband, who have undergone preimplantation and prenatal diagnoses.
Obstetrics and Gynecology. 2012;(4-1):59-60
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MASSIVE SUBCHORIAL THROMBOSIS OF THE PLACENTA AND PREGNANCY OUTCOME

BARINOVA I.V., KONDRIKOV N.I., NOVIKOVA S.V., VITUSHKO S.A., BIRYUKOVA N.V.

Abstract

Objective. To make a clinical and anatomic analysis of the etiology, clinical course, and outcomes of massive subchorial thrombosis (MSCT), a rare type of uterine-placental circulatory disorders. Subjects and methods. Eight cases of MSCT during singleton pregnancy, including 4 cases of intra- and antenatal fetal deaths at 18—31 weeks’ gestation and 4 cases of live babies born at 32 and 37—38 weeks, were analyzed. Clinical and anatomic comparisons were made to determine the value of the placenta in critical condition and antenatal fetal death. While examining the placenta, the investigators determined its weight and placental-fetal index, the state of the intervillous space, villous tree, villous vessels, and trophoblast. Results. MSCT in the placentas of intranatal dead fetuses occupied as high as four-fifths of the chorial plate area, by spreading to the basal plate and compressing the villous tree. MSCT in the neonatal placentas appeared as solitary subchorial hematoma or subchorial fibrin masses that occupied as high as half of the chorial plate area. The neonatal infants with MSCT showed fetal growth retardation syndrome and low-weight placentas with pronounced compensatory changes in the villous chorion. Thrombotic masses were composed of unaltered, hemolyzed red blood cells and fibrin of various ages, which was arbitrarily classified as mature (6—24-hour) and old (more than 24—48-hour). The chorial plate in the area of MSCT showed fibrinoid necrosis. Conclusion. The poor fetal outcome of MSCT is due to the low-weight placenta and physiological immaturity of compensatory processes. Prolonged MSCT makes it possible to diagnose this critical condition of the fetoplacental unit, to perform appropriate therapy, and to generate an idea of further pregnancy management.
Obstetrics and Gynecology. 2012;(4-1):61-64
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EVALUATION OF ENDOMETRIAL RECEPTIVITY IN PATIENTS WITH A HISTORY OF FAILED IN VITRO FERTILIZATION PROGRAMS

LEVIASHVILI M.M., DEMURA T.A., MISHIYEVA N.G., FAIZULLINA N.M., NAZARENKO T.A., KOGAN E.A.

Abstract

Objective. To make clinical, morphological, and immunohistochemical (IHC) evaluations of endometrial receptivity in women with a history of failed in vitro fertilization (IVF) programs. Material and methods. Endometrial scrapes were examined in 36 infertile women with a history of failed IVF programs and 6 fertile women of reproductive age in the implantation window period. Results. The endometrium of the patients with a history of IVF failures is characterized by decreased integumentary epithelial cells with the presence of mature pinopodia. IHC study of biopsy specimens showed an imbalance between steroid hormone receptors more frequently with a smaller number of estrogen receptors, as well as a lower expression of leukemia inhibitory factor with no tendency towards an enhanced cytokine expression from the deep endometrial histological layer to the more superficial one.
Obstetrics and Gynecology. 2012;(4-1):65-69
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DESTRUCTION BY FOCUSED ULTRASOUND UNDER GUIDANCE OF MAGNETIC RESONANCE IMAGING AS THE FIRST STAGE OF COMBINATION TREATMENT FOR SUBMUCOUS UTERINE MYOMAS

KURASHVILI Y.B., BARANOV I.I., KANAYEVA E.Y., BATARSHINA O.I.

Abstract

Objective. To study whether destruction by focused ultrasound (FU) under guidance of magnetic resonance imaging (FUMRI) may be used as a preoperative stage of surgical treatment for submucous uterine myoma. Subjects and methods. In 20 reproductive- and late reproductive-age patients, submucous uterine myoma was preoperatively prepared by FU MRI. Nodules were 3 to 6 cm in diameter. Results. Due to FU destruction, nodular regression was 20 to 60%. All the patients satisfactorily experienced the procedure and called it comfortable. Typical transcervical myomectomy without complications was carried out 3—4 months after FU MRI. Conclusion. FU MRI-guided ablation may serve as the method of choice for the preparation of 3—7-cm submucal nodules for transcervical myomectomy since it is an effective method to reduce nodular volume and an outpatient noninvasive procedure that has no clinically significant systemic effect on the body and that requires no rehabilitation or temporary disability.
Obstetrics and Gynecology. 2012;(4-1):70-73
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WAYS OF REDUCING OBSTETRIC LOSSES

MILOVANOV A.P., LEBEDENKO E.Y., MIKHELSON A.F.

Abstract

Materials and methods. Two hundred and twenty-eight cases that had nearly ended in death from severe obstetric complications in pregnant women, parturients, and puerperas and 74 maternal death cases were analyzed. A comprehensive analysis of maternal deaths, assessment of perinatal risk factors, study of a correlation of signs, and statistical data processing were made. Results. Analysis of the defects at the stages of medical care revealed substantial differences for the women who had and nearly died: in the former, the defects per patient were 1.5-fold greater than those in the latter (the errors in assessing risk factors were 0.922±0.017 and 0.733±0.12; the defects of diagnostic and therapeutic measures, 0.894±0.023 and 0.666±0.11; low specialist training level, 0.892±0.023 and 0.616±0.090; inadequate level of obstetric services, 0.844±0.035 and 0.583±0.096). In-depth clinical analysis of critical obstetric complications suggests the definition of nearly dead female cases and provides evidence that it is necessary to calculate the index similar to that of maternal mortality (per 100000 live births) in a specific region. Conclusion. Thorough clinical analysis of nearly dead cases is a weighty contribution to the further reduction of maternal mortality rates, which is borne out by the equitype defects of a therapeutic and diagnostic process, which lead to fatal outcome in cases of preventable maternal death and its high risk in nearly dead women. Better conditions for maintaining maternal health should be aimed at reducing the number of fatal outcomes and be achieved by decreasing that of nearly dead female cases with a prior obstetric catastrophe.
Obstetrics and Gynecology. 2012;(4-1):74-78
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OPTIMIZATION OF POSTOPERATIVE MANAGEMENT IN PATIENTS AFTER PLASTIC OPERATIONS IN GYNECOLOGY

VDOVIN S.V., SELIKHOVA M.S., FILINA E.V., SELIKHOV A.V., PANKRATOV S.B.

Abstract

Objective. To improve postoperative management in patients with genital prolapse after surgical treatment. Subjects and methods. Examinations were made 57 patients who were, according to the postoperative management, divided into 2 groups: 1) 22 patients who received conventional vaginal suture treatment methods; 2) 35 patients who had a package of medical measures comprising the combined drug depantol. In addition to postoperative clinical characteristics, the authors estimated the time course of changes in vaginal smears, by determining the counts of white blood cells and epithelial cells in the field of vision, the presence of key cells, the qualitative and quantitative composition of the vaginal microflora by a microscopic study. Results. The clinical and laboratory findings confirmed the efficiency of incorporating depantol into a package of medical measures, as suggested by no infectious complications in the study group patients and by the shorter length of hospital stay. Conclusion. The incorporation of depantol into a package of medical measures in the management of a postoperative period in patients with genital prolapse decreases the frequency of infectious complications and accelerates regeneration, which favors its more favorable course.
Obstetrics and Gynecology. 2012;(4-1):79-82
pages 79-82 views

POSSIBILITIES OF COMBINATION TREATMENT FOR CHRONIC CERVICITIS

DOVLETKHANOVA E.R., ABAKAROVA P.R.

Abstract

Objective. To assess whether tyloron (lavomax) may be used in the combination treatment of cervicitis caused by Chlamydia infection. Subjects and methods. The study enrolled 30 patients aged 18 to 45 years (mean age 26.2±1.2 years) with the clinical manifestations and verified diagnosis of urogenital chlamydiasis; according to the clinical and laboratory findings, they were divided into 2 groups: 1) 15 patients who took lavomax as part of combination therapy; 2) 15 patients who received standard antibacterial therapy for chlamydiasis. Results. The clinical symptoms observed before therapy and the signs of cervicitis during expanded colposcopy were absent in 93.3 and 80% of Groups 1 and 2 patients, respectively. Insignificant clinical symptoms were observed in 6.7 and 20% of Groups 1 and 2 patients, respectively. The levels of interferons (IFN) a and γ were substantially unchanged in Group 2 patients; Group 1 patients showed almost 1.5- and almost 3-fold increases in the concentrations of IFN-a and IFN-γ, respectively. Conclusion. The use of lavomax as part of combination therapy for cervicitis caused by Chlamydia infection results in a pronounced positive clinical effect and promotes more complete cessation of the clinical symptoms of urogenital chlamydiasis than the standard antibacterial therapy.
Obstetrics and Gynecology. 2012;(4-1):83-86
pages 83-86 views

HIRSUTISM: PATHOGENESIS, CLINICAL PRESENTATION, DIAGNOSIS, TREATMENT

GRODNITSKAYA E.E., KURTSER M.A.

Abstract

Hirsutism is a common clinical problem characterized by the excessive growth of terminal hair in the androgen-dependent areas. Although hirsutism is frequently considered to be of aesthetic concern, it may be a symptom of the diseases associated with the excessive production or activity of androgens. The paper describes the etiology, pathogenesis, clinical picture of hirsutism and discusses the matters of its diagnosis and therapy.
Obstetrics and Gynecology. 2012;(4-1):87-90
pages 87-90 views

TREATMENT FOR CHLAMYDIA INFECTION IN GYNECOLOGY AND OBSTETRICS: A REVIEW OF CURRENT FOREIGN AND RUSSIAN GUIDELINES

KISINA V.L., ANDREYEVA I.V., STETSYUK O.U.

Abstract

The review deals with the treatment of infection caused by Chlamydia trachomatis in obstetric and gynecological care, considers antimicrobial drugs and therapy regimens, which are given in the current foreign and Russian guidelines for the treatment of urogenital Chlamydia infection in nonpregnant and pregnant patients, and analyzes the data of clinical trials of the efficacy and safety of recommended antibiotics.
Obstetrics and Gynecology. 2012;(4-1):91-98
pages 91-98 views

SIGNIFCANCE OF THE INTRA-ABDOMINAL HYPERTENSION IN REALIZATION OF OBSTETRIC END PERINATAL PATHOLOGY AT PREGNANT WOMEN WITH OBESITY

SALOV I.A., SHIFMAN E.M., MARSHALOV D.V., PETRENKO A.P.

Abstract

Objective. Revealing correlation of level of intra-abdominal pressure with frequency and structure obstetrics and perinatal complications at pregnancy women with obesity. Material and methods. The clinical current of pregnancy, outcomes of labors and dynamics of intra-abdominal pressure at 60 patients with normal weight of a body, 60 patients with overweight and 93 women with obesity were studied. Results. The magnitude intra-abdominal pressure (IAP) at pregnant women had close interrelation with the trophic status of the patients were established. The reference values of IAP at pregnant women with obesity corresponded to I—II degree of an intra-abdominal hypertension. The quantity obstetric and perinatal complications in larger correlates degrees with level IAP, rather than with initial BMI. Ascending of IAP during pregnancy is closely connected with rate of an increase of the body weight. Frequency obstetric and perinatal complications is closely connected with value IAP, but in larger degrees with temp of change IAP during pregnancy.
Obstetrics and Gynecology. 2012;(4-1):99-102
pages 99-102 views

HYPOPARATHYROIDISM IN AN OBSTETRICIAN-GYNECOLOGIST'S PRACTICE

TERESHCHENKO I.V.

Abstract

The paper intended for the practitioner considers the effect of parathyroid hormone on the course of pregnancy and labor and analyzes their pathology in women with hypoparathyroidism.
Obstetrics and Gynecology. 2012;(4-1):103-107
pages 103-107 views

GENITAL INFECTIOUS AND INFLAMMATORY DISEASES IN CHILDREN AND ADOLESCENTS

ADAMYAN L.V., SIBIRSKAYA E.V., GLYBINA T.M., BOGDANOVA E.A.

Abstract

This paper considers the causes of genital infectious and inflammatory diseases in children and adolescents and the incidence of this pathology. It describes the clinical picture and diagnosis of major nosological entities of genital infectious and inflammatory diseases and gives their key treatment regimens in children and adolescents.
Obstetrics and Gynecology. 2012;(4-1):108-112
pages 108-112 views

PROPHYLACTIC PASSIVE IMMUNIZATION IN CHILDREN AT HIGH RISK FOR SEVERE RESPIRATORY SYNCYTIAL VIRUS INFECTION

BAIBARINA E.N., RYUMINA I.I.

Abstract

The paper gives an account of the roundtable meeting held at the Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia, on December 9, 2011, which was dedicated to the prevention and treatment of respiratory syncytial virus infection in neonates and babies during the f irst year of life.
Obstetrics and Gynecology. 2012;(4-1):113-116
pages 113-116 views

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