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No 7 (2013)

Articles

ROLE OF HEREDITARY THROMBOPHILIA IN THE GENESIS OF COMPLICATED PREGNANCY

ZARUDSKAYA O.M., CHURNOSOV M.I.

Abstract

The literature review shows the role of hereditary thrombophilia in the development of different gestational complications. It gives information on the contribution of individual gene polymorphisms of inherited thrombophilia and their combination (Leiden FV 1691G/A, thrombin FII 20210G/A, MTHFR 677C/T, etc.) to the development of major obstetric complications (recurrent miscarriage, placental insufficiency, fetal growth restriction, placental abruption).
Obstetrics and Gynecology. 2013;(7):4-7
pages 4-7 views

OVARIAN HYPERSTIMULATION SYNDROME: ETIOPATHOGENESIS, CLINICAL PRESENTATION, DIAGNOSIS (PART 1)

KORNEEVA I.E., SAROYAN T.T., KALININA E.A., SMOLNIKOVA V.Y.

Abstract

The objective of the study is to acquaint clinicians with current problems in the diagnosis and treatment of ovarian hyperstimulation syndrome (OHSS). Part 1 of the article discusses the pathophysiological aspects of the development of OHSS, its classification, and course.
Obstetrics and Gynecology. 2013;(7):8-13
pages 8-13 views

PREGNANCY IN THE PRESENCE OF ANXIETY AND DEPRESSIVE CONDITIONS

PEROVA E.I., STENYAEVA N.N., APOLIKHINA I.A.

Abstract

In recent years, there is a growing number of investigations dealing with the pathophysiological state of pregnant women Increased anxiety and depression are common, but often unrecognized conditions that give rise to negative female and fetal health effects. The number of women who experience anxiety throughout pregnancy and take psychotropic medications thereof continues to increase. However, the use of drugs is not considered to be safe for the mother and fetus, which calls for a search for alternative methods to correct psychological states in pregnant women. The review gives data in the past decade on the impact of anxiety, depression, and childbirth fear on the course of labor, as well as on possible methods of prenatal non-drug psychocorrection.
Obstetrics and Gynecology. 2013;(7):14-17
pages 14-17 views

VAGINAL LACTOBACILLI: CURRENT APPROACHES TO SPECIES IDENTIFICATION AND TO THE STUDY OF THEIR ROLE IN THE MICROBIAL COMMUNITY

MELKUMYAN A.R., PRIPUTNEVICH T.V.

Abstract

The development of innovation medical technologies promotes the wide introduction of new laboratory methods for the diagnosis of dysbiotic states and for the pharmacological correction of unbalanced interactions in the ecological human-microbial system. One of these areas is to promote the fundamentally new method - time-of-flight mass spectrometry. MALDI-TOF mass spectrometry of the species spectrum of vaginal lactobacilli in reproductive-aged women showed that it had a wide variety and contained 21 species, the leading ones of which are L. crispatus, L. iners, L. jensenii, and L. gasseri. Further investigation of Lactobacillus species and strain differences in health and disease will become a basis for selecting the most promising strains as probiotic agents. Genome-proteome typing along with proteomic studies and an investigation of new molecular mechanisms in view of the data of bacteriological testing and metagenomic analysis may provide new insights into the colonization mechanisms for the formation of microbiocenoses.
Obstetrics and Gynecology. 2013;(7):18-23
pages 18-23 views

PLACENTAL PROTEOMIC PROFILE DURING PHYSIOLOGICAL AND PREECLAMPSIA-COMPLICATED PREGNANCY

POGORELOVA T.N., GUNKO V.O., LINDE V.A.

Abstract

Objective. To reveal changes in the preeclamptic placental proteomic spectrum. Subject and methods. Thirty-two women, among whom there were 17 women with preeclampsia who formed a study group and 15 women with physiological pregnancy who were included in a control group, were examined. Placental proteomic analysis was made using two-dimensional electrophoresis and time-of-flight mass spectrometry. Results. The performed studies could reveal and identify difference proteins, the rate of whose production was considerably different in physiological pregnancy and preeclampsia. Among the proteins with decreased expression, there was α-tropomyosin, actin-related protein 2/3 complex subunit 2, cytoplasmic actin 1, annexin A4, 20S proteasome, and 60S acidic ribosomal protein. The proteins with increased expression included the molecular chaperones heat shock protein (Hsp60) and endoplasmin, as well as peroxidoxin-4, mitochondrial aconitate hydratase, and 14-3-3 protein epsilon. Conclusion. The established differences in the placental proteomic spectrum obviously reflect impaired molecular cell interactions in the maternal-placental-fetal system in preeclampsia-complicated pregnancy.
Obstetrics and Gynecology. 2013;(7):24-29
pages 24-29 views

DIFFERENTIATED APPROACH TO SURGICAL TREATMENT FOR DEEP INFILTRATIVE BOWEL ENDOMETRIOSIS

MELNIKOV M.V., CHUPRYNIN V.D., ASKOLSKAYA S.I., ABRAAMYAN M.S.

Abstract

Objective. To define criteria for choosing the volume of surgery for deep infiltrative bowel endometriosis in relation to the location and depth of bowel wall involvement and to clinical manifestations. Subject and methods. Ninety-nine clinical cases of surgical treatment in patients with the verified diagnosis of deep infiltrative bowel endometriosis in the period 2010 to 2013 were considered. Results. The indications for surgical treatment for deep infiltrative bowel endometriosis were chronic pain syndrome in 99 (100%) cases, cyclic intestinal bleeding in 17(17.2%) cases, and colonic evacuatory dysfunction in 82 (82.3%) patients. The surgical volume depended on the location, extent, and depth of invasion of endometriosis into the bowel wall and the women’s readiness for undergoing the required surgical volume. Out of the total number of operations, laparoscopic surgery was performed in 81 (81.9%) cases; laparotomic conversion was required in 18 (18.1%) cases. The endometrioid infiltrate was excised within the visible intact tissues, without opening the bowel lumen in 48 (48.5%) cases, when the muscular and submucosal layers were involved by endometriosis in a limited area of up to 3 cm. The bowel was resected in 51 (51.5%) patients. Among them, 7 (7.1%) patients underwent discal resection involving three fourths of the lumen; circular colon resection (anterior resection of the rectum) was carried out in 43 (43.2%) cases. Simultaneous resection of the large and small bowels with their synchronous involvement was performed in 7 (7.1%) patients. A protective colostomy was needed to create a low anastomosis (less than 5 cm from the anus) in 4 (4.4%) cases. In the immediate postoperative period, 2 (2.0%) patients were found to have an incompetent enteric anastomosis, which required re-surgery. Conclusion. Surgical treatment for deep infiltrative bowel endometriosis is indicated for chronic pain syndrome unrelieved by medical therapy, for intestinal evacuatory dysfunction and intestinal bleeding. The correspondence of the volume of an undertaken operation to the found pathological changes will be able to avoid the situation that the risk of surgical treatment overweighs the expected result. The surgical approach to treating bowel endometriosis must not depend only on a surgeon’s readiness to perform one or another surgical volume.
Obstetrics and Gynecology. 2013;(7):30-35
pages 30-35 views

PREDICTION OF THE EFFICIENCY OF SURGICAL TREATMENT FOR INFERTILITY IN WOMEN WITH MINOR FORMS OF EXTERNAL GENITAL ENDOMETRIOSIS

KRASILNIKOVA A.K., MALYSHKINA A.I., SOTNIKOVA N.Y., ANTSIFEROVA Y.S.

Abstract

Objective. To assess whether the immunological parameters associated with the activity of humoral immune reactions may be used to predict the efficiency of surgical treatment for infertility in women with minor forms of external genital endometriosis. Subject and methods. Peripheral blood was examined in 33 women with infertility caused by minor forms of external genital endometriosis (a study group) and 19 healthy fertile women (a control group). The levels of B, B1 cells, Th2 lymphocytes and the serum content of IL-4 and IL-6 were determined. Results. In the study group women, the peripheral blood showed increases in the content of B1 lymphocytes and Th2 cells and the serum level of IL-4 and IL-6. The maximum magnitude of immune disorders was associated with the absence of pregnancy after laparoscopy. Conclusion. The level of B1 lymphocytes enables one to predict the efficiency of surgical treatment for infertility in women with minor forms of external endometriosis.
Obstetrics and Gynecology. 2013;(7):36-39
pages 36-39 views

INFERTILITY AND AN ADHESIVE PROCESS IN THE SMALL PELVIS: LONG-TERM RESULTS OF TREATMENT

DUBINSKAYA E.D., GASPAROV A.S., BABICHEVA I.A., TER-OVAKIMYAN A.E., LAPTEVA N.V., DMITRIEVA N.V.

Abstract

Цель исследования. Оценка отдаленных результатов лечения пациенток с бесплодием и тазовыми перитонеальными спайками (наступление маточной беременности). Материал и методы. В исследование были включены 140 пациенток, из них 33 (23,6%) — со спаечным процессом I—II стадии, 107 (76,4%) — с распространенным процессом III—IV стадии. Результаты исследования. Доказано, что при бесплодии, обусловленном средними и тяжелыми формами спаечного процесса, частота наступления маточной беременности после хирургического лечения пациенток не превышает 25%. У пациенток с бесплодием и тазовыми перитонеальными спайками 3-4-й стадии проведение лапароскопии позволяет выявить степень распространения процесса и прогнозировать вероятность наступления беременности. Заключение. Учитывая низкую частоту восстановления фертильности у этой группы больных, пациенткам рекомендовано использование методов вспомогательных репродуктивных технологий.
Obstetrics and Gynecology. 2013;(7):40-44
pages 40-44 views

PAPILLOMAVIRUS INFECTION CAUSED BY HUMAN PAPILLOMAVIRUS TYPES 52 AND 58 AND ITS ROLE IN THE DEVELOPMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIAS

BESTAYEVA N.V., NAZAROVA N.M., PRILEPSKAYA V.N., TROFIMOV D.Y., BURMENSKAYA O.V., PAVLOVICH S.V.

Abstract

Objective. To study the prevalence and role of different human papillomavirus (HPV) types, including HPV 52 and 58, in the development of cervical intraepithelial neoplasia (CIN) and cancer of the cervix uteri (CCU). Subject and methods. 548 women aged from 18 to 60 years with cervical pathology were examined. A study group consisted of 383 HPV-positive women. Clinical, anamnestic, gynecologic, molecular biological, and morphological studies and extended colposcopy were used. Results. The most common HPV types were 16, 58, 31, 52, 33, and 44(55). HPV 52 and 58 were more frequently found in women younger than 35 years (88%). Cytological examination revealed NILM in 169 (44.1%) patients, АSCUS in 16 (4.2%), LSIL in 82 (21.4%), HSIL in 99 (25.8%), and CCU in 17 (4.4%). HPV 52 and 58 were detected in 22(13%) women with HILM, in 1 (6.2%) with АSCUS, in 20(24.4%) with LSIL, in 25(25.2%) with HSIL, and in 2 (11.7%) with CCU. The HSIL and CCU groups displayed a significant increase in viral load as compared to the HILM group. Conclusion. HPV 52 and 58 have turned out to be more common than the previously presented data; they are a cause of abnormal cytology in 22.4% of the patients. The magnitude of viral load is associated with the degree of cervical lesion; however, it cannot be used as the only indicator of the unfavorable course of HPV infection.
Obstetrics and Gynecology. 2013;(7):45-50
pages 45-50 views

IMPACT OF DIFFERENT ANESTHETIC TECHNIQUES ON MATERNAL, FETAL, AND NEONATAL STATES AFTER ABDOMINAL DELIVERY

KINZHALOVA S.V., MAKAROV R.A., DAVYDOVA N.S.

Abstract

Objective. To comparatively analyze maternal central hemodynamic parameters, fetal gaseous homeostasis, acid-base state (ABS), and perinatal outcomes after abdominal delivery under different anesthetic modes. Subject and methods. The investigation enrolled 65 pregnant women undergoing cesarean delivery under general and spinal anesthesia (GA and SA). Noninvasive bioimpedance technology was used to measure central hemodynamic parameters at surgical stages. The neonatal infants were evaluated using Apgar scoring at 1 and 5 minutes after birth. Umbilical venous blood gaseous homeostasis and ABS were examined. Results. At all surgical stages, the SA group presented a more favorable hemodynamic profile than did the GA group. The application of GA was followed by lower Apgar scores at 1 minute; no differences were found at 5 minutes. The study groups showed no great differences in umbilical venous blood pH, standard base excess, and lactate levels. In the GA group, the oxygen saturation in umbilical blood was significantly higher than that in the SA group. All the neonates had no complications in the early neonatal period. Conclusion. This study demonstrates a greater hemodynamic stability after cesarean section under SA. The GA newborn babies had higher umbilical blood oxygen saturation levels; however, both anesthetic modes indicated that adequate uteroplacental perfusion was preserved and they were safe for the fetus.
Obstetrics and Gynecology. 2013;(7):51-55
pages 51-55 views

INDOLE CARBINOL IS A MULTITARGETED THERAPY OPTION FOR CYCLIC MASTODYNIA

KISELEV V.I., SMETNIK V.P., SUTURINA L.V., SELIVANOV S.P., RUDAKOVA E.B., RAKHMATULLINA I.R., ANDREYEVA E.N., FADEYEVA N.I., KHASANOV R.S., KULAGINA N.V., ROZHKOVA N.I., ARTYMUK N.V., GAVISOVA A.A., MUIZHNEK E.L., KUZNETSOV I.N., DRUKH V.M.

Abstract

Objective. To determine the efficacy of a new indole carbinol-based medication (indinol forto) in treating cyclic mastalgia (mastodynia) and benign breast dysplasia (fibrocystic mastopathy). Subject and methods. A multicenter randomized double-blind placebo-controlled trial was conducted in 156 patients who received 400 mg/day of indole carbinol or placebo during 6 menstrual cycles. Results. According to the breast pain criterion, the therapeutic effectiveness was significantly higher in the indinol forto group than in the placebo group (84.4% versus 53.3%; p = 0.002). After 6 months of therapy pain was relieved or gone in 85.1% of the patients in the mastopathy subgroup (50.0% in the placebo group; p = 0.004). The indinol forto group showed a decrease in the size of cysts in 18% of the patients, its stabilization and growth in 71 and 11%, respectively. In the placebo group, there was stabilization of cyst sizes in 75% of the patients and their growth in 25%; no reduction in cyst sizes was noted. It was also ascertained that in the indinol forto group, there was an increment of plasma sex-steroid-binding globulin levels and an increase in the ratio of urinary estrogen metabolites (2-hydroxyestrone/16α-hydroxyestrone). Conclusion. Indinol forto may be recommended for the treatment of patients with both cyclic mastalgia (mastodynia) and mastopathy.
Obstetrics and Gynecology. 2013;(7):56-62
pages 56-62 views

OBSTETRICS IN EXTREMELY PRETERM PREGNANCY: EXPERIENCE IN SOLVING SOME PROBLEMS

KOVALEV V.V.

Abstract

The decision on the final transition to the WHO live birth criteria has become one of the most significant challenges of modern obstetrics in our country. This decision puts a number of new ideological, organizational, and technological questions to perinatal care providers, the answers to which are directly associated with the survival of extremely premature infants and their further fate. The paper gives the experience of the Ural Research Institute of Maternity and Infancy Care in solving some obstetric problems in extremely preterm pregnancy.
Obstetrics and Gynecology. 2013;(7):63-66
pages 63-66 views

PATIENT SATISFACTION AS ONE OF THE CRITERIA FOR OBSTETRIC AND GYNECOLOGIC CARE QUALITY (According to the results of analyzing written complaints from the population of Nizhny Novgorod)

FILIPPOV Y.N., ABAYEVA O.P., FILIPPOV A.Y., SHCHELTSINA N.Y.

Abstract

Objective. To seek possible ways to increase the quality of obstetric and gynecologic care, by analyzing written complaints from citizens (in case of Nizhny Novgorod). Subject and methods. The citizens’ written complaints to the Healthcare Department of the Nizhny Novgorod City Administration in 2008 to 2011 were analyzed by copying out and processing them using Microsoft Excel 2007. Results. 54.3% of 182 complaints were associated with extremely severe obstetric complications: neonatal death, a baby’s severe health problems, a parturient’s death, etc. 12% of the complaints came due to the refusal of the personnel to give medical assistance. 25.2% were made due to the actions posing no substantial health risk. The reasons for the other complaints did not depend on the activities of specific health care workers who directly carried out a therapeutic and diagnostic process. According to the investigation results, 63.3% of the complaints were recognized unfounded and associated with the lack of population awareness about the procedure of medical care and the scope of people’s rights. Conclusion. To upgrade the quality of medical care, it is necessary to improve specialists’ qualification, including short-term subject improving cycles on specialized issues; to increase the legal literacy of health care workers; to expand explanatory work among the population on the scope of free medical care rendered by the health care facilities involved in its provision.
Obstetrics and Gynecology. 2013;(7):67-71
pages 67-71 views

THE STATE OF NURSING PREMATURE NEONATES IN RUSSIA TODAY: RESULTS OF A SURVEY OF NEONATOLOGISTS

MOSTOVOI A.V.

Abstract

Objective. To study the real state of affairs on the introduction of up-to-date medical nursing and intensive care technologies for premature infants in the Russian Federation, by surveying medical specialists. Subject and methods. The results of surveying neonatologists from 80 regions of the Russian Federation on different issues in neonatal care were analyzed. The questionnaire contained 30 questions related to the key aspects of newborn health care to neonatal infants. 421 of 700 sent questionnaires were filled out. A number of replies were obtained during interactive voting. A total of 532 neonatologists took part in the survey. Results. It was found that the obstetricians/gynecologists did not participate in primary neonatal intensive care in the delivery room; either a neonatologist or a team of a neonatologist, a nurse, and, occasionally, an anesthesiologist/resuscitation specialist more frequently did. Over 65% of the respondents had not been trained in respiratory care. More than half of the neonatologists did not provide adequate parenteral nutrition to the infants in need. This survey could reveal the acute problems and weak points which called for corrective actons. Its results allowed the main educational areas of the Department to be shaped in the near future. This was Russia’s first independent survey of the specialists; we need a full-scale, well-designed study to obtain reliable results. Conclusion. To survey specialists from different regions of the Russian Federation, by applying a questionnaire on the key issues of health care is an objective method for assessing the readiness of services to render up-to-date specialized care in situ.
Obstetrics and Gynecology. 2013;(7):72-79
pages 72-79 views

EXPERIENCE WITH TEMPORARY BALLOON OCCLUSION OF THE COMMON ILIAC ARTERIES IN PATIENTS WITH PLACENTA INCRETA DURING ORGAN-SPARING OPERATIONS

KURTSER M.A., BRESLAV I.Y., GRIGORYAN A.M., LATYSHKEVICH O.A.

Abstract

Placenta increta remains a leading cause of massive obstetric hemorrhage, requiring the elaboration of new optimal delivery approaches. Progress in endovascular surgery and a yearning for organ-sparing operations have contributed to the use of uterine artery embolization and temporary balloon occlusion of the common iliac arteries to minimize blood loss in patients with placenta increta. The authors describe their two observations of organsparing surgery applying temporary balloon occlusion of the common iliac arteries in true invasive placenta.
Obstetrics and Gynecology. 2013;(7):80-84
pages 80-84 views

LOCAL THERAPY FOR UROGENITAL DISORDERS COMPLICATED BY IMPAIRED URINATION AND PELVIC PAIN SYNDROME IN POSTMENOPAUSAL WOMEN

NEIMARK A.I., SHELKOVNIKOVA N.V., RAZDORSKAYA M.V.

Abstract

Objective. To determine the efficiency of combination therapy involving depantol for postmenopausal women with urogenital disorders. Subject and methods. Fifty women aged 42 to 62 years with urogenital disorders were followed up. Physical and bimanual vaginal examinations, vaginal pH determination, colposcopy, vaginal index scoring, urine and vaginal swab culture testing for flora, urinary diary keeping, complex urodynamic study, cystoscopy and laser Doppler flowmetry of the vaginal and bladder mucosae, and small pelvic ultrasound imaging were used in all the patients. The tests were repeated after termination of a 3-month course of therapy and 6 months after the patients being recruited into the trial. Two patient groups were identified. Control Group 1 comprised 20 patients who received etiotropic therapy for chronic cystitis. Group 2 was additionally given depantol as vaginal suppositories per day for 20 days. Results. In Group 1, the disease recurred in 50% of the patients; the clinical presentation of atrophic colpitis and cystourethritis continued or even worsened. Much better results were recorded in Group 2: 70% of the patients had no recurrent urogenital disorders, such as urination disorders, dyspareunia, vaginal dryness and burning, and profuse unpleasant vaginal discharges. Normal vaginal acidity (pH <5) was preserved; the signs of mucosal atrophy noticeably reduced. Group 2 patients receiving depantol showed a substantial microcirculatory improvement in the bladder and vagina mucosae by the end of drug administration. Conclusion. Depantol can effectively relieve the symptoms of urogenital disorders, resume or improve sexual life and eventually increase considerably quality of life in these women.
Obstetrics and Gynecology. 2013;(7):85-88
pages 85-88 views

POSSIBILITIES OF THE ULTRASOUND DIAGNOSIS OF FETAL GASTROINTESTINAL TRACT MALFORMATIONS. PART 1

DEMIDOV V.N., MASHINETS N.V.

Abstract

Congenital abnormalities of the gastrointestinal tract are one of the most common fetal developmental pathologies. The paper presents the population-based rate of these abnormalities and describes in detail the echographic signs of esophageal and gastric atresia, duplication of different parts of the gastrointestinal tract, microgastria, and abnormal stomach position. It reports the detection time of different defects of the gastrointestinal tract and the accuracy of their diagnosis. Data on the incidence and pattern of concomitant malformations and chromosomal pathology are given. Much consideration is given to the decision whether it is advisable to continue or interrupt pregnancy, to the most rational tactics of pregnancy management, the times and modes of delivery, the choice of optimal treatment options for neonatal infants in the postnatal period, and prognosis of their further development.
Obstetrics and Gynecology. 2013;(7):89-92
pages 89-92 views

CONGENITAL MALFORMATIONS AS A RESULT OF VITAMIN DEFICIENCIES: SYSTEMATIC ANALYSIS AND PRACTICAL CONCLUSIONS

GROMOVA O.A.

Abstract

The provision of the maternal organism with all essential vitamins, vitamin-like substances, and trace elements is an undeniable factor contributing to physiological pregnancy and normal fetal development. It is commonly stated that micronutrient support of pregnancy is quite sufficient if it includes only iodine and folates. The results of a systematic analysis, which are given in this paper, show that deficiency of vitamins A, E, D, C, and virtually any of B Group vitamins (including folates, pyridoxine, and cyanocobalamin) during pregnancy substantially increase the risk of pregnancy pathology and fetal malformations. The available fundamental and clinical findings demonstrate that the use of just multivitamin preparations during pregnancy will have the highest effect for the effective micronutrient support of pregnant women and the prevention of pregnancy pathology and fetal malformations.
Obstetrics and Gynecology. 2013;(7):93-100
pages 93-100 views

USE OF CARBETOCIN FOR PREVENTING POSTPARTUM HEMORRHAGE

BAYEV O.R.

Abstract

Carbetocin is a long-acting structural analogue of natural human oxytocin. As compared to oxytocin, the carbetocin molecule is better protected from the effects of aminopeptidases and disulfidases, prolonging the half-life and decreasing the likelihood of enzymatic degradation, which in turn potentiates the functional and pharmacological properties of the agent. Carbetocin is effective in preventing postpartum hemorrhage in both high- and low-risk groups, not being inferior or superior to oxytocin or syntometrine in its action. Compared to oxytocin that should be used as long-term dropwise infusions to ensure a prolonged effect, carbetocin is administered once. The safety profile of carbetocin is similar to that of oxytocin. As compared to ergometrine-containing drugs, carbetocin much less causes side effects and it may be used in a wider range of patients, including parturients with arterial hypertension and preeclampsia (gestosis).
Obstetrics and Gynecology. 2013;(7):101-105
pages 101-105 views

HORMONAL CONTRACEPTION AND FEMALE SEXUALITY

STENYAEVA N.N., KHRITININ D.F.

Abstract

The paper deals with one of the most important sociomedical problems — the impact of hormonal contraception on female sexuality. The data available in the literature on the specific features of sexual functioning in women using different hormonal contraceptives are analyzed. The paper shows that sexual health is determined by a set of factors rather than the level of sex hormones or the qualitative and quantitative content of hormones in the hormonal agents. It also demonstrates that the specialists have consensus about the problems of contraception, the need to discuss issues related to sexual health when counseling patients.
Obstetrics and Gynecology. 2013;(7):106-111
pages 106-111 views

NEONATAL MANIFESTATION OF INHERITED HYPOPITUITARISM

RYNDIN A.Y., IONOV O.V., KIRILLOVA E.A., DEGTYAREVA A.V., MELIKYAN M.A., SHARIPOVA L.V., BALASHOVA E.N., EVTEEVA N.V., ONISHCHENKO Y.G.

Abstract

Background. Inherited hypopituitarism is a disease characterized by hypothalamic or pituitary malfunction with the decreased or ceased production of one or a few tropic hormones. Despite the congenital pattern of the pathology, the clinical picture of hormone deficiency is frequently obscure in infants, leading to its late diagnosis. Neonatality is marked by the development of hypoglycemic states, cholestatic syndrome, muscular hypotonia and related respiratory disorders. Description. The paper describes a clinical case of an infant with the neonatal manifestation of hypopituitarism, the main clinical signs of which were recurrent hypoglycemias, progressive diffuse muscular hypotonia, and progressive cholestatic syndrome. Hormone replacement therapy improved the infant’s state and relieved glycemic episodes and respiratory disorders. Skin icteritiousness was diminished, the liver reduced in size, and blood biochemical parameters showed positive changes. Conclusion. The early diagnosis of hypopituitarism and its timely treatment substantially improve the prognosis of the disease.
Obstetrics and Gynecology. 2013;(7):112-116
pages 112-116 views

Vikhlyaeva Ekaterina Mikhailovna

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Obstetrics and Gynecology. 2013;(7):117-117
pages 117-117 views

PRAVILA DLYa AVTOROV

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Obstetrics and Gynecology. 2013;(7):120-120
pages 120-120 views

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