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No 10 (2015)

Articles

Efficiency of X-ray endovascular arterial vessel occlusion techniques in reducing intraoperative blood loss in pregnant women with placenta previa

Tskhai V.B., Yametov P.K., Brezhneva N.V., Levanova E.A.

Abstract

Objective. To investigate the efficiency of X-ray endovascular arterial vessel occlusion techniques in reducing intraoperative blood loss in pregnant women with placenta previa. Subject and methods. Currently available publications showing the role and efficiency of preventive use of uterine artery embolization and temporary balloon iliac artery occlusion during curation of patients with placenta previa and increta who have frequently large amounts of blood loss were reviewed. Results. In some specialists’ opinion, preventive pelvic artery catheterization and embolization in patients with placenta increta are a safe and effective technique to avoid hysterectomy and should be used in women who wish to preserve their fertility. Conclusion. The current data demonstrating the safety and efficiency of endovascular uterine artery and iliac artery occlusion techniques are based on single clinical cases and non-randomized trials with small sample sizes so further large multicenter randomized trials are needed to obtain an evidentiary base. At the same time, numerous results of balloon occlusion of iliac arteries are controversial as some investigators have given data that this technique reduces blood loss while other investigators have not obtained positive results.
Obstetrics and Gynecology. 2015;(10):5-10
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Pharmacogenetic approach to preventing folate deficiency: L-5-methyltetrahydrofolate or folic acid?

Donnikov A.E.

Abstract

Objective. To analyze data on the impact of single nucleotide polymorphisms on the metabolic features of different biochemical folate formulations used in clinical practice and to evaluate the efficiency and safety of using folate-containing drugs in the context of pharmacogenetics. Subject and methods. Publications over the past 20 years on the impact of polymorphism in different genes of folate cycle enzymes on the efficiency and safety of using L-methylfolate and folic acid were sought in the NSBI PubMed database. Results. The peculiarities of the use of folate-containing drugs are described and data on the impact of polymorphism in the key genes (MTHFR, MTR, MTRR, SLC19A1, MTHFD1, SHMT1, and DHFR) on the metabolic features of L-methylfolate and folic acid are given. There is strong evidence that multivitamin supplements containing 800 μg of folic acid have a high protective effect in preventing congenital malformations. Conclusion. The use of alternative sources of folates versus traditionally administered folic acid has failed to demonstrate unique advantages, but may be a potentially promising area in a further research search.
Obstetrics and Gynecology. 2015;(10):11-18
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Predictors for the development of ovarian hyperstimulation syndrome in an IVF program

Strelchenko D.A., Perminova S.G., Donnikov A.E.

Abstract

Objective. To investigate the prognostic value of clinical and laboratory markers in the development of ovarian hyperstimulation syndrome (OHSS), which are used at different stages of implementing an in vitro fertilization program. Subjects and methods. Fifty current Russian and foreign literature sources dealing with the problem of OHSS in assisted reproductive technology (ART) programs were analyzed. Results. The paper emphasizes the most important and valid results of these investigations. Assessment of the role of molecular genetic markers as predictors of OHSS and the possibilities of their use in the practice of ART occupy a special place. Conclusion. OHSS is a topical and interesting problem from both scientific and practical standpoints and calls for further investigation.
Obstetrics and Gynecology. 2015;(10):19-26
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Risks factors for breast cancer at a reproductive age

Novikova V.A.

Abstract

Objective. To investigate risk factors for breast cancer (BC) according to the data available in the Russian and foreign literature. Subject and methods. The key words risk factors, BC, and reproductive age were sought in the Pubmed, Scopus, and Russian Scientific Electronic Library. A total of 47 publications were chosen. Results. The paper considers risk factors, such as proliferative diseases and traumas of the breast, hormone-dependent and some extragenital diseases, mutations in the BRCA1 and BRCA2 genes, obstetric complications, the use of combined oral contraceptives and cyclic hormonal therapy. It also presents the Russian and foreign experience in preventing BC. Conclusion. By taking into account the risks of BC in women in different age periods, it is necessary to use targeted cancer preventive and symptomatic therapy.
Obstetrics and Gynecology. 2015;(10):27-34
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Current assisted reproductive technologies and child and adult health programming

Bashmakova N.V., Tsyvyan P.B.

Abstract

The periconceptional period in human development is defined as a highly narrow window of time, which covers the preconceptional period and the period of conception to embryo implantation, during which actions on the mother and impregnated ovum are able to affect the further growth and physiological characteristics of progeny. Investigations using human and animal models have shown that in vitro embryo culturing conditions and actions on gametes and embryos may considerably influence an individual’s health in further life. Epigenetic DNA exposures and chromatin organization processes are the most likely mechanisms for the influence of environmental factors and assisted reproductive technologies on further development and phenotype. The long-term effects of modifying periimplantation development conditions on the progeny’s further health are discussed.
Obstetrics and Gynecology. 2015;(10):35-40
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Echographic characteristics of the uterus in the early and late period after abdominal delivery

Prikhodko A.M., Baev O.R., Lunkov S.S., Eremina O.V., Gus A.I.

Abstract

A search for optimal criteria in assessing the morphofunctional status of the uterus in patients after abdominal delivery does not lose its relevance now. For this purpose, a study of the echographic characteristics reflecting the status of the organ in the early and late postoperative period not only will extend our views on the specific features of the process of uterine involution and the pathophysiological mechanisms of scar formation, but will also allow the management of subsequent pregnancies and deliveries to be predicted. Objective. To investigate the echographic characteristics of the uterine status in the early and late period after cesarean section (CS). Subjects and methods. The echographic parameters of a scar and the uterus were analyzed in 115 puerperas with uncomplicated postpartum (n = 30) and postoperative (n = 85) periods on day 4 and three months after spontaneous (n = 26) and surgical (n = 18) delivery. Results. On day 4 after CS, the women with spontaneous labor showed significant differences in the anteroposterior sizes of the wall of the uterus in the area of its isthmus (p = 0.023) and in the length of the cervix uteri (p = 0.028) as compared with ultrasound parameters. Three months after surgery, only the width of the uterus was significantly smaller than that in the women after spontaneous labor (p = 0.0001). At the same time, the anteroposterior size of the uterus (р = 0.0082) and the thickness of its anterior (р = 0.025) and posterior (р = 0.0001) walls and myometrium in the scar area (р = 0.0001) proved to be significantly larger. No differences among the groups were found in the volume of the uterus (p = 0.74). Three months following CS, the scar area displayed remnants of suture materials in 6.67% of cases and niches in 6.67%. Conclusion. CS surgery affected the processes of uterine involution in the late postoperative period. The scar formation-induced uterine anatomic and functional differences found at ultrasound study are also detected 3 months following delivery. The echographic signs of incomplete and inadequate regenerative processes in 13.34% of cases necessitate the continuation of studies identifying the determinants of the formation of scar incompetence and those preventing these disorders. The described features should be kept in mind when evaluating the morphofunctional status of the uterus in women after CS and predicting the course of a subsequent pregnancy and labor.
Obstetrics and Gynecology. 2015;(10):41-46
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Serum erythropoietin and its placental expression in preeclampsia-complicated pregnancy

Medvedev B.I., Syundyukova E.G., Sashenkov S.L.

Abstract

Objective. To define the significance of serum erythropoietin and its placental expression in the pathogenesis of preeclampsia. Subjects and methods. The case-control study enrolled 11 women without preeclampsia, 14 with moderate preeclampsia, and 14 with severe preeclampsia. The specific features of pregnancy and delivery were analyzed and production adequacy of erythropoietin and its placental expression were determined. Results. Cases of inadequate erythropoietin production were registered in preeclampsia, more commonly in severe one. The adequacy of erythropoietin production was lower in severe preeclampsia. The inadequate production of erythropoietin correlates with its enhanced placental expression in the symplastotrophoblast, capillary endothelium, and villous stromal macrophages with its decreased expression in the red blood cells of villous capillaries. The correlations of the indicators of erythropoietin status in pregnant women with obstetric complications (preeclampsia, placental insufficiency) are suggestive of the similar mechanisms of their development. A scheme of the involvement of erythropoietin in the pathogenesis of preeclampsia is proposed. Conclusion. Erythropoietin takes part in the pathogenesis of a number of obstetric complications, including preeclampsia; however, the significance of erythropoietin in the development of this abnormality calls for further investigation. The authors declare no conflicts of interest.
Obstetrics and Gynecology. 2015;(10):47-53
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Impact of intravenous laser blood irradiation on the morphofunctional status of platelets in puerperas after abdominal delivery

Fedorova T.A., Vasilenko I.A., Puchko T.K., Bykova K.G., Metelin V.B., Matveeva A.V.

Abstract

Objective. To evaluate the impact of intravenous laser blood irradiation (ILBI) as a technique to prevent IICs on the morphofunctional parameters of platelets in puerperas after cesarean section. Subjects and methods. A total of 126 postcesarean section puerperas who received antibiotic prophylaxis with intravenous amoxiclav 1.2 g 15 minutes before skin incision were examined. On day 1 postsurgery, Group 1 (a study group) (n = 65) had daily 15-minute ILBI using a Solaris apparatus (Russia) with a helium-neon laser irradiation at 0.63 nm for 5 days. Group 2 (a comparison group) (n = 61) had antibiotic prophylaxis only. On days 1 and 6, the 126 puerperas underwent peripheral blood tests: platelet counts, blood coagulation tests with thromboelastography and platelet aggregation, and real-time monitoring of the morphofunctional status of platelets by coherent phase microscopy (CPM) using a Bioni-CPM module of a hardware and software complex (Westtrade, Russia) for clinical and laboratory diagnosis with digital image processing. Results. The mean age of Groups 1 and 2 puerperas was 31.2±5.4 and 30.5±5.1 years, respectively (р ?? 0.05). According to their somatic and obstetric/gynecological status, all the puerperas belonged to an IIC risk group. The investigation established that ILBI had an integral modifying effect on the functional activity of circulating platelets. ILBI in the puerperas contributed to the increased counts of resting platelets and the decreased level of active platelets, leading to suppression of the total adhesive and aggregation ability of platelets. After ILBI, the mean values of platelet diameter, perimeter, and area were slightly higher than the control ones, which might be due to the fact that there were young platelet subpopulations having high morphometric values, but a normal functional status in the bed. ILBI lowered the blood coagulation potential, as witnessed by decreases in fibrinogen concentrations, thrombodynamic potential index, and intravascular coagulation, and a prolongation of the r+k index, which favored better microcirculation and tissue oxygenation. Conclusion. The investigation has shown that postoperative ILBI is efficient and safe in IIC risk group puerperas, by affecting platelet morphofunctional parameters and hemostatic system, which allows ILBI to be recommended as part of measures to prevent IICs after cesarean section.
Obstetrics and Gynecology. 2015;(10):54-61
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Clinical and immunological rationale for the frequency of immunocytotherapy in married couples with recurrent miscarriage

Tetruashvili N.K., Krechetova L.V., Vtorushina V.V., Golubeva E.L., Ziganshina M.M., Stepanova E.O., Saribegova V.A., Nikolaeva M.A.

Abstract

Objective. To investigate the impact of immunization frequency on the levels of anti-paternal leukocyte antibodies (APLA), as well as the blocking effect of female serum during pregravid preparation of women with recurrent miscarriage (RM). Subjects and methods. APLA and the blocking effect of autologous serum were determined by flow cytometry. The 2007 to 2014 immunological findings were retrospectively analyzed in patients with RM of unknown genesis. A total of 152 patents with RM were examined. Results. Analysis of the chosen indicators of the immune system in women with RM during pregravid preparation using an immunocytotherapy procedure has led to the conclusion that double alloimmunization using the cells of a sexual partner’s leukocyte fraction as a necessary and adequate procedure in married couples with RM of alloimmune genesis in a pregravid preparation program may be recommended. Conclusion. The results allow to recommend a 2-fold immunization with sexual partner cells (TIC) as a necessary and sufficient procedure for married couples with RM of alloimmune genesis in pregravid preparation programs.
Obstetrics and Gynecology. 2015;(10):62-67
pages 62-67 views

Endometrial ezrin expression in women with tuboperitoneal factor infertility and repeated in vitro fertilization failures

Kogan E.A., Demura T.A., Seidova L.A., Perminova S.G.

Abstract

Objective. To investigate endometrial morphological characteristics and ezrin expression in women with tuboperitoneal factor (TPF) infertility and repeated in vitro fertilization (IVF) failures. Subjects and methods. The investigation enrolled 60 patients aged 26 to 38 years with TPF infertility and a history of more than 2 repeated IVF failures (a study group) and 20 healthy fertile women of the same age with a history of healthy children (a control group). Endometrial pipelle biopsy was carried out during the implantation window (LH+7) and on days 8-9 of the cycle to rule out chronic endometritis. A semiquantitative method was used to estimate immunohistochemistry results in scores: O, no immunostaining (-); 0.5, less than 5% of the immunostained cells (±); 2, less than 20% (+); 4, 20 to 40% (++); and 6, more than 40% (+++). The investigation results were statistically processed using the analysis of variance ANOVA (for several groups) and Mann- Whitney test. Results. Analysis of the morphological structure of the endometrial indicated that its secretory transformation was seen during the implantation window in all the patients. At the same time, the study group was observed to have early, mid, and late secretory phases in 24 (40%), 27 (45%), and 9 (15%) patients, respectively; whereas in the control group there was a preponderance of a mid-secretory phase (80%; n = 16). The examination of mature endometrial pinopodia showed the preponderance of study group patients who had less than 20% of the mature pinopodia in the surface epithelium (45%). In the control group, mature pinopodia were 40% more common in the endometrial surface epithelium in the majority of the women. The highest erzin expression was detected in the endometrial pinopodia and epitheliocytes in the control group whereas it was lowest in the study group. Erzin accumulated in slightly lower amounts in the study group than in the control one. Conclusion. The infertile women showed the reduced accumulation of erzin in the pinopodia and cytoplasm of the endometrial epithelium, suggesting the possible occurrence of impairments in the adhesion of blastocysts, the generation and maturation of pinopodia, and the remodeling of cellular cytoskeleton, which made itself evident in abnormal receptivity of the endometrium and its abnormal implantation properties.
Obstetrics and Gynecology. 2015;(10):68-72
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Optimization of in vitro fertilization programs by replacing an ovulation trigger

Martazanova B.A., Mishieva N.G., Levkov L.A., Gracheva A.M., Bogatyreva K.A., Eapen S.M., Lapina V.S., Abubakirov A.N.

Abstract

Objective. To optimize in vitro fertilization programs in patients at high risk for ovarian hyperstimulation syndrome (OHSS) through replacement of an ovulation trigger and simulation of the luteal phase. Subjects and methods. The investigation enrolled 258patients aged 20 to 39 years at high risk for OHSS. The patients were divided into three groups according to the injected ovulation trigger: 1) gonadotropin-releasing hormone (GnRH) agonist (GnRH-a) 0.2 mg (n = 91); 2) GnRH-a 0.2 mg with simultaneous injection of human chorionic gonadotropin (hCG) 1500I U(n = 82); 3) hCG 10,000 IU(n = 85). Micronizedprogesterone 600mg/day and estradiol valerate 4 mg/day were used for luteal phase support in Groups 1 and 2. In Group 1, hCG was additionally injected in a dose of 1500 IU for luteal phase support on the day of transvaginal puncture (TVP). In Group 3, micronized progesterone was administered in a dose of 600 mg/day for luteal phase support. Results. Comparison of Groups 1 and 3 revealed a statistically significant difference in the incidence of mild OHSS (< 0.001); that of Groups 1 and 2 and that of Groups 2 and 3 disclosed no statistically significant difference (p > 0.05). Thus, mild OHSS developed in 11 (12.1%) patients in the group where the trigger was replaced by GnRH agonist, in 16 (19.5%) in the double trigger (GnRH-a + hCG) group, and in 27 (31.8%) in the hCG group. Moderate OHSS developed in 7 (7.7%) patients in Group 1, in 6 (9.8%) in Group 2, and in 8 (9.4%) in Group 3; comparison of the incidence of moderate OHSS revealed no statistically significant differences in the examined groups (p > 0.05). No case of severe OHSS was recorded in the GnRH-a group. In the GnRH-a + hCG group, the incidence of severe OHSS was 1.2% (n = 1), which was statistically significantly lower than that in the hCG group [10.6% (n = 9)] (р >0.05, р <0.001, р = 0.011). The rate of conception after embryo transfer was 45.2, 42.2, and 45.6% in the GnRH-a, GnRH-a + hCG, and hCG groups, respectively (p > 0.05, ANOVA). There were no statistically significant differences in the rates of clinical pregnancy, pregnancy termination, and progressive pregnancy. Conclusion. Replacement of the ovulation trigger by GnRH-a in the patients at high risk for OHSS is effective in reducing its risk and has no negative impact on conception rates when the luteal phase is modified.
Obstetrics and Gynecology. 2015;(10):73-80
pages 73-80 views

Effects of leptin and insulin on the production of gonadotropins in girls with abnormal uterine bleeding

Dynnik V.A., Shcherbina N.A., Dynnik A.A.

Abstract

Objective. To study the associations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin (PRL) with the basal levels of leptin and insulin in abnormal uterine bleeding (AUB) in female adolescents with different body weights. Subjects and methods. The study enrolled 146 female adolescents aged 11 to 18 years with AUB, including 58 adolescents with the physiological parameters growth and weight (Group 1), 57 overweight girls (Group 2), and 31 underweight adolescents (Group 3). The serum levels of LH, FSH, PRL, leptin, and insulin were measured. Results. Multiple regression analysis revealed the specific features of associations of gonadotropic hormones with leptin and insulin. Energy metabolic hormones were shown to have a selective effect on body mass index (BMI)-dependent gonadotropin production. Conclusion. Leptin and insulin play an important role in the pathogenesis of AUB in the pubertal period and have a significant BMI-dependent effect responsible for uterine bleeding on the production of pituitary hormones.
Obstetrics and Gynecology. 2015;(10):81-85
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Comparison of the informative value of testing the biological material obtained from the cervical canal and vagina during examinations of non-pregnant patients for genital infections

Rumyantseva T.A., Dolgova T.I., Goloveshkina E.N., Gushchin A.E.

Abstract

Objective. To estimate the informative value of testing the biological material from the cervical canal and vagina for the diagnosis of vulvovaginal and cervical infections in patients seeing a gynecologist. Subjects and methods. The investigation enrolled 206 non-pregnant patients. The biological material obtained from the cervical canal and vagina was tested by real-time polymerase chain reaction. Results. С. trachomatis and T. vaginalis were more frequently found in the vaginal samples. M. genitalium and N. gonorrhoreae were more common in the vaginal and cervical samples. Opportunistic genital mycoplasmas were also more frequently detected in the vaginal biomaterial; DNA concentrations in these microorganisms demonstrated a significant correlation in the vaginal and cervical samples. Conclusion. The informative value of testing the biological material obtained from the vagina is higher than that from the cervical canal during examinations of non-pregnant patents.
Obstetrics and Gynecology. 2015;(10):86-90
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Clinical evaluation of the efficiency and safety of topical treatment for bacterial vaginosis in pregnant women

Logutova L.S., Novikova S.V., Tsivtsivadze E.B., Fedotova A.V.

Abstract

Objective. To evaluate the efficacy and safety of Multi-Gyn-ActiGel used to treat bacterial vaginosis (BV) and to prevent its recurrences in pregnant women before labor. Subjects and methods. A study group included 50 pregnant women with threatened preterm labor and new-onset BV. A comparison group consisted of 30 pregnant women with BV who had been treated with metronidazole and clindamycin 3 months before hospitalization. All underwent clinical and laboratory examinations. During BV therapy, Group 1 received Multi- Gyn-ActiGel and Group 2 used a probiotic. Results. Multi- Gyn-ActiGel was proved efficient and safe in treating BV and preventing obstetric complications. During therapy with this drug, the patients had no complaints and achieved optimal pH values and the normal pattern of vaginal smears. In the study group, all the pregnant women delivered at term. Conclusion. Multi-Gyn-ActiGel is an effective medication to treat BV and to prevent its recurrences. It is safe for a fetus and may be used in pregnant women at early gestational ages when a decision is made on the most effective prevention of pregnancy and labor complications.
Obstetrics and Gynecology. 2015;(10):91-96
pages 91-96 views

Optimization of combination therapy for female genital inflammatory diseases in the context of clinical immunology

Nadei E.V., Nechaeva G.I., Shupina M.I.

Abstract

Objective. To provide a rationale for the incorporation of neovir (oxodyhydroacridinylacetate sodium) into combination therapy for bacterial vaginosis and vulvovaginitis. Subjects and methods. The investigation lasted 6 months. It enrolled 56 patients with bacterial vaginosis and vulvovaginal candidiasis. The main criteria for inclusion into the investigation were: diagnosed bacterial vaginosis and vulvovaginal candidiasis; a disease duration of at least 1 year; previous ineffective treatment in accordance with standards and clinical guidelines. The patients underwent clinical, laboratory, and immunological examinations before and after therapy. The following treatment efficiency criteria were taken in the investigation: disappearance of clinical symptomatology; positive changes in the interferon status; a longer interrecurrent interval. Neovir used in the combination therapy was injected at an intramuscular dose of 250 mg (500 mg on day 1) with a total 10 injections per cycle according to a definitive regimen. Results. Serum interferon concentrations were noted to be increased just after the second injection of neovir (oxodyhydroacridinylacetate sodium) and the blood cell production of INF-α and INF-γ was intensified by the end of the therapy. There were positive changes in the study immunological and clinical parameters after completion of an oxodyhydroacridinylacetate sodium therapy cycle. No recurrences of inflammation were recorded in the examinees within 6 months after initiation of the therapy. Conclusion. The use of neovir (oxodyhydroacridinylacetate sodium) in the combination treatment of bacterial vaginosis and vulvovaginal candidiasis is pathogenetically sound and induces a persistent and sustained remission. This medication contributes to the normalization of immunological factors.
Obstetrics and Gynecology. 2015;(10):97-102
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Complete maternal and fetal histocompatibility as one of the factors for preterm delivery and placental insufficiency

Khoroshkeeva O.V., Tetruashvili N.K., Agadzhanova A.A., Burmenskaya O.V., Trofimov D.Y.

Abstract

Background. Parental histocompatibility prevents the recognition of paternal embryonic antigens from early pregnancy, which favors the development of different obstetric complications. Impaired trophoblast invasion processes in the first trimester of pregnancy give rise to late gestational complications: fetal growth retardation, preeclampsia, preterm delivery, and antenatal fetal death. Description. The paper describes a clinical case of the course and outcomes of 5 pregnancies in a patient with varying degrees of fetal histocompatibility. The poorest result was obtained after pregnancy where the fetus major histocompatibility complex antigens were similar to maternal in spite of performed therapy. Conclusion. Lymphocyte immune therapy in the patient with concurrent factors for miscarriage could achieve pregnancy prolongation up to 34 weeks and, as consequence, the birth of a viable child.
Obstetrics and Gynecology. 2015;(10):103-106
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Prevention of preterm delivery in the first trimester of pregnancy

Padrul M.M., Olina A.A., Klyausova E.G., Sadykova G.K.

Abstract

Objective. To evaluate the efficiency of measures to prevent preterm delivery in a risk group formed according to identified risk factors and cervicometric findings in the first trimester of pregnancy. Subjects and methods. The investigation enrolled 183 pregnant women from a high-risk group who were detected in view of risk factors and cervicometric findings in the first trimester. Results. Incorporation of cervicometry into an ultrasound study protocol in the f irst trimester will considerably enhance the efficiency of identifying pregnant women at high risk for preterm delivery. Conclusion. A comprehensive approach with consideration for history data, risk factors, and first-trimester cervicometry results makes it possible to identify pregnant women at high risk for preterm delivery in early pregnancy and to perform timely and effective prophylaxis.
Obstetrics and Gynecology. 2015;(10):107-111
pages 107-111 views

Vaginal dysbiosis: The species composition of lactobacilli and the potentialities of non-drug correction

Plotko E.E., Zornikov D.L., Khayutin L.V., Voroshilina E.S.

Abstract

Objective. To evaluate the clinical and microbiological efficiency of a two-stage vaginal dysbiosis correction regimen using a low-frequency ultrasound (LFU)-treated processed 0.05% aqueous chlorhexidine solution and the probiotic drug ecofemin floravag (EF). Subjects and methods. The investigation enrolled 88 women aged 18 to 49 years with vaginal dysbiosis. According to the magnitude of dysbiotic disorders, the examinees were divided into 2 groups: 1) 33 women with moderate anaerobic dysbiosis and 2) 55 women with severe one. A two-stage correction regimen for vaginal dysbiosis was applied. At Stage 1, the vagina was treated with a LFU-processed 0.05% aqueous chlorhexidine solution. At Stage 2, all the patients took 2 EF capsules orally once daily for 10 days. The lower genitalia were clinically evaluated before and after treatment. Vaginal microbiocenosis and lactobacillus species composition were examined by a real-time polymerase chain reaction assay (a Femoflor16 test system, DNA-Technology, Moscow) thrice: before treatment (at the stage of primary counselling (Point 1)); immediately after the third vaginal treatment with LFU-processed 0.05% aqueous chlorhexidine solution (Point 2); a month after completion of EF intake (Point 3). Results. The potentialities of vaginal dysbiosis correction depend on the baseline status of microbiocenosis. Normocenosis was restored without antibiotics twice more frequently in moderate dysbiosis than in severe one. Overall, the proportion of lactobacilli was increased in 75.79% of the patients with moderate anaerobic dysbiosis and in 69.1% of those with severe anaerobic dysbiosis. This investigation recorded no case of Lactobacillus crispatus detected after an EF therapy cycle in the absence of this species among the lactobacilli at the start of follow-up. The species composition of the normal flora in each specific woman is stable and little influenced by physicochemical and biological factors. The administration of a probiotic drug containing L. crispatus does not lead to that the latter is supplanted by other dominant Lactobacillus species, but it favors the restoration of an intrinsic lactobacillus population. Conclusion. The two-stage regimen for non-drug correction of vaginal dysbiosis, which involves triple vaginal treatment with LFU-processed 0.05% aqueous chlorhexidine solution and the probiotic drug EF, demonstrates high efficiency: every two patients have achieved clinical recovery and restoration of normocenosis.
Obstetrics and Gynecology. 2015;(10):112-117
pages 112-117 views

A differentiated tactics of treating patients with HPV-related genital diseases

Dovletkhanova E.R., Prilepskaya V.N.

Abstract

Object. To study the differential tactics of patients with HPV-associated diseases. Subject and methods. By Keywords: human papillomavirus, cervical cancer, persistence, reinfection, of virus, immunomodulators, inosine pranobex searched databases eLIBRARY, Scopus, Elsevier, PubMed. Selected 38 sources. Results. Analyzed foreign and domestic sources of literature have shown that timely diagnosis and treatment of diseases associated with HPV pursues primarily a warning and prevention of cervical cancer. It is noted that the use of antiviral drugs with immunomodulating effect, promotes the elimination of HPV reduces the likelihood of HPV persistence and recurrence of the disease. Conclusion. The possibility of the drug inosine pranobex in the treatment of diseases associated with HPV.
Obstetrics and Gynecology. 2015;(10):118-124
pages 118-124 views

Additional possibilities for pharmacological correction of menstrual irregularities

Batishcheva G.A., Mubarakshina O.A., Dronova Y.M., Mubarakshin E.A., Prokudina Y.A.

Abstract

Objective. To study possibilities for the nonhormonal correction of menstrual dysfunction with natural agents, including medicinal plants, vitamins, and trace elements. Subject and methods. Data on the frequency of menstrual irregularities, main directions of their drug treatment and use of phytopreparations were analyzed in 25 literature sources. Results. The results of the analysis are suggestive of the possibility of using a new formulation of the complex time factor in the combination therapy of menstrual disorders, by taking into account the composition of the drug, the pharmacological effects of components and a dosage regimen. Conclusion. The complex of biologically active substances of time factor makes it possible to effectively and simultaneously safely correct menstrual dysfunction.
Obstetrics and Gynecology. 2015;(10):125-129
pages 125-129 views

Resolution of II All-Russian Scientific Forum «Mother and Child»

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Obstetrics and Gynecology. 2015;(10):130-132
pages 130-132 views

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