No 12 (2012)

The leading risk factors for symptoms of urinary incontinence in women are pregnancy and childbirth. Currently, much attention is paid to the planned (elective) caesarean section in patients at risk of urination disorders. Among the methods of prevention and treatment of urinary incontinence during pregnancy, the use of behavioral therapy is feasible.

Folate (vitamin B9) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities). This article reviews the metabolism of folic acid, the appropriate use of folic acid supplementation in pregnancy, and the potential benefits of folic acid, as well as the possible supplementation of L-methylfolate for the prevention of pregnancy-related complications other than neural tube defects.

Overactive bladder is a wide spread condition among female population in the world. Overactive bladder symptoms negatively affect quality of life, leading to self-feeling decrease, sexual dysfunction and depression. Antimuscarinic agents are still the main drugs for treatment of overactive bladder symptoms. The article shortly reviews data concerning trospium chloride for treatment females with overactive bladder. The main differences of trospium chloride from large number of modern antimuscarinics are the absence of central nervous system adverse events due to no cross of blood-brain barrier, and wide spectrum of therapeutic doses which allows to adjust optimal dose for more patients with overactive bladder.

Due to the high prevalence and great clinical significance of nonspecific vaginitis, rational and effective treatment of this disease is difficult but highly topical problem. Restoration of vaginal microbiocenosis requires a comprehensive assessment of existing violations, extragenital pathology, and the development of individual schemes of therapy. The use of the drug Vaginorm-C®, which is a special form of ascorbic acid specifically designed for intravaginal use (vaginal tablets, 250 mg) deserve attention. The high efficacy Vaginorm-C® in the treatment of vaginal dysbiosis, including among pregnant women, is discussed. Ability to use during pregnancy and lactation is an important advantage of this drug, in contrast with drugs with antianaerobic activity, considering that their use is permitted only with the II trimester of pregnancy. Vaginorm-C® is well tolerated, can be used for a long time in treatment and prevention of bacterial vaginosis.

The article highlights the main benefits of combined oral contraceptives containing drospirenone, a gestagen of last generation. The results of numerous studies of foreign and domestic authors are presented. Particularly, the therapeutic potentials of drospirenone-containing drugs are discussed.

Iron deficiency is one of the most common problems of health care services worldwide. Even if it is possible to determine the origin of iron deficiency, administration of ferropreparations is an essential component of treatment (in addition to the impact on the factor caused the disease), and oral route of administration as more safe is preferred, if the clinical situation allows. Ferro-Folgamma is one of the oral medication with an attractive profile of efficacy and safety. The article highlights some aspects of use of Ferro-Folgamma in clinical practice.

It is commonly known that endometriosis (EM) is an extremely common disease that most often occurs among patients of reproductive age. In practice of gynecologist-reproductologist, every third patient with infertility suffers from EM. It is often to faced with the fact that these women have previously received special treatment. But more often it is consistent with the tactics of management of patients with pain, not planning a pregnancy. This leads to unreasonable material and time consuming inputs, which reduce the chance of conceiving in the long term. The objective of this publication is combination of foreign and Russian guideline data for management of patients with EM for the purpose of development of common tactics of treatment of this group of patients and acceleration of difficult way to delivery of a child.

It is shown that higher rates of cardiac minute output (CMO) and cardiac index (CI), and lower rates of total peripheral resistance (TPR) are attributable to the physiological course of pregnancy. Complicated course of the early stages of gestation is characterized by reduction of CMO and SI and tendency towards increase of TPR. Short-term 5-day course of metabolic therapy as a preventive treatment for women with complicated pregnancy in the I trimester lead to increases of CMO and the SI and the reduction of TPR, but not completely normalizes these parameters.

The efficacy and tolerability of soy isoflavones, which have hormone-like effects, in the treatment of vasomotor and emotional and autonomic manifestations of the menopausal syndrome in postmenopausal women were evaluated. Patients received Inoclim containing 40 mg of soy isoflavones, 2 pills a day. Mean age - 52.7 ± 1.4 years, duration of treatment - 3 months. Kupperman index before treatment was 28.4 ± 1.7, after treatment - 15.6 points. After 3 months of treatment, 83.8 % of women reported a significant improvement in health, reduction of frequency and severity of hot flashes, sleep disturbances, which led to increased working ability. However, the short treatment period (3 months) suggests the feasibility for further research in this direction.