№ 3 (2015)

The article presents the literature data on the evolution of hormonal contraception, types and composition of modern hormonal preparations; modes and routes of administration are described; safety data and features of the influence of contraceptives on women's health are discussed.

The prospective analysis of course of pregnancy, childbirth and the postpartum period in 677 pregnant women who were screened for the presence of vulvovaginal and cervical infections, and early neonatal period in infants from these mothers was performed. Genital mycoplasmas (GM) in the vagina and cervix were found in 304 patients, accounting for 44.9% of all women surveyed. In the vast majority (232; 76.3%) of pregnant women, GM in the lower genital tract were combined with other opportunistic pathogens. Only in 72 (10.6%) cases, GM were isolated as a monoculture or in combination with only Lactobacillusspp. It has been shown that in pregnant women colonization of the lower genital tract with opportunistic pathogens is an important risk factor for premature labor, premature discharge of amniotic fluid, low birth weight infants (<2500 g), postpartum endometritis and wound infection. Obviously, GM do not have vital importance in the pathogenesis of adverse outcomes of pregnancy, childbirth, postpartum and early neonatal period.

The study was aimed to the prevention the fetal complications in women with gestational hypertension (GAH) by the application of preventive pathogenetic treatment still at the preclinical stage of placental insufficiency (PI). Sixty pregnant women with GAH aged from 20 to 39 years were divided into 2 groups - experimental group and comparison group; 20 pregnant women without GAH were included in the control group. The following methods of evaluation were used: ultrasound, Doppler ultrasound, cardiotocography, and the definition of von Willebrand factor (vWF). Women in 1st (experimental) group have received sulodexide in combination with antihypertensive therapy and folic acid preparations. Despite the standard therapy, formation of GAH in women in the 2nd half of pregnancy was accompanied by increased vWF levels, development of hemodynamic disorders IA degree (76.6%), ultrasound signs of PI (63.3%), fetal hypoxia (43.3% ) with the development of fetal growth retardation (FGR) - in 30% of women. In women receiving sulodexide in the complex treatment, signs of PN observed to a lesser extent: the level of vWF was 46.5% lower, hemodynamic instability IA degree (63.3%), ultrasound signs of PI (23.3%), fetal hypoxia (10%), the development of FGR (6.6%) occurred significantly less often. The ratio of the risk of occurrence of complications in patients of the experimental group treated with sulodexide in relation to the comparison group was 0.37 for the PI (95% CI; 0.18-0.74), 0.23 for hypoxia (95% CI, 0.07-0.73) and 0.38 for FGR (95% CI, 0.20-0.72). Thus, sulodexide significantly reduces the risk of PI and fetal complications in women with GAH.

This study was carried out to investigate efficacy of concurrent application aminodihydrophthalasindione sodium and dietary supplement consisted of indole-3-carbinol epigallocatechin-3-gallate combined with cervical conization. This combination therapy was employed in the treatment of 19 women with mild and severe cervical squamous epithelial dysplasia (CSED) and human papilloma virus infection (HPV) type 16 and 18. Aminodihydrophthalasindione sodium was prescribed in rectal suppositories at the dose 100 mg daily for 5 days followed by cervical conization. Postoperatively the patients continued receiving rectal aminodihydrophthalasindione sodium 3 times a day for 30 days andbiologically active complex 2 capsules twice daily for 6 months. As a result of the treatment normalization of leukocyte, lymphocyte, monocyte and granulocyte counts were found, as well as immunological parameters, including T-cells. Cytologic investigation of smears conducted after 6 months of treatment showed that all women were free of CSED. No HPV cases were found with PCR testing as well. The evidence from this study suggests the need for combination treatment of mild and severe CSED. Timely pathognomonic treatment is believed to be effective approach to prevention of cervical malignancies.

The study was aimed to the evaluation of the effect of preventive influenza vaccination during pregnancy on some gestational indicators. The study included 110 patients. Group I (main) consisted of 58 pregnant women who underwent influenza vaccination at 23-35 weeks of gestation using trivalent inactivated subunit vaccine. Group II (control) included 52 patients who were not subjected to influenza vaccination. Following assessments were performed: ultrasound fetometry, analysis of serum α-fetoprotein, human chorionic gonadotropin, trophoblastic β1 -glycoprotein contents. Analysis of clinical and laboratory data of pregnant women vaccinated with subunit vaccine showed no destabilizing changes of homeostasis after vaccination. Post-vaccination period was accompanied by minor local and systemic reactions. Manifestations of influenza were noted in 3 (5.1%) patients of Group I, and in 16 (30.8%) patients of group II (p<0.05). Dysfunction of the fetoplacental complex was detected in 2 (3.4%) and 5 (9.6%) pregnant women in group I and group II, respectively (p<0.05). The results showed that influenza vaccination in pregnant women provides a reduction in the incidence of acute respiratory viral diseases, thereby reducing the frequency of functional disorders of the fetoplacental complex.

Endocrine physiological changes in menopausal women ultimately determine the presence of ovulatory or anovulatory menstrual cycles, which are characterized by abnormally high level of estradiol or abnormal rhythm of its secretion, as well as deficiency of progesterone. Against this background, heavy and/or prolonged menstruation and dysmenorrhea. The results of studies with various levels of evidence (A-C) show that levonorgestrel-releasing intrauterine system (LNG-IUS) Mirena has therapeutic benefits when it is used in women during perimenopause. These benefits are attributable to the combination of high contraceptive reliability with a healing effect for menorrhagia and dysmenorrhea and because of the presence of registered indications for the use of drug as a gestagenic component for the hormone therapy of menopause.