Vol 1, No 2 (2014)

Original papers
Mesh-associated complications. Risk factors
Ishchenko A.I., Shulchina I.V., Ishchenko A.A., Zhumanova E.N., Gorbenko O.Y.
Abstract
The importance of the genital prolapse and stress urinary incontinence and wide use of mesh implants in pelvic floor surgery has prompted us to analyze recent published data on this problem. The incidence, risk factors, and methods for prevention of the major mesh-associated complications are presented.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):4-7
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Clinical significance of endothelial dysfunction in pregnancy as a component of comprehensive evaluation of pre-eclampsia risk
Dikur O.N., Kopylov F.Y.
Abstract
Vascular endothelium dysfunction is an important component of the pathogenesis of pre-eclampsia - one of the leading causes of maternal morbidity and mortality, perinatal deaths, and intrauterine development of small-for-date fetuses. Evaluation of the vascular endothelium status during gestation is a promising method for predicting the development of this condition. This paper presents a critical review of the major clinical studies of the prognostic significance of endothelial dysfunction markers, aimed at prediction ofpre-eclampsia. Modern methods for evaluating the endothelial function, including detection of biochemical markers of endothelial dysfunction and functional tests for evaluating the endothelium-dependent vasodilatation, are described. The significance of the best studied specific markers of gestosis, such as soluble fms-like tyrosine kinase-1, soluble endoglin, placental growth factor, for the prognosis and diagnosis ofpre-eclampsia is discussed.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):7-13
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Gausknecht’s test: A method for prediction of caesarean section and newborn resuscitation
Radzinskiy V.E., Urakova N.A., Urakov A.L., Nikityuk D.B.
Abstract
Gausknecht's test is suggested for detection of hypoxic resistance in the fetus for more accurate prediction of labor outcome. The Gausknecht's test value is evaluated by ultrasonic study by the interval between the onset of apnea in the mother and emergence of respiratory movements in the fetus. The results of Gausknecht's test longer than 30 sec indicates high hypoxic resistance of the fetus and high probability of delivery of a normal infant in natural labor. Gausknecht's test result below 10 sec indicates poor hypoxic resistance of the fetus and predicts a high probability of acrocyanosis, asphyxia, meconium release into the amniotic fluid, resuscitation of the newborn, and symptoms of ischemic encephalopathy in the newborn. Hence, it is desirable to be ready for resuscitation measures for the newborn and/or urgent cesarean section.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):14-18
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Clinical laboratory regularities of pregnancy course in patients with obesity and the metabolic syndrome
Levakov S.A., Borovkova E.I., Shchegolev A.I., Martinova I.V.
Abstract
A total of 685 pregnant patients with obesity and the metabolic syndrome were examined. The characteristic obstetrical complications were detected and the relevant prognostic criteria were defined. The time course of carbohydrate and lipid metabolism, hemostasis, hormonal profiles, and renal function during gestation was evaluated. Specific features of endothelial dysfunction, placentation, and vasculogenesis were detected.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):19-25
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Contribution of genital mycoplasmas (Ureaplasmaparvum, Ureaplasma urealyticum, Mycoplasma hominis, Mycoplasma genitalium) to the development of pregnancy, labor, and postpartum period complications
Belova A.V., Astsaturova O.R., Aleksandrov L.S., Nikonov A.P., Ivanova T.A., Gushchin A.E.
Abstract
Prospective analysis of the course of pregnancy, labor, and postpartum period was carried out in 677 women screened for vulvovaginal and cervical infections and the course of the early neonatal period in their newborns was analyzed. Genital mycoplasmas were detected in the vagina and cervical canal in 304 (44.9%) patients: Ureaplasma parvum in 40.2%, U. urealyticum in 7.1%, Mycoplasma hominis in 4.6%, and M. genitalium in 0.6%. Genital mycoplasmas in the lower genital tract were combined with other opportunistic infections in the overwhelming majority of patients - in 232 (76.3%). Monocultures or combinations with only Lactobacillus spp. were isolated in just 72 (10.6%) cases. Colonization of the lower genital tract ofpregnant patients by opportunistic micro-organisms was an important risk factor for preterm delivery, preterm amniorrhea, delivery of small-for-date (<2500 g) babies, for postpartum endometritis and wound infection. On the other hand, it was obvious that genital mycoplasmoses were inessential for the pathogenesis of unfavorable outcomes ofpregnancy, labor, and postpartum period in women and of the early neonatal period in newborns.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):26-31
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Changes in ovarian function in women of reproductive age after organ-sparing interventions on the pelvic organs
Sosnova E.A., Gasymova U.R.
Abstract
The objective. Changes in the function of the ovaries were evaluated in women of reproductive age after organ-sparing interventions on the pelvic organs. Patients and Methods. The study was carried out in 98 women of reproductive age with benign tumors of the pelvic organs (uterine myoma, ovarian cysts, tuboperitoneal sterility), who wished to remain fertile after the intervention. The patients ’ ages varied from 22 to 44 years (median 32.9 ± 0.5 years), 58 of them were operated on for the first time and 40 repeatedly. Significant differences were detected between the groups of patients after a single and repeated surgeries. Results. Hormonal analysis showed significantly higher concentrations of LH and FSH and lower levels of E2 and anti-Muller hormone 6 months after the operation, these shifts more pronounced after repeatedly operations. Echographic examination of the pelvic organs showed a significant shrinkage of the uterus and both ovaries and reduction of the follicular pool. Conclusion. Hence, the ovarian reserve underwent more profound changes with every new surgical intervention on the pelvic organs. Organ-sparing operations on the pelvic organs led to reduction of the follicular pool with the formation of preterm failure of ovarian function.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):32-36
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NAT2, GST T1, and GST M1 gene polymorphisms in women with pelvic organ prolapse and stress urinary incontinence
Rusina E.I., Bezhenar V.F., Ivashchenko T.E., Pakin V.S., Baranov V.S.
Abstract
The objective. The relationship between C481T(S1), G590A(S2), and G857A(S3) polymorphisms in acetyltransferase 2-coding NAT2 gene and glutathione-S-transferase T1 and M1 deletion polymorphisms in GST T1 (del) and GST M1 (del) genes and the risk of pelvic organ prolapse (POP) and stress urinary incontinence (SIU) was studied. Patients and Methods. The study was carried out in 2 groups of patients. Group 1 consisted of patients with stages I-IV POP according to POP-Q scale (n=67). Group 2 included patients with POP and SIU (n=63). Control group (n=89) included women without POP and complaint of SIU. Specimens of DNA were isolated from whole blood. Polymorphisms were identified by PCR by evaluating the restriction fragment length polymorphisms. Results. Significant differences in the incidence of NAT2, GST T1, GST M1 polymorphisms in the patients and controls were detected. Genotype NAT2 N/N was associated with a 3.7 times lesser probability of POP with SIU (OR=3.67, 95% CI 1.01- 13.38). Genotype GSTM1 (del) was associated with higher probability of POP with SIU - about 1.5 times (OR=1.49, 95% CI 1.04-2.15). Combined genotype GST T1+/GST M1+ was associated with a 2.5 times lower probability of POP with SIU (OR=2.5, 95% CI 1.19-2.24). Conclusion. Hence, NAT2 gene C481T(S1), G590A(S2), and G857A(S3) polymorphisms and GST T1(del) and GS TM1(del) gene deletion polymorphisms were involved in the etiology and pathogenesis of POP and SIU.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):36-40
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Anticoagulant therapy in pregnancy
Koroleva N.S., Murashko A.V.
Abstract
High blood clotting is one of the main problems of modern obstetrics. A total of 80 women with gestoses, receiving anticoagulant therapy, were examined; the reference group included 20 women. The incidence of preterm deliveries was significantly higher in women treated by anticoagulants. The body length and weight values of the newborns were better in the reference group. Blood loss volume was virtually the same in the two groups. These results prompt more accurate definition of indications for anticoagulant therapy in pregnant patients.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):41-43
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Malignant tumors of the female genitals in Russia: State of the art and problems
Kaprin A.D., Starinskiy V.V., Petrova G.V., Gretsova O.P., Aleksandrova L.M.
Abstract
Presents analysis of morbidity, 5-year survival, and mortality of patients with malignant tumors of the female genitals, based on the data offederal statistical files recorded at PA. Hertzen Moscow Oncological Institute. Approaches to improvement of the efficiency of cancer control measures and care of the female population of Russia are discussed.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):44-47
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Office hysteroscopy in the diagnosis of intrauterine abnormalities in sterile women
Bortsvadze S.N., Dzhibladze T.A., Ishchenko A.I., Zuev V.M., Bryunin D.V., Arutyunyan N.A.
Abstract
The role of office hysteroscopy in the diagnosis of intrauterine disease is discussed as exemplified by examinations of 280 patients. Office hysteroscopy is the most informative screening method for the diagnosis of intrauterine abnormalities, which can be carried out in an outpatient setting. An important advantage of office hysteroscopy is that it involves no dilatation of the cervical canal and anesthesia. It can also be used to monitor the status of the uterine cavity during the postoperative period.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):48-49
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Rare thrombotic complications in obstetrical practice
Ishchenko A.I., Aleksandrov L.S., Nikonov A.P., Kharnas S.S., Sokolina I.A., Kaptilnyi V.A., Belova A.V.
Abstract
Two cases with ovarian vein thrombosis and thrombophlebitis during the postpartum period in patients after spontaneous and surgical deliveries are presented. The clinical picture, differential diagnosis, and therapeutic strategy are described in detail. This pathological process was a rather rare serious complication of the postpartum period, difficult to diagnose, fraught with unfavorable outcomes.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):50-54
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Information
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Abstract
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(2):55-55
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