Open Access Open Access  Restricted Access Access granted  Restricted Access Subscription or Fee Access

Vol 4, No 4 (2017)

Original papers
MULTIMODAL STRATEGY FOR THE MANAGEMENT OF SURGICAL PATIENTS(FAST TRACK SURGERY)
Ishchenko A.I., Aleksandrov L.S., Ishchenko A.A., Khudoley E.P.
Abstract
There was executed an analysis of the literature data on fast track surgery in foreign and domestic publications for the last 7 years, included in the database PubMed, Medline, Scientific electronic library (elibrary.ru). The review considers in details the principles of fast track surgery and the rationale for their use. The results of application of accelerated rehabilitation programs in surgical specialties are presented and analyzed. The use such programs allow shorten the duration of hospitalization, restore the patient’s ability to work in a more shorter time, without reducing the effectiveness of the treatment, which would have a positive economic effect. The implementation of the fast track surgery program requires a multidisciplinary approach of all specialists involved in perioperative management of the patient.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):172-177
views
MODERN METHODS OF VISUALIZATION OF PATHOLOGICAL PLACENTATION
Kadyrova A.F., Puzakov K.B., Murashko A.V., Seredina T.A., Gadaeva I.V.
Abstract
The deterioration of the attachment of the placenta is associated with an increased risk of the development of its premature detachment, postpartum hemorrhages, intrauterine and intranatal fetal death. The fused placenta occurs approximately in 9% of women with placenta previa and in 0.004% of women without placenta previa. The timely made diagnosis of this pathologyis critically important for choosing the amount of surgical intervention for delivery, which is always associated with increased blood loss. This review examines issues of the diagnosis of placenta attachment. Data on advantages and disadvantages of ultrasound and MRI methods are given. The frequency of abnormal placentation is known to correlate with the increase in the number of surgical interventions on the uterus, in particular, the operation of cesarean section. In this regard, there is a need for accurate and early diagnosis of placenta attachment. Currently, the ultrasound method is leading in the detection this pathology, but this method has its drawbacks. In this review, the authors attempted to collect experience with the use of MRI for early diagnosis of abnormal placentation.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):178-180
views
THE ROLE OF BIOCHEMICAL MARKERS IN THE RISK STRATIFICATION FOR DEVELOPMENT OF PREECLAMPSIA: THE CLINICIAN’S VIEW
Ignatko I.V., Florova V.S., Kuznetsov A.C., Kuzina E.Y.
Abstract
Preeclampsia is one of the main causes of maternal mortality and leads to 50-60 thousand deaths annually worldwide, its prevalence in the world is 5-8%. Moreover, this complication is associated with an increased risk of the development of cardiovascular diseases and diabetes in the mother and child. Preeclampsia is a multi-systemic syndrome including hereditary and environmental factors in its pathogenesis and pathophysiology, and the only effective method of the treatment is still delivery. Regardless of the time of debut, preeclampsia is often characterized by the relative well-being of a pregnant woman, right up to the development of severe pre-eclampsia. This review is devoted to biochemical markers of the high risk of pre-eclampsia. Of particular interest there is the balance of proangiogenic (PIGF) and anti-angiogenic (sFlt) growth factors at different gestational ages; both the correct interpretation of the sFlt/PIGF balance and the correlation with the history data already allow us to expand the criteria for the prevention of preeclampsia and open up prospects for optimizing obstetric tactics in the third trimester of pregnancy.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):181-186
views
MODERN CONDITION OF THE PROBLEM OF THE PREMATURE RUPTURE OF MEMBRANES DURING FULL-TERM PREGNANCY (REVIEW OF LITERATURE)
Astafev V.V., Nazarova S.V., Li A.D., Podzolkova N.M.
Abstract
Premature rupture of membranes (PRM) during full-term pregnancy is a common obstetric complication. Childbirths on the background of PRM are accompanied by an increase in the frequency of the operative deliveries, as well as various obstetric complications. However, for all the diversity of tactics, techniques, clinical recommendations devoted to actions of a doctor in the management of PRM patients, the question of their choice depends on many factors. For more than 20 years of studying the PRM problem, a technique for preparing the cervix, providing 100% result has not been developed. With all the variety of choice of methods, none of them is devoid of shortcomings (contraindications to the use, cost-effectiveness, compliance of the patient, etc.). In this regard, the optimal choice of the tactics of labor in PRM cases is the insurance of the preservation of the health of the future generation.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):187-193
views
JUSTIFICATION OF THE APPLICATION OF THE METHOD OF THREE-DIMENSIONAL PHOTODYNAMIC THERAPY OF DISEASES AND PROCESSES OF MICROBIAL AND NEOPLASTIC NATURE IN CLINICAL GYNECOLOGY
Aleksandrov M.T., Zuev V.M., Pimancheva Y.I., Pashkov E.P., Bagramova G.E.
Abstract
There were executed experimental studies on test subjects of microbial (Staphylococcus aureus and Pseudomonas aeruginosa) and neoplastic nature (in vitro - suspension of cells of the line of chronic myelogenous leukemia K562 in a volume of 60 μl and in an amount of 60 ± 1 × 103, in vivo - mice infected with Ehrlich carcinoma) on the substantiation the use of chlorophyll-containing drugs activated for photodynamic therapy (PDT) outside the biological object. No additional PDT activation of the drug was performed.The high bactericidal (on the test objects of microbes) and anti-tumor PDT efficacy of chlorophyll-containing preparations activated outside the organism was substantiated, with their subsequent administration per os and accumulation in practically all organs and tissues of the body was validated. The developed medical diagnostic technology in its clinical application has proved its effectiveness in women with inflammatory and/or neoplastic processes of the pelvic organs. The used equipment and preparation are approved for clinical use.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):194-200
views
HYPERPLASTIC PROCESSES OF ENDOMETRIUM IN WOMEN OF PERIMENOPAUSAL AGE: CLINICAL ASPECTS OF THE PROBLEM
Baburin D.V., Unanyan A.L., Sidorova I.S., Kudrina E.A., Ishchenko A.I.
Abstract
The aim of the study is to identify the most significant clinical and anamnestic risk factors for the onset and progression of endometrial hyperplastic processes and the development of malignant transformation of endometrium in women of perimenopausal age, with taking into account their importance on the basis of statistical analysis. Methods. Based on Spearman’s correlation analysis and determination the degree of dependence of the development of endometrial cancer (from 0 to 1) on clinical-anamnestic and diagnostic risk factors (risk ratio (RR) in groups), there were obtained coefficients for a mathematical model allowing with the use of the binary logistic regression method predict the risk of the appearance of endometrial cancer. Results. The most clinically and statistically significant risk factors for the progression of the pathological process of the endometrium, having a high RR (greater than 1) and a confidence interval of 95% (p < 0.05), are (in the order of significance): recurrence of the endometrial hyperplastic process, obesity, the pronounced blood flow in Ultrasound with color Doppler mapping, polycystic ovary syndrome, abnormal ovarian formations, infertility (primary and secondary), type 2 diabetes mellitus, combined uterine pathology (myoma and/or adenomyosis), hereditary predisposition to cancer development, hypertension, age of 50 years and older. Conclusion. The tactics of the management and treatment of patients with hyperplastic endometrial processes should be based on the detection of the degree of the risk of the progression of pathological processes and the development of the malignant transformation of the endometrium. The study of the individual prognosis of endometrial cancer in patients with hyperplastic endometrial processes currently is becoming increasingly important due to the need to construct a rational treatment plan of the management and performing the follow-up dispensary observation on the basis of a scientifically justified forecast. Results obtained during our work allowed us identify statistically significant risk factors for the development of endometrial cancer. There were obtained coefficients for the creation a reliable mathematical model. With the use of the method of binary logistic regression, it is possible to calculate the risk of developing cancer and choose an effective management tactic for patients with hyperplastic endometrial processes at the perimenopausal age.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):201-207
views
CLINICAL AND MORPHOLOGICAL FEATURES OF CHRONIC ENDOMETRITIS IN INFERTILE WOMEN
Unanyan A.L., Kossovich Y.M., Demura T.A., Baburin D.V., Sidorova I.S., Ishchenko A.I.
Abstract
Morphofunctional state of the endometrium is one of the key factors determining both the successful implantation and full development of the embryo, including in cycles of «in vitro fertilization» (IVF). The most common cause of the impairment of the structure and function of the endometrium being chronic endometritis (CE), the frequency of its detection in infertile patients varies between 13 and 68%, reaching its maximum in women with tubal peritoneal factor and unsuccessful attempts of IVF in the anamnesis. The increasing prevalence and steady growth of the currently occurrence rate of CE cases in infertility is promoted by an increase in the role of intrauterine contraception and intrauterine interventions, including artificial abortions. On the other hand, happened in the last decades the evolution of the etiologic factor of CE towards the predominance of associations of facultative and obligate anaerobic microorganisms and viruses in the endometrium often leads to the development of erased, sluggish and atypical forms of the disease, which significantly hamper the diagnosis of CE and significantly reduce the effectiveness of traditional schemes of its treatment. CE is a clinically significant nosological form requiring the timely detection and treatment. The complex phased and pathogenetically substantiated therapy of CE in most cases leads to the restoration of the morphofunctional potential of the endometrium and, as a consequence, promotes the successful realization of the reproductive function.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):208-213
views
OXIDATIVE STATUS OF BLOOD PLASMA IN REFRACTORY PREGNANCY LOSS
Pokaleneva M.S., Nesterova A.M., Sosnova E.A., Bolevich S.B., Proskurnina E.V.
Abstract
The habitual miscarriage of the pregnancy is one of the most urgent problems in obstetrics and gynecology. There was performed a study of the antioxidant activity of blood plasma by kinetic chemiluminescence, the determination of tryptophan fluorescence was used to evaluate the oxidative modification of albumin. The study included 28 pregnant women with the threat of abortion (TA), 19 of them had a diagnosis of habitual miscarriage, and 9 women - an undeveloped pregnancy. The control group 1 included 61 women with normal pregnancy, the control group 2 - 22 non-pregnant women, control group 3 - 5 women after spontaneous miscarriage (up to 22 weeks).The results showed spontaneous abortion to be followed by the decline in the antioxidant capacity of the plasma, which indicates to the development of oxidative stress; on the contrary, in women with an undeveloped pregnancy, the antioxidant capacity was higher. In the determination of the proportion of oxidized albumin in all patients, but nonpregnant women, there were noted negative values indicating to the presence of specific antibodies or, possibly, cytokines possessing tryptophan fluorescence.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):214-219
views
EPIDURAL ANALGESIA AND LABORS IN WOMEN WITH A UTERINE SCAR: WHAT IS THE DEGREE OF RISK?
Bozhenkov K.A., Gustovarova T.A., Shifman E.M., Vinogradov V.L.
Abstract
The article presents the results of a prospective controlled longitudinal study involving 69 reproductive women with a uterine scar after a cesarean section in previous labor. In women included in the study births were performed vaginally. Patients were divided into two groups: the first group consisted of 38 women with a uterine scar, whose vaginal deliveries were anesthetized by the method of epidural analgesia; the second group included 31 multipara patients with a uterine scar, in which the births were carried vaginally without epidural analgesia. Over the course of a study epidural analgesia was shown to be effective method of anesthetizing labor in women with a uterine scar. Epidural analgesia in vaginal delivery in women with a uterine scar is concluded do not influence on the risk of untimely diagnosis of the beginning uterine rupture. Diagnostic criteria for the beginning uterine rupture on the background of epidural analgesia should be considered for any of following criteria: the emergence of a severe pain syndrome, not associated with the contractile activity of the uterus; signs of the sudden deterioration of the state of the fetus; change in the fetal heart rate; change in the tone of the uterus and the nature of its contractions; termination of labor activity; a sudden change in one or more vital signs of the parturient (BPmean, HR, RR).
V.F.Snegirev Archives of Obstetrics and Gynecology. 2017;4(4):220-224
views

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies