Vol 5, No 3 (2018)

Original papers
ACUTE CYSTITE: CURRENT ISSUES OF DIAGNOSTICS AND ANTIMICROBIAL THERAPY
Kaptilnyy V.A., Mikhailova V.I.
Abstract
The review considers modern data on the diagnosis and treatment of acute cystitis. Questions of epidemiology and etiology of acute cystitis are covered. Regimens of basic and alternative treatment for acute cystitis are presented in terms of the perspective of evidence-based medicine.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):116-127
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METHODS OF PRECLINICAL DIAGNOSIS OF PREECLAMPSIA. COMPARISON OF BIOCHEMICAL AND INSTRUMENTAL METHODS OF EXAMINATION
Eristova S.K.
Abstract
The review presents current information on the predictive diagnosis of preeclampsia. The data of instrumental and laboratory diagnostics are described. Laboratory diagnostics includes such biochemical markers as PAPP-A, PIGF, VEGF, sFlt-1, sEng, NSE; instrumental diagnostics consists of ultrasound evaluation of placental structure, ultrasound dopplerometry of uterine arteries and determination of the index of vascularization of the placenta. Not all methods of the examination presented by the author have diagnostic value in the clinical use. Biochemical markers present the most accurate diagnostic picture. It is necessary to evaluate sFlt-1, PIGF and other markers in dynamics since their change with the increase in the gestation age differs significantly from the change in those in women with normal pregnancy.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):128-131
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ATYPICAL HEMOLYTIC-UREMIC SYNDROME IN GENERAL AND IN PREGNANCY
Novikov A.V.
Abstract
Atypical hemolytic-uremic syndrome (aHUS) is an ultra-rare (orphan) disease, a form of thrombotic microangiopathy, which arises from a disturbance of the activation of an alternative complement pathway. Pregnancy is a frequent trigger for the onset of obstetric aHUS. Against the background of the disease in pregnant women, there is a high risk of developing pre-eclampsia, acute renal damage and consequently maternal mortality. In the world over the past 5 years, the number of confirmed cases of aHUS has increased. However, this is due not so much to the increase in the occurence of the disease as to the improvement in the methods of its diagnosis. The genetic nature of the aHUS dictates the need to create modern sensitive tests for the study of the complement system: measurement of the plasma concentration of factor H and factor I, C3, C4, genetic screening of regulatory genes, and others. It is also necessary to develop new drugs that, along with Eculizumabum (Soliris®, Alexion Pharmaceuticals, Cheshire, CT, USA) would be used in the therapy of aHUS.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):132-139
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MORPHOLOGY AND PATHOGENESIS OF THE DETERIORATION OF THE OVARIAN RESERVE IN ENDOMETRIOSIS AND METHODS OF ITS PRESERVATION
Paramonova N.B., Semeryuk T.A.
Abstract
Reduction of the ovarian reserve, infertility and recurrent course in endometriosis make to consider this disease as an important scientific, medical and socially significant problem. The clarification of the pathogenesis of ovarian stock reduction and deterioration of oocyte quality, development of infertility and the possibility of using methods of assisted reproductive technologies appear to be especially relevant.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):140-147
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EXPERIENCE OF LAPAROSCOPIC CORRECTION OF FAILURE OF THE UTERINE SCAR AFTER THE CESAREAN OPERATION
Bryunin D.V., Mikhayelyan N.S., Khokhlova I.D., Dzhibladze T.A., Ishchenko A.I., Gorbenko O.Y., Gavrilova T.V., Gadaeva I.V.
Abstract
The article presents the results of laparoscopic correction of the failure of uterine scar after a cesarean section operation in 12 patients of reproductive age who are planning another pregnancy and having clinical symptoms that significantly impair the quality of life. The developed by ourselves three-stage reconstructive-plastic surgical program with the laparoscopic access in case of incompetence of the uterine scar contributed to an improvement in the quality of life in all subjects, pregnancy, and childbirth in 41,6% of patients. The use of laparoscopic techniques provided an improved visualization of anatomical structures (vessels, nerves, ureters, bladder), which led to a decrease in intraoperative blood loss, a reduction in the risk of damage to adjacent organs and the development of adhesions, and acceleration of postoperative rehabilitation of patients.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):148-153
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EARLY DIAGNOSTIC SIGNS OF ENDOMETRIOSIS
Karachentsova I.V., Logacheva T.M., Kashoyan A.R.
Abstract
Over the past few years, there has been a gain in the incidence of endometriosis, which is associated with an increase in the life expectancy of women with neuroendocrine disorders. Despite a large number of studies, many aspects of the etiology and pathogenesis of the disease remain unexplained. This work is aimed at revealing the hereditary factor as one of the reasons for the development of endometriosis.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):154-156
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COMPARISON OF DIAGNOSTIC METHODS AND TREATMENT OF ENDOMETRIOSIS OF ATYPICAL LOCATION
Shlyk D.D., Kitsenko Y.E., Markaryan D.R., Lanchinskiy V.I., Tulina I.A., Tsarkov P.V.
Abstract
Surgical treatment and subsequent management of women of reproductive age with endometriosis of extragenital localization involving intestine, whose frequency is up to 37%, currently do not have a detailed and clearly described protocol, which may be caused by the complexity of diagnosis at the preoperative stage. In most cases, extragenital localization is an intraoperative finding. The purpose of the article is to evaluate the complexity of diagnosing the atypical location of extragenital endometriosis, systematize the diagnostic protocol and present the chosen treatment tactics. Material and methods. In the clinic of coloproctology and minimally invasive surgery, 4 observations of extragenital endometriosis with intestinal lesions were noted. According to the results of diagnostic studies (multispiral computed tomography - MSCT of the abdominal cavity with intravenous contrast, irrigoscopy with double contrasting, colonoscopy with biopsy), endometriosis was confirmed in 2 patients at the preoperative stage. All patients underwent surgical interventions in the volume of resection of the affected segment of the intestine within the unchanged tissues. Results. According to the intraoperative revision, in all patients there was noted the presence of additional extragenital foci of different localization, which were destroyed by diathermocoagulation. Patients with unverified endometriosis also underwent lymphadenectomy in D2 volume due to the inability to exclude malignant neoplasm. In the early postoperative period, no complications were noted. Only 1 patient decided to take hormonal therapy for 6 months after the operation. At present, none of the relapses have been observed, the mean follow-up time is 17.3 ± 13.6 months (4-33 months). In all patients there was recovered the menstrual cycle, menstruation moderately painful, previous abdominal pains before menstruation and spotting discharges from the rectum stopped. Conclusion. Surgical treatment of extragenital endometriosis of intestinal localization in the volume of resection of the affected intestine within the unchanged tissues is the optimal treatment technique and is not accompanied by significant complications. However, in cases of unverified histologically endometriosis, principles of oncological radicalism should be kept. To select the optimal volume of surgical intervention and access, a multidisciplinary consultation with the coloproctologist, gynecologist and with the obligatory consideration of the patient’s opinion is required.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):157-163
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LYMPHOGRANULOMATOSIS AND PREGNANCY: THE EDGE OF THE POSSIBLE
Ignatko I.V., Afanasyeva N.V., Samoylova Y.A., Golubenko E.O., Dudina I.A., Matsneva I.A.
Abstract
The prevalence rate of Hodgkin’s lymphoma is the fourth among malignant neoplasms in women of the reproductive age, so the problem of the association of this disease with the pregnancy inevitably arises. The tactic of the management of the pregnancy and childbirth in such patients depends on the stage and time of the detection of the disease. This article presents a clinical observation of a patient whose pregnancy occurred in the fourth year of the sustained remission of stage IV lymphogranulomatosis and had a favorable outcome.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2018;5(3):164-168
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