Vol 1, No 1 (2014)

Original papers
From the Editorial Board
Sosnova E.A.
Abstract
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):4-4
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Hypoparathyroidism and pregnancy
Lesnikova S.V., Fadeev V.V., Melnichenko G.A.
Abstract
No clear-cut clinical recommendations for the management ofpatients with hypoparathyroidism have been developed. Reports on the use of vitamin D in pregnant patients are scanty. This review of literature describes the specific features ofphosphoruscalcium metabolism during pregnancy in health and hypoparathyroidism and discusses problems of therapy for this conditions and the safety of calcitriol during gestation and breast feeding.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):5-12
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Angiogenesis placental factors imbalance and clinical features of “early” and “late” pre-eclampsia
Kozlovskaya N.L., Merkusheva L.I., Kirsanova T.V., Bobkova I.N., Bobrova L.A., Runikhina N.K.
Abstract
Nephrological manifestations of “early” and “late” pre-eclampsia (PE) are described. Clinical manifestations are analyzed with consideration for the placental angiogenesis markers: VEGF and sFlt-1. Women with early PE (gestation age Me32 [29; 34] weeks) had higher systolic and diastolic BP (170 ± 16.8 vs. 156 ± 6.56 mm Hg and 105 ± 8.9 vs. 99 ± 6.9 mm Hg, respectively), 4-fold higher incidence of renal dysfunction, presented by low glomerular filtration rate (GFR; Me 70 [51; 80] ml/min) and/or high serum creatinin levels (Me 90 [78; 102] мmol/liter), 7-fold higher incidence of the nephrotic syndrome, and 3-fold higher level of sFlt-1 than patients with late PE (gestation age Me 38 [36; 39] weeks). Inverse correlation between GFR and sFlt-1 (r = -0.42; p = 0.050) and direct correlation between GFR and VEGF (r = 0.47; p = 0.038) were detected in PE patients. The contribution of angiogenesis placental markers imbalance to the formation of proteinuria, arterial hypertension, and renal dysfunction in PE and the contribution of thrombophilia to PE development are discussed.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):13-21
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Use of human placenta hydrolysate in therapy for endometrial dysfunction
Kuznetsova I.V., Uspenskaya Y.B., Kovalenko M.A.
Abstract
Open comparative randomized study of human placenta hydrolysate (Laennec®) efficiency in patients with endometrial proliferative failure demonstrated its efficiency in restoration of the endometrial regenerative potential, normalization of ovarian function, and improvement of pregnancy outcomes in women with infertility and miscarriages. The efficiency of placental hydrolysate was higher than that of immunomodulators and vitamins and the effect was more lasting. Hence, human placenta hydrolysate effectively prepared women with sterility and habitual fetal loss syndrome to pregnancy.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):22-24
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Correction of pelvic floor defects by trocar-free synthetic systems
Makarov O.V., Kamoeva S.K., Loboda T.I.
Abstract
Elevate transvaginal system was used for surgical correction of the pelvic floor defects in 156 patients with the pelvic organ prolapse. Intraoperative blood loss of more than 500 ml was recorded in 15 (9.4%) patients. Two cases with negligible (no more than 10-15 mm 3) hematomas of Retzius ’ space and paraurethral zone were recorded. No complications, such as vaginal erosion, extrusion of mesh implant, painful syndrome, dyspareunia were recorded over the period of observation. No intraoperative complications were recorded. Three (1.9%) patients developed relapses (elongation of the uterine cervix and cervix stump). The long-term (3 years) anatomic (objective) efficiency of pelvic organ prolapse correction in our study reached 92.1%. The functional efficiency of Elevate transvaginal system anterior was 94.6%. The results indicated that in cases with the cervix uteri or cervix uteri stump elongation they were to be resected or amputated when implanting the Elevate anterior system.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):25-28
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Efficiency of infertility control in myomectomy
Bezhenar V.F., Dolinsky A.K., Yarmolinskaya M.I., Tsypurdeeva A.A., Chmaro M.G.
Abstract
Myomectomy via a laparoscopic access and myomectomy with laparotomy were carried out in 125 and 25 patients, respectively. The immediate and late results of the operations were analyzed. The criteria of efficiency of differentiated postoperative hormone rehabilitation were defined. New data on the methods for objective evaluation of the postoperative cicatrix on the uterus were obtained.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):28-35
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Efficiency of aromatase inhibitors in combined therapy for external genital endometriosis
Yarmolinskaya M.I., Molotkov A.S., Bezhenar V.F., Kvetnoi I.M.
Abstract
Aromatase expression in endometrioid heterotopies was studied. The results served as pathogenetic validation of using aromatase inhibitors in combined therapy for genital endometriosis. Aromatase inhibitors were used in the treatment of endometriosis patients. The efficiency of sterility control and painful syndrome arrest were evaluated and the side effects of therapy were characterized.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):36-40
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Use of single-port and three-port laparoscopy in gynecology
Ishchenko A.A., Ishchenko A.I., Maximov A.I., Zhumanova E.N., Toniyan K.A.
Abstract
The modern trend to wider use in gynecology of little invasive and little traumatic surgical interventions, including single- and three-incision laparoscopic access, prompted us to carry out a comparative analysis of case histories ofpatients treated with the use of these endoscopic technologies at Gynecological Department of Therapeutic Rehabilitation Center.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):41-43
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Obstetrical peritonitis and surgical strategy: Modern aspects
Davydov A.I., Podtetenev A.D.
Abstract
Obstetrical peritonitis is the most severe septic complication of cesarean section, which can eventuate in maternal death. Its incidence varies from 0.05 to 1.5% all over the world. Surgical strategy in this condition includes 1) extirpation of the uterus as a source of infection and 2) resection of necrotic tissues on the uterus with subsequent metroplasty. The conditions for, indications for, and contraindications precluding organ-sparing surgical treatment of puerperae with incompetent sutures on the uterus after cesarean section in the presence of peritonitis are presented. The authors emphasize that sepsis is the main contraindication precluding metroplasty.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):44-47
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Gestation diabetes mellitus
Petrukhin V.A., Burumkulova F.F.
Abstract
Pregnancy aggravated by gestation diabetes mellitus (GDM) is associated with a higher risk of serious obstetrical and perinatal events. Gestation diabetes mellitus is a risk factor for obesity, diabetes mellitus-2, and cardiovascular diseases in the mother and progeny. The results of Hyperglycemia and Adverse Pregnancy Outcome (HAPO) studies indicate that the previous criteria for GDM diagnosis should be revised. A new universal standard for the diagnosis and therapy of carbohydrate metabolism disorders during pregnancy was adopted in the Russian Federation in December, 2013.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):48-51
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Antenatal ultrasonic diagnosis of diabetic fetopathy and macrosomia
Krasnopolsky V.I., Petrukhin V.A., Chechneva M.A., Lysenko S.N., Ermakova L.B.
Abstract
Echography is an important instrument for the diagnosis of diabetic fetopathy. Detection of the specific symptom complex of the endocrinopathy, including evaluation of the proportional size of the fetus and visceral signs, promotes detection ofpregnancy complications sometimes before the clinical diagnosis of gestation diabetes mellitus. Ultrasonic findings can serve as the criteria for starting insulin therapy and evaluating its efficiency.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):51-53
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HELLP-HUS. Clinical case with delivery in a patient with the HELLP syndrome
Yastrebov M.A., Shakurova E.Y.
Abstract
The differential diagnosis of the HELLP syndrome with the development of renal failure and the hemolytic uremic syndrome, aggravating the course of the postpartum period, is rather difficult. These syndromes are based on microangiopathic hemolytic anemia, determining their virtually identical clinical picture. However, the difficulties in the differential diagnosis of these syndromes during the postpartum period do not preclude the correct choice of therapeutic strategy. The efficiency of efferent therapeutic methods in cases with manifest hemolysis causes no doubts by the present time. A clinical case is presented: diagnosis and treatment of the HELLP syndrome with the development of acute renal failure, manifesting during the postpartum period.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2014;1(1):54-55
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