Vol 6, No 3 (2019)

Original study articles

EATING DISORDERS AND PREGNANCY: LITERATURE REVIEW

Poznukhova E.V., Murashko A.A., Kurinova A.N.

Abstract

This review highlights the features that affect fertility and pregnancy in women with eating disorders, possible complications and clinical management of such patients by an obstetrician-gynecologist. Such obstetric and gynecological aspects associated with eating disorders as fertility disorders, unplanned pregnancy, intrauterine growth retardation, miscarriage and premature labor, deficit of lactation and others are considered. We also describe the influence of pregnancy on the course of eating disorders: the possibility of remission, followed by a high risk of relapse, postpartum depression and anxiety disorders. Moreover, we talk about the necessity of screening eating disorders among women of reproductive age and the importance of multidisciplinary management of pregnancy in such patients.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):116-120
pages 116-120 views

THE ROLE OF MODERN PHYSIOTHERAPY IN THE PREVENTION AND TREATMENT OF GYNECOLOGICAL DISEASES (REVIEW OF LITERATURE)

Ozolinya L.A., Savchenko T.N., Anisimova M.A.

Abstract

Physiotherapy is an important component in the prevention and treatment of obstetric and gynecological pathology. Physical factors should be used as primary or secondary treatment methods. The effects of physiotherapy are based on the absorption of physical (electrical, radiation, magnetic, etc.) energy by living tissues. The result of treatment depends on the physical factor, the number and a single dose of the procedures received. The best is the use of physiotherapy during several procedures (course of treatment). In connection with the progress of science and technology, new methods of physiotherapy have appeared: magnetic, infrared-laser-therapy, ozone, impulse-low-frequence-physiopherapeutical-apparat (ILPHYSA)-therapy, extremely-hign-frequence(EHF)-therapy. These methods began widely to use in gynecology.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):121-127
pages 121-127 views

PERSPECTIVITY OF THE APPLICATION OF MEDICAL SULPHIDE-SILT MUD “TINAKSKAYA” IN GYNECOLOGICAL PRACTICE (BASED ON LITERATURE REVIEW)

Sinchikhin S.P., Stepanyan L.V., Tsurigova Z.A., Muradkhanova N.A., Chernikina O.G., Kuz’mina M.A.

Abstract

The article presents data on the therapeutic properties of sulphide-silt mud “Tinakskaya” extracted from the Healing Lake located in the Astrakhan region of the Russian Federation. Data on the positive effect of this mud in the treatment of various diseases are presented. The perspectivity of more active use of sulphide-silt mud “Tinakskaya” in gynecological practice is shown.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):128-131
pages 128-131 views

PREGNANCY WITH UTERINE MYOMA AND AFTER MYOMECTOMY: RESULTS OF THE COHORT STUDY

Timokhina E.V., Gubanova E.V., Silayeva T.M.

Abstract

Objective - to identify risk factors, complications, and pregnancy outcomes in patients with uterine fibroid (myoma) and after myomectomy. Material and methods. Investigated 100 pregnancy and delivery stories, where 1st group consists of 40 patients with uterine myoma from 3 to 12 cm, 2nd group - 30 patients with a history of myomectomy, 3rd group - control of 30 patients. Results. The average age of patients from group 1 is 34.9 years, group 2 - 35.7 years. Both in group 1 and group 2 there is a large percentage of surgical interventions on the uterus: a history of abortion (35%/20%) and miscarriage (15%/36.6%). Significant sizes of fibroids contribute to incorrect fetal position - breech presentation (17.5%/3.3%), transverse (2.5%), oblique (2.5%). The presence of fibroids is associated with certain complications: the growth of the placenta in the myomatous node (5%), disorder of blood supplying and ischemic changes of the nodes during pregnancy (2.5%), late postpartum hemorrhage (2.5%), fetal distress (12.5%). Surgical delivery by Cesarean section (85%) is the method of choice for uterine myoma, based on a combination of another relative indications. Caesarean section in such patients is associated with an increase in the volume of surgical intervention, in the form of conservative myomectomy according to indications (58.8%), which may be a factor in pathological blood loss (2.5%). Pregnancy and delivery after myomectomy is accompanied by the occurrence of specific complications: scar failure after myomectomy, the threatening of uterine rupture in the scar (6.7%), adhesions in the pelvis III-IV degrees (16.7%).
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):132-139
pages 132-139 views

EVALUATION OF THE FREQUENCY AND STRUCTURE OF ABORTIONS IN THE REGION OF CENTRAL RUSSIA

Akhilgova Z.S., Volkov V.G., Granatovich N.N.

Abstract

Abortion occupies a leading place in the structure of reproductive losses. The purpose of the study is to assess the structure and frequency of abortions in the Tula region Russia. Material and methods. In the period from 2013 to 2017, the analysis of the dynamics of fertility and abortion in the period up to 22 weeks was carried out. Results. During 5 years in the region of 73 517 was born living children. The analysis showed that the number of termination of pregnancy was 25 126, of them in the early stages (up to 12 weeks) 23 396 (93.1%), in the period from 12 to 22 weeks - 1730 (6.9%). The number of abortions in the region to 22 weeks decreased from 47.9 to 29.4 per 1,000 women (15-49 years) and from 19.9 to 11.4 per 100 born alive and dead. Compared with other types of abortion, the lowest basic rate of decline (9.97%) was set for spontaneous abortion (9.97%), the highest for medical legal abortion - 62.11%. In the structure of termination of pregnancy up to 12 weeks there was an increase of spontaneous abortion for 2015 -2017 (the basic growth rate of 16.6%). In the region, there was an increase in the frequency of abortions in the first pregnancy by 33.9% and an increase in abortions for medical reasons by 16.85%. The age ratio of abortions remains stable throughout the follow-up period. Conclusion. The structure of reproductive losses in the region is still dominated by medical legal abortions, but among the true prenatal losses the leading role belongs to spontaneous abortion. Reducing the frequency of spontaneous abortion is the main unconditional reserve to increase the reproductive potential of the region.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):140-144
pages 140-144 views

FEATURES OF PREGNANCY IN NULLIPAROUS WITH EARLY PREECLAMPSIA

Volkov V.G., Badalova L.M.

Abstract

Objective - to study the characteristics of the course of pregnancy, maternal and perinatal outcomes in nulliparous with early preeclampsia. Methods. 127 nulliparas were included in the prospective case-control study. Two groups were formed: 1st (n = 27) - pregnant with early preeclampsia, 2nd (n = 100) - pregnant without preeclampsia. Mild preeclampsia occurred in 21 (77,8%) and severe in 6 (22,2%). Results. A significant difference was detected in the I trimester, which was expressed in differently directed changes in the indices of ß-hCG and PAPP-A. Violation of hemodynamic parameters was noted at 18-21 weeks which was observed in group 1st and was expressed by an increase in the systolic-diastolic ratio predominantly in the left uterine artery. In group 1st, shallow water, fetal growth retardation syndrome were more often detected, and antenatal death occurred in 2 cases. In total, 25 newborns were born alive in group 1st, 100 in group 2nd. Apgar score: less than 7 points in group 1st in 5 (18,5%), and in group 2nd - 8 (8%). Conclusions. The peculiarities of the course of pregnancy with early preeclampsia are a decrease in the level of PAPP-A in the period of 11-13 weeks and a violation of hemodynamics in the period of 18-21 weeks. The timely detection of pregnant women at risk of developing early preeclampsia will determine the criteria for more intensive monitoring and the use of prophylactic treatment methods.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):145-150
pages 145-150 views

COMPARATIVE EFFICACY OF HORMONAL DRUGS FOR THE PREPARATION OF THE ENDOMETRIUM FOR ABLATION IN PREMENOPAUSAL PATIENTS

Sinchikhin S.P., Kostenko E.V., Stepanyan L.V.

Abstract

The aim of the study is to compare the effectiveness of the use of hormonal drugs before hysteroresectoscopic ablation of the endometrium in premenopausal patients with abnormal uterine bleeding. Were examined 145 women aged from 45 to 54 years with recurrent endometrial hyperplasia, which were divided into three groups depending on the preoperative use of one of the hormonal drugs (gestagen preparation, microdose estrogen-gestagen contraceptive, gonadotropin-releasing hormone agonist - GnRHa). When medication-induced endometrial atrophy was achieved, the patients underwent hysteroresectoscopic endometrial ablation using the coagulation vaporization technique. The results of the study showed the feasibility of preoperative thinning of the uterine mucosa to improve the results of treatment of its benign changes. The most effective means for accelerating the attainment of drug regression of the endometrium were GnRHa, whose effectiveness was 95.7%. The estrogen-gestagen-containing contraceptive and gestagen preparation showed an efficacy of 65.3% and 42.8%, respectively. The results of the study should be considered when choosing the optimal tactics for management of premenopausal patients with abnormal uterine bleeding.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):151-156
pages 151-156 views

THE APPLICATION OF MAGNETIC FIELDS AND FLUCTUORIZATION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS AFTER RADICAL MASTECTOMY

Gerasimenko M.Y., Evstigneyeva I.S., Perfil’yeva O.M., Tumbinskaya L.V.

Abstract

We conducted an objective and instrumental examination in 76 patients with radical mastectomy in the early postoperative period (2-4 days), after which the patients of the 1st group (n = 38) underwent a course of fluctuation of the muscles of the shoulder girdle and upper extremity from the side of operative interference without interruption. Group 2 (n = 38) after the course, the course of fluctuation of the muscles of the shoulder girdle and upper limb from the side of operative interference without interruption was carried out extended low-intensity magnetic therapy of the postoperative area and arm. It has been proved that with this combination, the patient notes an improvement in the quality of life, postoperative swelling decreases, pain syndrome decreases, lymphorrhea periods shorten. As a result of the study, the number of postoperative complications in the wound area decreased (inflammation, infectious processes, pain, seam divergence). There is an increase in the amount and quality of movements, reduced sensitivity disorders in the upper limbs. The results of remote infrared thermography showed that the positive dynamics remained only in patients from both groups who received the combined use of two factors, which proves the prolongation of the clinical effect. Thus, the combination of two physical factors in the early postoperative period, in patients after radical mastectomy, has broad functionality and allows to obtain a more pronounced and stable clinical result.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):157-162
pages 157-162 views

THE USE OF AN ADAPTED CLINICAL AND PSYCHOLOGICAL APPROACH TO THE TREATMENT OF PATIENTS WITH ENDOMETRIAL HYPERPLASIA IN THE POLYCLINIC

Efanova N.A., Emel’yanova T.A., Mikhel’son A.F., Lazareva I.P., Lebedenko E.Y., Bogachenko S.M., Kutuzova E.A., Groshilina G.S., Markina V.V.

Abstract

The study confirmed that reproductive age patients with endometrial hyperplasia with initial severe hyperestrogenemia, autonomic regulation imbalance, and pronounced psychosomatic disorders as hormonal therapy showed marvelone in the prolonged mode, because in this case the gradient of estrogen incidence is smoother than during application depot forms of buserelin. In addition, the possibility of simplifying the algorithm for applying a verifiable clinical-psychological approach through the use of simple, automated physiological and psychodiagnostic research methods, which makes it possible to effectively use this algorithm in polyclinic conditions, is shown.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2019;6(3):163-168
pages 163-168 views


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