Vol 6, No 2 (2019)

The article presents data on the management of pregnancy in women with eye diseases. Ophthalmological manifestations in various pathological conditions on the part of the organs of vision are clearly shown. Presents the procedure for management of pregnancy and childbirth in women with both eye diseases and ophthalmic morpho-functional changes associated with the development of gestational complications. The admissibility of carrying out laser-surgical treatment methods for pathological changes in the organs of vision in a pregnant woman is noted. Ophthalmological changes are indicated, which are taken into account when choosing a mode of delivery.

According to last research, receptors for vitamin D are found in many organs and tissues. Vitamin D deficiency leads to the development of pathological conditions in children and adults. The non-classical effects of vitamin D are important in modulating congenital and acquired immunity, regulating cell proliferation, in the progress of diabetes, the pathology of the cardiovascular system, and autoimmune diseases. The inverse correlation between the level of 25(OH)D3 and the incidence of cancer has been determined. Vitamin D affects the course of pregnancy, and the decidual and placental tissues synthesize 1.25(OH)2D. Vitamin deficiency is found in pregnant women with preeclampsia and gestational diabetes. Timely diagnosis and adequate correction of the level of vitamin D in the blood reduces the risk of developing diseases.

Conducted experimental and clinical studies on the implementation of the rapid diagnosis of endometrial morphofunctional state in perimenopausal women. The age-related features of the structural and functional state of the endometrium in women in this age period and in women with a reduced follicular reserve after ovarian surgery have been revealed. The developed medical diagnostic technology has confirmed its clinical efficacy in rapid diagnosis in the conditions of follow-up observation of perimenopausal women.

The aim of the study was to assess the course of pregnancy and childbirth in patients with varying degrees of obesity.Material and methods of research. A retrospective study of pregnant women with different body mass index (BMI), the delivery of which occurred in the period 01.01.2018-06.30.2018, was conducted. The results of the study. In the study, the largest proportion - 53% were pregnant women with a BMI above 30 kg/m2, the proportion of women with premorbid obesity - 47%. The incidence of diseases that complicate the course of pregnancy (chronic hypertension, gestational hypertension and preeclampsia) was highest in women with a BMI higher than 30 kg/m2. In the study groups, gestational arterial hypertension was the most common - 14%. Pregnancy complications, namely, fetal growth retardation/placental insufficiency, occurred with a frequency of 8% in the group with premorbid obesity. In pregnant women with a BMI of more than 30 kg/m2, acute/chronic fetal hypoxia was observed, the frequency of which in total was 10%. Complications of the fetus in the studied women showed that the risk of fetal hypoxia in pregnant women with a BMI above 30 kg/m2 is very high. Large fruit was found in 15% of cases of the total number of women studied, in groups with a BMI of more than 30 kg/m2, with a frequency equal to 10% of the total number. The number of births through the birth canal in women with a BMI of more than 30 kg/m2 was 28%, and the frequency of cesarean section operations was 24%. Conclusion. Women with a BMI above 30 kg/m2 have a high frequency of pregnancy complications (gestational arterial hypertension, preeclampsia, chronic arterial hypertension). A high frequency of perinatal pathology was revealed - acute/chronic fetal hypoxia, placental insufficiency, fetal growth retardation, macrosomia. Pregnant women with a high BMI should be closely monitored by an obstetrician-gynecologist, observe proper nutrition, monitor weight gain, and timely treat chronic diseases, in particular hypertension.

The article is devoted to the assessment of the results of hysteroresectoscopy in hyperplastic processes in endometrium, namely, menstrual status, as well as such an important aspect as the quality of life of women after this treatment method. 52 patients with hyperplastic processes in the endometrium were examined, in all cases the effectiveness of hysteroresectoscopy in eliminating uterine bleeding, with the achievement of the maximum result, amenorrhea, was observed in 43 (82.69%) women. In all the subjects, a significant decrease in the quality of life and impaired sexual function were found, which significantly improved after surgery: energy 8.86 ± 2.92, pain 2.88 ± 0.83, sleep 6.65 ± 2.46, emotional reactions 6.02 ± 0.69, social isolation 3.23 ± 0.89, physical activity 4.55 ± 2.11; 22 (42.31%) - increased satisfaction; 9 (17.31%) - noted an increase in the frequency of sexual contacts.

Endomeriosis is rightly called a mystery of the XXI century. In some cases, this disease requires constant monitoring and treatment. This clinical case demonstrates the outcome of multiple surgical treatment of ovarian endometriosis - a spontaneous, long-awaited pregnancy that occurred 2 years after signs of an exhausted ovarian reserve.