Journal of obstetrics and women's diseases

Peer-review medical journal

Editor-in-Chief

Eduard K. Ailamazyan, MD, PhD, Academician of the Russian Academy of Sciences

The Journal has been issued since 1887. It is the first scientific journal in Russia for obstetricians and gynecologists. For over a century, the Journal regularly covers the latest achievements of Russian science.

Journal of Obstetrics and Women's Diseases, a Gold Open Access journal, publishes six volumes per year. Additionally, the Journal will publish occasional special issues featuring selected papers from major conferences.

Abstracting and Indexing

Journal Topics

Journal of Obstetrics and Women's Diseases is a scientific and practical peer-reviewed medical journal, which discusses the most pressing health issues:

  • reproductive health;
  • results of clinical and sociological research;
  • current problems in perinatal obstetrics;
  • issues of gynecological endocrinology, pregravid preparation, and family planning;
  • actual problems in operative gynecology;
  • diagnostics and therapy of reproductive tract infections;
  • advances in clinical genetics and prenatal diagnosis of hereditary and congenital diseases, immunology, and pathology;
  • new and important information and recommendations for the practical physicians (introduction of modern diagnostic and therapeutic technologies, the use of effective drugs, etc.);
  • impact of harmful environmental and production factors on the female reproductive system.

Journal Mission

The main mission of the Journal is to provide new scientific and technical information, to promote scientific knowledge, to help obstetricians and gynecologists to choose the best methods of diagnosis and treatment, and to help improve their skills.

The publications of the Journal are of interest to a wide range of scholars in the field of obstetrics, gynecology, reproduction, genetics, pathology, and immunology of reproduction, as well as for medicine and biology tutors and students.

Announcements

 

Management of pregnant, parturient, and postpartum women with novel coronavirus infection (COVID-19)

Posted: 11.01.2021

New publication: Brief clinical guidelines. Management of pregnant, parturient, and postpartum women with novel coronavirus infection (COVID-19). ICD-10: U07.2, U07.1 (Version 2.0 of 11/01/2021). Download

Journal of obstetrics and woman diseases indexing in SCOPUS

Posted: 20.09.2020

In September 2020 the Journal of obstetrics and woman diseases have been recommended for indexing in SCOPUS.

 
More Announcements...

Current Issue

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Vol 71, No 2 (2022)

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jubilee

Professor Inna I. Evsyukova: Celebrating the 80th Birthday
Abstract

March 24, 2022 marks the 80th anniversary of the birth of the outstanding Russian neonatologist and scientist, Doctor of Medicine, Professor Inna I. Evsyukova.

Journal of obstetrics and women's diseases. 2022;71(2):5-6
pages 5-6 views

Public Health Organization

Obstetric audit of cesarean sections according to M. Robson classification criteria – the experience of St. Petersburg in 2020-2021
Bezhenar V.F., Nesterov N., Pryalukhin I.A.
Abstract

An external audit of the childbirth outcomes was conducted in accordance with M. Robson’s 10-group classification. The main determinants of indications and the frequency of cesarean section in obstetric medical organizations of St. Petersburg in 2020-2021 were analyzed in order to find effective mechanisms for reducing the frequency of сesarean delivery within the framework of compliance with modern principles of perinatal-oriented obstetrics and the preservation of a woman’s reproductive health. Possible effective reserves for reducing the frequency of CS are presented: personalized pre-gravidar preparation in high-perinatal risk women groups, personalized approach to methods of pre-induction and induction of labor in high-risk groups’ patients, rational management of labor in compliance with modern clinical recommendations, wider use of current classical external manual methods for antenatal correction of fetus pelvic presentation, prevention the primary cesarean deliveries, increase in the rate of vaginal deliveries among women with previous cesarean deliveries, optimization of effective antenatal psychological consultation about the delivery methods among pregnant women with breech presentation, previous cesarean deliveries and multiple pregnancy.

Journal of obstetrics and women's diseases. 2022;71(2):7-16
pages 7-16 views

Original Research

Analysis of polymorphic variants of the survivin promoter and p53 transcription factor in patients with genital endometriosis, type 1 diabetes mellitus and their combination
Andreeva N.Y., Ivaschenko T.E., Yarmolinskaya M.I., Misharina E.V., Shagina A.A., Sergeeva M.L.
Abstract

AIM: The aim of this study was to analyze the association between the SNP surviving, the p53 gene polymorphisms and the risk of developing genital endometriosis and type 1 diabetes mellitus.

MATERIALS AND METHODS: The frequency of allelic variants of the BIRC5 and TP53 genes was studied by PCR-RFLP analysis in 243 women, including 84 patients with genital endometriosis (stages I–IV), 85 patients with type 1 diabetes mellitus, 47 women with diabetes mellitus type 1 and endometriosis and 27 women of the control group represented by the population sample.

RESULTS: It was found that the frequency of the allele C polymorphic variant of rs9904341 in the BIRC5 gene was significantly higher in the group of patients with diseases compared to the population sample (p < 0.05). Significant differences for the C / C genotype in patients with genital endometriosis relative to the control group (p = 0.01) According to the odds ratio, the risk of developing genital endometriosis was 56 times higher for this genotype (ОR 56.31, CI 2.52–1258.7). Significant differences for the ins/ins genotype of TP53(p16) gene in patients with genital endometriosis relative to the control group (p = 0.005). According to the odds ratio, the risk of developing genital endometriosis was 94 times higher for this genotype (ОR 94.29, CI 3.88–2288.81). In addition, the frequency of the allele ins polymorphic variant of p16 in the TP53 gene was significantly higher in the group of patients with diseases compared to the control group (p < 0.05). The same results for the P allele of the rs1042522 polymorphism in the TP53 gene (p < 0.05). According to the odds ratio, the risk of developing genital endometriosis with diabetes mellitus type 1 was 3 times higher for G/A genotype of rs9930232 (p6) than for other genotypes (ОR 3.1, CI 2.52–1258.7)

CONCLUSIONS: The investigated factors can be considered as risk markers for the development of genital endometriosis and diabetes mellitus type one.

Journal of obstetrics and women's diseases. 2022;71(2):17-28
pages 17-28 views
Mesenchymal stromal cells application for experimental genital tuberculosis combination therapy
Afanaseva F.M., Niauri D.A., Vinogradova T.I., Kogan I.Y., Tapilskaya N.I., Dzhemlikhanova L.K., Ryzhov J.R., Gzgzyan A.M.
Abstract

BACKGROUND: Cell therapy is a promising trend in treating characterized by inflammation and sclerosis diseases such as genital tuberculosis, marked by pelvic inflammatory disease and uterine tube occlusion.

AIM: Efficacy evaluation of combined mesenchymal stem cells and specific polychemotherapy treatment of the experimental genital tuberculosis.

MATERIALS AND METHODS: Chinchilla rabbits (n = 27) were divided on 4 groups. Group 1 (n = 6) comprised control group, healthy animals. Group 2 (n = 7) infected with genital tuberculosis, without treatment. Group 3 (n = 7) infected with genital tuberculosis, treated with anti-tuberculous drugs only. Group 4 (n = 7) infected with genital tuberculosis, treated with anti-tuberculous drugs and mesenchymal stem cells. Culture of M. tuberculosis Erdman in dose 107 CFU/0.2 ml was injected under the left uterine tube serosa for the genital tuberculosis modelling. For treatment efficacy evaluation following tests were used: full blood count, blood chemistry, hysterosalpingography, diagnostic laparoscopy, peritoneal macrophage phagocytic activity assessment.

RESULTS: Infected with genital tuberculosis animals had leukocytosis, elevated C-reactive protein, swelled and occluded uterine tubes. Treated with anti-tuberculous drugs and mesenchymal stem cells rabbits had lower white blood cell count (8.18 ± 1.39 · 109/L vs 9.32 ± 1.36 · 109/L, р < 0.05) and C-reactive protein (1.1 ± 0.8 mg/L vs 2.2 ± 1.2 mg/L, р < 0.01) compared to animal treated with anti-tuberculous drugs only. Animals in group 4 had also increased peritoneal macrophage phagocytic activity. Treated with mesenchymal stem cells animals had unobstructed uterine tubes, stabilized adhesive process within small pelvis with reparative process prevalence.

CONCLUSIONS: Mesenchymal stem cells combined with anti-tuberculous drugs therapy favors reparative process in uterine tubes in genital tuberculosis.

Journal of obstetrics and women's diseases. 2022;71(2):29-38
pages 29-38 views
Prognostic value of sFlt-1 and PlGF in the diagnosis of abnormally deep placental invasion
Godzoeva A.O., Zazerskaya I.E., Vasilyeva E.Y., Mashchenko I.A., Yakovleva N.Y., Li O.A.
Abstract

BACKGROUND: Placental adhesive disorder is associated with a high risk of massive bleeding during pregnancy and caesarean delivery. Abnormal trophoblast invasion and pathological hypervascularization detected in these patients may be due to the imbalance of angiogenic factors such as PlGF and sFlt-1, which makes their study an important area of scientific and clinical practice.

AIM: The aim of this study was to evaluate sFlt-1 and PlGF levels in women with placenta accrete spectrum and to compare the data with the results in women with normal pregnancy.

MATERIALS AND METHODS: This “case-control” study included 71 pregnant women in the third trimester of pregnancy. The main group (n = 32) consisted of patients with prenatally diagnosed placenta previa and abnormally invasive placenta; the control group (n = 39) included patients with normal pregnancy. In the study groups, the levels of sFlt-1 and PlGF were determined, with ultrasound and MRI characteristics evaluated. Statistical analysis was performed using IBM® SPSS® Statistics 26.0.

RESULTS: Serum sFlt-1 and PlGF levels in the study group differed as compared to controls. In women with placenta accreta spectrum, the median sFlt-1 level was 2886.0 [2175.0–4127.0] pg/ml vs. control: 1890.0 [1807.0–2205.0] pg/ml (р < 0.001); the median PlGF level was 233.5 [171.4–460.5] pg/ml vs. control: 880.9 [746.6–1210.0] pg/ml (p < 0.001). A correlation was revealed between the angiogenic factor levels and the degree of pathological hypervascularization and collaterization according to MRI data. When comparing the probability of abnormally invasive placenta (PAS Grades 2 or 3) and the sFlt-1/PlGF ratio, an ROC curve was obtained with the AUC of 0.74 ± 0.13 (95% CI: 0.48–1.0; p = 0.021).

CONCLUSIONS: Patients with placental adhesive disorder had increased sFlt-1 levels and decreased PlGF levels compared to patients with normal pregnancy. The above levels correlated with the degree of pathological hypervascularization and collaterization detected by MRI. A prognostic model has been obtained, according to which the threshold value of the sFlt-1/PlGF ratio of 4.22 allows for distinguishing patients with deep placental invasion (PAS Grades 2 or 3).

Journal of obstetrics and women's diseases. 2022;71(2):39-48
pages 39-48 views
Assessment of the risk of spontaneous preterm birth in pregnant women with the Dr. Arabin cervical pessary
Sargsyan G.S., Bespalova O.N.
Abstract

BACKGROUND: Preterm birth has a multifactorial etiology, including both maternal and fetal complications, amid the effect of functionally impaired variants of multiple genes. Preterm birth is therefore considered as the “major obstetric syndrome.” One of the anatomical components of this syndrome is a short cervix, and a cervical pessary is used as a prevention of preterm birth in these patients.

AIM: The aim of this study was to identify risk factors for spontaneous preterm birth in pregnant women who received a cervical pessary.

MATERIALS AND METHODS: This prospective, open, randomized cohort study included 189 women with a singleton pregnancy and a short cervix (<25‰ according to the Salomon scale) and a threatened miscarriage / preterm birth in the second and third trimesters trimester, who received the Dr. Arabin cervical pessary. We analyzed 183 parameters and identified the main risk factors leading to spontaneous preterm birth based on pregnancy outcomes.

RESULTS: Based on the pregnancy outcomes, all patients were categorized into two main groups: group I included 167 women with term birth and group II consisted of 19 pregnant women with spontaneous preterm birth. The main risk factors for spontaneous preterm birth in singleton pregnancies in descending order were: the Bishop score ≥7 points (p = 0.00032, OR 12.38, 95 % CI [3.50–43.87]), the modified Steinberg score ≥8 points (p = 0.00056, OR 10.55, 95% CI [3.09–36.03]), cervical length ≤15 mm by transvaginal cervicometry (p < 0.001, OR 7.94, 95% CI [2.83–22.26]), history of preterm birth (p = 0.00128, OR 6.91, 95% CI [2.32–20.56]), chronic placental insufficiency (p = 0.00307, OR 5.06, 95 % CI [1.82–14.01]), genital anomalies (p = 0.07452, OR 5.03, 95% CI [1.15–22.06]), and history of surgical manipulations on the cervix (p = 0.07003, OR 2.90, 95% CI [1.05–8.00]). In multivariate analysis, the risk of spontaneous preterm birth was five times higher in pregnant women with the concomitant presence of three risk factors: cervical length ≤15 mm, the modified Steinberg score ≥8 points, and the Bishop score ≥7 points (83.33% of spontaneous preterm birth compared to 16.67% of term birth; p < 0.05, OR 59.29, 95% CI [6.47–543.29]).

CONCLUSIONS: Among patients with a short cervix and the Dr. Arabin cervical pessary, we have identified groups at higher risk for spontaneous preterm birth.

Journal of obstetrics and women's diseases. 2022;71(2):49-60
pages 49-60 views
Borderline ovarian tumors: modern diagnostic criteria at the preoperative stage
Tsypurdeyeva A.A., Protasova A.E., Solntseva I.A., Mikhelashvili L.I.
Abstract

AIM: The aim of this study was to define and standardize the clinical and diagnostic criteria for borderline ovarian tumors at the preoperative stage.

MATERIALS AND METHODS: A retrospective analysis of 35 clinical case histories of patients with morphologically established borderline ovarian tumors has been conducted. Clinical and morphological data were analyzed: age, anamnesis, examination data, disease stage, histological study results. Laboratory parameters were assessed: CA-125 tumor marker level and ultrasound characteristics using criteria defined by IOTA, ADNEX and O-RADS groups.

RESULTS: A single cyst with a solid component was a typical ultrasound type of borderline ovarian tumors (45.71%). The application of the simple IOTA rules in regards to evaluating the formations proved possible in 100% of the cases and the formation was regarded as undefined in 62.86% of the cases. In 51.43% of the cases, the formation belonged to O-RADS 4 (10% to <50% risk of malignancy). The study of CA-125 tumor marker levels showed insufficient sensitivity, only 57.14% of patients having the parameter above the norm.

CONCLUSIONS: The application of the IOTA and O-RADS criteria allows for differentiating not only benign and malignant, but also borderline ovarian tumors, thus determining the choice of an organ-preserving treatment for patients of reproductive age.

Journal of obstetrics and women's diseases. 2022;71(2):61-68
pages 61-68 views
Anemia and thrombocytopenia in HIV-positive pregnant women
Mozalyova O.L., Samarina A.V., Rassokhin V.V.
Abstract

BACKGROUND: During pregnancy and childbirth, anemia and thrombocytopenia are twice as common among HIV-positive women as in the general population. It has not been yet clear to what extent HIV affects the incidence of cytopenias, therefore, the correlation between the incidence and the HIV RNA level and CD4 count in HIV-positive pregnant women, as well as the role of antiretroviral therapy, requires further study.

AIM: The aim of this study was to assess the effect of the HIV RNA level and CD4 count on the frequency of anemia and thrombocytopenia in HIV-positive pregnant women.

MATERIALS AND METHODS: In this study, we analyzed social and demographic features, epidemiological personal history data, the frequency of pregnancy and delivery complications, and the timing of the initiation of antiretroviral therapy in 303 HIV-positive pregnant women, as well as the data of screening for HIV infection of their children. The study included 27 mother-child pairs with perinatal HIV transmission and 276 mother-child pairs without mother-to-child transmission of HIV. All pregnant women were divided into groups depending on the CD4 count and HIV RNA level. A comparative analysis of anemia and thrombocytopenia frequencies was carried out in the study groups.

RESULTS: A direct correlation was revealed between the frequency of anemia and thrombocytopenia in HIV-positive pregnant women and markers of HIV infection: severe immunodeficiency (CD4 ≤ 200 cells/µl, p < 0.01) and high HIV RNA levels (more than 100,000 copies / ml, p < 0.01) in peripheral blood.

CONCLUSIONS: We confirmed the high frequency of cytopenias in HIV-positive pregnant women, which exceeds the general population level. In addition, we demonstrated the effectiveness of prescribing antiretroviral therapy among women of reproductive age who planned to become pregnant or did not exclude the possibility of pregnancy (who did not use the effective methods of contraception), as a means of anemia and thrombocytopenia prevention during pregnancy.

Journal of obstetrics and women's diseases. 2022;71(2):69-78
pages 69-78 views

Reviews

Uterine fibroids and fertility: a modern view of the problem. A literature review
Bezhenar V., Linde V.A., Arakelyan B.V., Sadykhova E.E., Reznik M.V., Tarasenkova V.A.
Abstract

The review was made based on https://cyberleninka.ru/, PubMed, MedArt and https://rucml.ru/. Uterine fibroid is one of the most common noninflammatory diseases of female reproductive system of reproductive age. Estrogens and progesterone are tightly connected with various growth factors such as transforming growth factor beta, insulinlike growth factor, endothelial growth factor etc. Dysfunction of sex steroids, alteration of myometrium vascularization and proinflammatory changes of endometrium, associated with leiomyoma can prevent from adequate preparation of endometrium to implantation. The situation is often complicated by combination of leiomyoma and adenomyosis. Pregnancy in women with leiomyoma is associated with increased risk of miscarriage, preeclampsia and placental insufficiency. Isthmic localization of uterine fibroid is considered to be the most unfavorable as it increases the risk of cervical insufficiency. Thus, uterine fibroid is a serious reproductive problem associated with fertility reduction and other problems with childbearing.

Journal of obstetrics and women's diseases. 2022;71(2):79-86
pages 79-86 views
Modern concepts about the mechanisms of initiation and regulation of labor activity
Mudrov V.A.
Abstract

BACKGROUND: The mechanisms of initiation and regulation of labor activity remain insufficiently studied. Currently, there are a significant number of theories that explain the mechanism of onset and regulation of labor, many of which are only of historical interest. Meanwhile, awareness of the true causes and mechanisms of regulation of labor activity will allow preventing not only premature or postmature birth, but also abnormal labor.

AIM: The aim of this study was to discover modern concepts about the mechanisms of initiation and regulation of labor activity.

MATERIALS AND METHODS: We carried out a detailed systematic analysis of modern domestic and foreign literature on the mechanisms of initiation and regulation of labor activity. The study used data hosted by such databases as e-LIBRARY, Scopus, PubMed, MEDLINE, ScienceDirect, and the Cochrane Library (from January 2015 to December 2021).

CONCLUSIONS: According to the literature, the most significant role in the initiation and regulation of labor activity is played by epigenetic mechanisms that reflect the transmission of genetically encoded information in response to a great number of exogenous and endogenous signals varying from patient to patient.

Journal of obstetrics and women's diseases. 2022;71(2):87-100
pages 87-100 views
Congenital diaphragmatic hernia. A systematic analysis
Ovsyannikov P.A., Kosovtsova N.V., Ryabokon N.R., Sukhotskaya A.A., Beliaeva O.A., Zazerskaya I.E.
Abstract

Congenital diaphragmatic hernia is a condition characterized by a defect in the diaphragm that leads to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the fetal lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of the diaphragm. The pathophysiology of congenital diaphragmatic hernia is a combination of lung hypoplasia and immature birth associated with persistent pulmonary hypertension of the newborn and cardiac dysfunction. Prenatal assessment of the lung-to-head ratio and the position of the liver (presence or absence of a liver lobe in the chest) by ultrasound are used to diagnose and predict outcomes. Delivery of infants with congenital diaphragmatic hernia is recommended close to term gestation. Immediate management at birth includes bowel decompression, avoidance of mask ventilation and endotracheal tube placement if required. The primary focus of management includes gentle ventilation of the lungs, hemodynamic monitoring and treatment of pulmonary hypertension, followed by preparation for surgery only after stabilization of the newborn’s condition. Although the US Food and Drug Administration do not approve inhaled nitric oxide, it is commonly used to treat persistent pulmonary hypertension of the newborn induced by congenital diaphragmatic hernia. Extracorporeal membrane oxygenation is usually considered after failure of standard resuscitative interventions in neonates with congenital diaphragmatic hernia born at ≥34 weeks of gestational age or with body weight >2 kg and no associated gross fetal anomalies. Multiple factors such as premature birth, congenital anomalies, severity of pulmonary hypertension, type of postpartum recovery, and the need for extracorporeal membrane oxygenation affect the overall survival of infants with congenital diaphragmatic hernia. Thanks to advances in the management of patients with congenital diaphragmatic hernia, overall survival has increased, reaching 70–90 %, and with the use of extracorporeal membrane oxygenation up to 50 %.

Journal of obstetrics and women's diseases. 2022;71(2):101-112
pages 101-112 views
The role of proteomics in the modern diagnosis of cervical cancer
Hamadyanova A.U., Sultanmuratova A.S., Disbiyanova A.K., Akhmadeyeva S.N., Yadgarov N.O., Burangulova L.E.
Abstract

Cervical cancer is a leading global health problem and the second most common form of cancer in women living in developing countries. Despite the available methods of diagnosis and treatment, cervical cancer is still the cause of a large number of deaths among vulnerable groups of the female population, which makes further research relevant. The aim of this study was to summarize new technological developments and scientific information about proteomics, which will allow for deepening the understanding of the pathogenesis of cervical cancer and developing new methods of diagnosis and treatment of this pathology. Recent achievements in the field of analytical research methods and bioinformatics provide a wide range of alternatives in the field of proteomic research. To date, proteomic analysis can be performed on almost any biological sample (tumor tissue, blood, urine, saliva, vaginal secretions). Each type of biological sample represents a potential source of diagnostic and prognostic biomarkers, as well as potential targets for therapy. The main limitation of proteomic studies aimed at finding potential biomarkers of the disease is the high variability of the results depending on the specific laboratory. There is variability in concentrations and even in the type of biomarker identified, even though research teams are working with the same samples.

Journal of obstetrics and women's diseases. 2022;71(2):113-122
pages 113-122 views

Theory and Practice

Spontaneous ovarian hyperstimulation syndrome in the postpartum period
Rudenko K.A., Zazerskaya I.E., Li O.A., Bezrukikh V.A., Parfyonov I.V., Yakubov A.V., Vyshedkevich E.D., Mashchenko I.A.
Abstract

Spontaneous ovarian hyperstimulation syndrome is an extremely rare complication that develops during or after a spontaneous pregnancy and requires timely diagnosis and appropriate intensive care. This article presents a rare clinical case of spontaneous ovarian hyperstimulation syndrome with the development of its severe clinical picture in the postpartum period. The article focuses on the fact of the difficult diagnosis of this syndrome in the postpartum period and the difficulties of differential diagnosis with systemic inflammatory response syndrome associated with current infection process. The correct diagnosis changed the treatment landscape, when the administration of the right therapeutic doses of low molecular weight heparin provided positive changes in the disease course with a benign outcome.

Journal of obstetrics and women's diseases. 2022;71(2):123-131
pages 123-131 views

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