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

  • SCOPUS
  • Russian Science Citation Index (RSCI) on Web of Science
  • elibrary
  • Google Scholar
  • Ulrich's Periodicals Directory
  • WorldCat

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.

The Journal is published with the assistance of:

  • Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott
  • Society of Obstetricians and Gynecologists of St. Petersburg and North-West Region of Russia
  • Military Medical Academy named after S.M. Kirov of the Ministry of Defence of the Russian Federation

Announcements

 

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

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

11.01.2021
Posted: 11.01.2021

Journal of obstetrics and woman diseases indexing in SCOPUS

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

20.09.2020
Posted: 20.09.2020
 
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Current Issue

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Vol 70, No 2 (2021)

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Original Research

Clinical and anamnestic data and morphofunctional characteristics of the endometrium in women with uterine developmental anomalies
Kazantseva E.V., Tral T.G., Tolibova G.K.
Abstract

BACKGROUND: Uterine developmental anomalies have a negative impact on the implementation of female reproductive function, leading to a high risk of reproductive failures, premature birth, placental insufficiency, intrauterine growth retardation syndrome, labor anomalies and postpartum bleeding. The presence of both structural anomalies themselves and the high frequency of reproductive failures leads to repeated intrauterine interventions, which are considered as a premorbid background for the endometrial pathology development. Despite the combined causes of reproductive failure, morphological studies of the endometrium in women with various uterine anomalies are scarce.

AIM: The aim of this study was to evaluate the clinical and anamnestic data and morphological characteristics of the endometrium in women with uterine anomalies and reproductive failures in the anamnesis.

MATERIALS AND METHODS: We examined 123 women with uterine developmental anomalies (49 patients with an arcuate uterus, 38 patients with a uterine septum, 16 patients with a bicornuate uterus, 10 patients with an unicornuate uterus, 10 patients with dimetria). Standard clinical and laboratory work-up, hysteroscopy with endometrial biopsy and laparoscopy were performed in all patients. Histological and immunohistochemical examination of the endometrium was carried out according to the standard technique with assessment of the relevant receptor profile (estrogen and progesterone receptors) and pro-inflammatory markers (CD8+, CD20+, CD4+, and CD138+).

RESULTS: Clinical and anamnestic data evaluation in patients with uterine anomalies revealed menstrual abnormalities, commonly, dysmenorrhea. Regardless of the type of uterine anomaly, a high incidence of pelvic inflammatory disease, endometriosis and a high frequency of reproductive failures were found. The morphological structure of the endometrium with uterine anomalies was characterized by a higher frequency of endometrial hyperplasia, impaired secretory transformation and the presence of chronic endometritis.

CONCLUSIONS: Patients with a variety of uterine developmental anomalies are characterized by menstrual irregularities, a high incidence of gynecological pathology and reproductive failures. There is no association between pathognomonic signs of endometrial morphofunctional abnormalities and the type of uterine anomaly; however, they are similar to those seen in recurrent miscarriages and infertility of various origins.

Journal of obstetrics and women's diseases. 2021;70(2):5-12
pages 5-12 views
Placental morphology in different types of diabetes mellitus
Kapustin R.V., Kopteyeva E.V., Tral T.G., Tolibova G.K.
Abstract

AIM: The aim of this study was to compare placental morphological features from women with different types of diabetes mellitus considering method of DM correction.

MATERIALS AND METHODS: A retrospective, single-center, cohort study was carried out. We analyzed morphological examination results of 3300 placentas, which made uр the following comparison groups: type 1 diabetes mellitus on continuous subcutaneous insulin infusion (n = 60), type 1 diabetes mellitus on multiple subcutaneous insulin injections (n = 446), type 2 diabetes mellitus on diet (n = 95), type 2 diabetes mellitus on insulin therapy (n = 134), gestational diabetes mellitus on diet (n = 1652), gestational diabetes mellitus on insulin therapy (n = 735), preeclampsia (n = 39), and the control group (n = 139). The examined placentas were weighed, with their sizes (two diameters and thickness), cotyledon structure and defects assessed. We determined the umbilical cord junction and external characteristics of extraembryonic membranes. Fragments of the placenta (5 pieces) were fixed in 10% neutral buffered formalin (pH 7.2), processed with the Leica TP1020 tissue processor and embedded in paraffin. Histological sections (3-4 μm thick) were prepared and stained with hematoxylin-eosin. Statistical analysis was performed using the SPSS 23.0 and GraphPad Prism 8.0 software.

RESULTS: Following characteristics were typical for all types of diabetes mellitus: increased placental mass metrics, chronic placental insufficiency, dissociated villous maturation disorder with prevalent immaturity, as well as involutive-dystrophic and circulatory disorders of varying severity. Placentas from women with type 1 diabetes mellitus had the specific sings: the predominance of intermediate immature villi and stem villi stromal fibrosis. The frequency of placental infarcts and fibrinoid content in the intervillous space were comparable to those in placentas from women with type 2 diabetes mellitus. Inflammatory changes and moderate placental calcification were most consistently associated with type 2 diabetes mellitus, while gestational diabetes mellitus was characterized by “soft” damages. Placentas with preeclampsia showed higher prevalence of premature villous maturation, compensated placental insufficiency, and fibrinoid depositions in the intervillous and subchorionic spaces.

CONCLUSIONS: Understanding relationships between placental histological features and clinical aspects of diabetes mellitus makes it possible not only to clarify the pathophysiological processes occurring in this pathology but also to optimize the algorithm for the rational management of the neonatal period of children from mothers with diabetes mellitus.

Journal of obstetrics and women's diseases. 2021;70(2):13-26
pages 13-26 views
“Relaxin-dependent” way of implementing spontaneous preterm labor in multiple pregnancies: The involvement of placental relaxin 2
Pachuliya O.V., Bespalova O.N., Butenko M.G., Milyutina Y.P., Tral T.G., Tolibova G.K.
Abstract

BACKGROUND: Despite numerous studies, the etiopathogenesis of preterm birth in multiple pregnancy remains unclear, which determines the low effectiveness of measures for the prevention of preterm birth. This fact makes it necessary to study possible ways of implementing preterm birth in multiple pregnancies and to search for new biomarkers of their pathogenetic links. Experimental and clinical studies have demonstrated the contribution of the pleiotropic hormone relaxin to the regulation of a wide range of physiological processes and its role in the implementation of the pathogenetic mechanisms of pregnancy complications, primarily premature birth. The proven autocrine / paracrine mechanism of placental relaxin action, which implements important local effects, determines the prospects for studying the contribution of its dysregulation to the implementation of spontaneous preterm labor in multiple pregnancies.

MATERIALS AND METHODS: A morphological examination of 92 placentas from 46 deliveries of dichorionic diamniotic twins was performed: 24 of them were spontaneous premature births and 22 spontaneous term births. Histological examination of placentas along with immunohistochemical verification of relaxin 2 expression in the chorionic villus of the dichorial twins’ placentas were carried out.

RESULTS: Histological examination of the dichorionic twins’ placentas revealed that those from spontaneous preterm birth were characterized by a higher frequency of chronic placental insufficiency with reduced compensatory and adaptive mechanisms and more pronounced circulatory disorders in the circulatory bed of the villous tree, when compared to placentas from spontaneous term labor. The first verification of relaxin 2 expression in the chorionic villi of the dichorionic twins’ placenta showed the role of the peptide in the initiation of spontaneous preterm birth. The relative area of relaxin 2 expression in spontaneous preterm labor was significantly higher (p < 0.05) compared to that in spontaneous term labor.

CONCLUSIONS: The data obtained confirm the hypothesis put forward about the involvement of placental relaxin in the pathogenesis of spontaneous preterm labor in multiple pregnancies. The authors were the first to propose the definition of a “relaxin-dependent” way of implementing spontaneous preterm labor. To help define new preventive strategies, the prospects for further studies of the role and significance of relaxin in the implementation of pathogenic processes involved in spontaneous preterm birth in multiple pregnancies have been outlined.

Journal of obstetrics and women's diseases. 2021;70(2):27-36
pages 27-36 views
Evaluation of the diagnostic possibility of hemorrhagic risk in pregnant women with severe preeclampsia by rotational thromboelastography
Peretyatko I.S., Mozgovaya E.V.
Abstract

AIM: The aim of this study was to determine the risk of hemorrhagic complications in pregnant women with severe preeclampsia using rotational thromboelastometry (ROTEM) in two screening tests — EXTEM and INTEM.

MATERIALS AND METHODS: We examined 30 pregnant women with severe preeclampsia, who were observed in the intensive care unit, the Department of Obstetrics and Perinatology, the Research Institute of Obstetrics, Gynecology, and Reproductology named after D.O. Ott, Saint Petersburg. The control group consisted of 10 patients with normal pregnancy, delivered by caesarean section for reasons not related to obstetric complications.

RESULTS: When interpreting the ROTEM results, the reference intervals for pregnant women in the third trimester were used, as determined in the study by J. Lee et al. (2019). According to the analysis of thromboelastograms of pregnant women with severe preeclampsia, 9 (30%) of them had a tendency towards hypocoagulation. Of these, 3 thromboelastograms had deviations via the intrinsic coagulation pathway (in the INTEM tests), 3 thromboelastograms via the extrinsic coagulation pathway (in the EXTEM tests), and the rest combined both options. Two patients with severe preeclampsia developed a complication in the form of HELLP syndrome, and the phenomena of hypocoagulation, according to the results of ROTEM performed before delivery, were observed in only one patient. A comparative analysis of ROTEM parameters among pregnant women with severe preeclampsia and normal pregnancy did not reveal statistically significant differences.

CONCLUSIONS: The use of the ROTEM method with the main screening tests (EXTEM and INTEM) did not show diagnostic value in assessing the risk of hemorrhagic complications of severe preeclampsia.

Journal of obstetrics and women's diseases. 2021;70(2):37-44
pages 37-44 views
Randomized comparative study of the effectiveness and safety of various bipolar devices during electrosurgical vaginal hysterectomy
Plekhanov A.N., Bezhenar V.F., Epifanova T.A., Bezhenar F.V., Karabak I.A.
Abstract

AIM: The aim of this study was to investigate the morphometric features of tissues after exposure to bipolar energy of various electrosurgical generators and surgical hemostatic instruments used in vaginal hysterectomy.

MATERIALS AND METHODS: The study included 48 individuals who underwent a vaginal hysterectomy. The patients were divided in three groups based on the instrument used for sealing blood vessels: a BiClamp® was applied in Group 1 (n = 16), a TissueSeal PLUS COMFORT® in Group 2 (n = 16), and a Thunderbeat® in Group 3 (n = 16). The maximum temperature of tissue measured using a Fluke FLK TIS 40 9HZ thermal imaging infrared camera was compared within the groups.

RESULTS: The maximum tissue temperature between the branches on electroligation, the minimum tissue temperature, and the tissue temperature at the coagulation boundary were significantly lower when using a TissueSeal PLUS COMFORT® clamp than when using BiClamp® and Thunderbeat® clamps (H value = 41.8, p ≤ 0.01). Morphometric parameters (prevalence, coagulation depth and area) were the smallest with a TissueSeal PLUS COMFORT® clamp compared to other clamps.

CONCLUSIONS: Using a TissueSeal PLUS COMFORT® clamp during vaginal hysterectomy is effective and safe and has the best thermometric and morphometric characteristics when applied to the tissue, thereby reducing the risk of lateral thermal damage. The possibility of perifocal heat transfer varies with the type of tool and with the temperature at the coagulation boundary.

Journal of obstetrics and women's diseases. 2021;70(2):45-54
pages 45-54 views
Experience of measuring glutathione peroxidase activity in surgically induced endometrial-like lesions in rats
Razygraev A.V., Baziyan E.V., Polyanskikh L.S., Petrosyan M.A.
Abstract

BACKGROUND: Endometriosis is known to be linked with altered activities of antioxidant enzymes and with their gene polymorphisms. Progestins are known to induce glutathione peroxidase activity in the endometrium and promote reduction of endometrial lesions. It could be useful to estimate the correlation between the activity of glutathione peroxidase within endometrial lesions and their degree of reduction.

AIM: The present study was aimed at estimating glutathione peroxidase activity in surgically induced endometrial-like lesions of different degree of reduction in rat model of endometriosis.

MATERIALS AND METHODS: The method for determining glutathione peroxidase activity using hydrogen peroxide as a substrate and 5,5’-dithiobis(2-nitrobenzoic acid) for estimation of residual reduced glutathione was applied for quantitative analysis of the enzyme activity in endometriotic foci, surgically induced in female Wistar rats. An assay of glutathione peroxidase activity in tissue homogenates was performed at 37°C in a reaction medium containing Tris-HCl buffer supplemented with tetrasodium ethylenediaminetetraacetate and sodium azide (pH 8.5) in the presence of 0.55 mM reduced glutathione and 0.192 mM hydrogen peroxide. Before adding trichloroacetic acid, 40-second incubation was used. The correlation between the specific activity of the enzyme and protein amount in endometriotic foci was estimated.

RESULTS: In a rat model of endometriosis, there was a high, well-determined glutathione peroxidase activity in endometriotic foci. For the same endometriotic tissue sample, the enzymatic activity was proportional to the amount of protein in the reaction mixture. The range of specific glutathione peroxidase activity was 2.43–6.45 micromoles of consumed glutathione per minute per milligram of protein (n = 7). In most reduced endometriotic foci (with the minimum amount of endometriotic tissue), the highest specific activity of glutathione peroxidase was found (the Spearman’s rho of –0.93 with p = 0.0067).

CONCLUSIONS: The method for determining glutathione peroxidase activity using hydrogen peroxide and 5,5’-dithiobis(2-nitrobenzoic acid) is convenient for working with the endometriotic tissue in a rat model of endometriosis. We can accept, with p < 0.01, that weight of endometriotic foci is negatively linked with specific glutathione peroxidase activity within their tissue. The results are analogous to the previously obtained data on catalase activity and suggest the involvement of both antioxidant enzymes in reduction of endometrial lesions.

Journal of obstetrics and women's diseases. 2021;70(2):55-61
pages 55-61 views
Assessment of actual nutrition in the first trimester of pregnancy as a premorbid indicator
Sadykova G.K., Olina A.A., Padrul M.M.
Abstract

AIM: The aim of this study was to assess the actual nutrition of pregnant women in the first trimester as the basis for a personalized approach to pregnancy management.

MATERIALS AND METHODS: The actual nutrition during pregnancy was studied by analyzing the frequency of food consumption using the food weighing method, and the average daily indicators were calculated based on data for a period of one week. In total, 417 women were surveyed. The diet was characterized to identify deficiencies of the vitamins and minerals most significant for the reproductive system using the Individual Diet (My Body 3.0 version) software. Descriptive statistics methods were used to quantify the results. In the course of the work carried out, descriptive statistics methods were used.

RESULTS: The energy value of the daily diet of pregnant women averaged 2294.3 ± 487.21 kcal, which is within normal values (2070.0–3507.5 kcal / day), a surplus being observed in almost a third of the respondents (n = 118, 28.3%). The analysis of the diet showed that most of the patients had a deficiency in vitamins, macro- and microelements most significant for the reproductive system. On average, pregnant women consumed 155.0 ± 0.52 μg / day of folic acid with food, no woman receiving enough folic acid to prevent congenital malformations of the fetus. The average dietary intake of iodine was 70 μg / day. Thus, focusing on the recommendations for pregnant women, a diet deficient in iodine was observed in 90% of the respondents, and only five women (1.2%) consumed a sufficient amount of iodine-containing products. It was found that pregnant women consumed 5.9 ± 2.10 mg / day of zinc, with the recommended intake level of more than 12.5 mg / day not recorded in any woman. Iron deficiency was found in 289 respondents (69%). According to the survey results, more than half of the respondents (n = 269, 64.5%) had insufficient selenium intake. Calcium deficiency was registered in half of pregnant women (n = 210, 50.0%). Only every tenth woman (n = 48, 10.0%) consumed a sufficient amount of calcium containing food. Poor magnesium consumption was rarer and was found in only one third of the respondents (n = 135, 32.0%).

CONCLUSIONS: The data obtained indicate the need to study the individual level of actually consumed vitamins and nutrients, which may be the basis for personalized selection of drugs and efficient microelement dosing strategy.

Journal of obstetrics and women's diseases. 2021;70(2):63-76
pages 63-76 views
An experiment of using the SonoVue ultrasound contrast agent for focused high-intensity ultrasound ablation of uterine fibroids
Slabozhankina E.A., Kira E.F., Politova A.K., Kitayev V.M., Bruslik S.V., Amelina Y.L., Politova A.A.
Abstract

BACKGROUND: One of the modern methods of organ-saving non-invasive remote treatment of uterine fibroids is ablation of myomatous nodes with high-intensity focused ultrasound (HIFU).

AIM: The aim of this study was to analyze changes in the parameters of ultrasonic ablation when using intraoperative control with the help of an ultrasound contrast agent.

MATERIALS AND METHODS: In the period from 2016 to 2018, a total of 208 patients with symptomatic uterine myoma underwent HIFU ablation of myomatous nodes. The two groups of patients were compared: group I included 98 patients aged 36 to 52 years (mean age: 44.39 ± 7.12 years) with intraoperative control with an ultrasound contrast agent (sulfur hexafluoride); group II consisted of 110 patients aged 20 to 55 years (mean age: 38.33 ± 8.72 years), whose treatment was not controlled by the contrast agent.

RESULTS: Using the Mann-Whitney test, we obtained statistically significant differences in the following parameters: the duration of ultrasound ablation was 215.28 ± 70.57 min (from 70 to 390 min) in group I, and 610.84 ± 56.26 min (from 290 to 1230 min) in group II (p < 0.005); the average energy was 329.06 ± 33.06 W in group I, and 293.68 ± 64.51 W in group II (p < 0.001); good tolerance of the operation was shown in 91% of cases in group I, and in 61.8% of cases in group II; satisfactory tolerance of the operation was shown in 7.7% of cases in group I, and in 37.3% of cases in group II (p < 0.001).

CONCLUSIONS: The data obtained indicate that the performance of HIFU ablation with the use of an ultrasonic contrast agent allowed halving the insonation time, while using submaximal and maximum ultrasound exposure powers with better tolerance of intervention by patients.

Journal of obstetrics and women's diseases. 2021;70(2):77-82
pages 77-82 views
Prognosis of iron deficiency anemia in pregnant women with different somatotypes
Tomayeva K.G., Gaidukov S.N., Komissarova E.N., Kokoyev L.A.
Abstract

BACKGROUND: Anemia during pregnancy, undiagnosed and untreated promptly, is the cause of various obstetric complications: spontaneous miscarriages, premature birth, placental insufficiency, obstetric bleeding, ante- and intrapartum fetal death.

AIM: The aim of this study was to evaluate the incidence of iron deficiency anemia in pregnant women with different somatotypes and to develop a prognostic model for the pathology onset.

MATERIALS AND METHODS: We examined 390 pregnant women. Somatometry was performed according to the method of R.N. Dorokhov in terms of pregnancy not exceeding 9-10 weeks. Of the examined pregnant women, 110 were of the macrosomatotype, 173 of the meso- and 107 of the microsomatotype. In a clinical blood test, the levels of hemoglobin and red blood cells were determined using well-known methods. Blood iron levels were evaluated by the colorimetric method with ferrozine using a Parma Iron Reagents Kit (Parma Diagnostics Ltd., Russia). Serum hepcidin levels were determined spectrophotometrically using ELISA methods.

RESULTS: Iron deficiency anemia was most commonly detected in pregnant women of the macro- and microsomatotype, when compared to those of the mesosomatotype (p < 0.05). There was no severe anemia in the study groups. The levels of hematological parameters (serum iron and serum hepcidin) were significantly higher in the group of pregnant women with latent anemia, compared to the study group without signs of anemia (p < 0.05). In the second trimester, iron deficiency anemia occurred in the group of patients with latent anemia. Using multiple regression analysis, a formula was obtained for predicting the onset of iron deficiency anemia in pregnant women of different somatotypes.

CONCLUSIONS: Hematological parameters (serum iron and serum hepcidin) should be attributed to markers of iron deficiency anemia and timely predict the onset of pathology. The mathematical formula obtained allows predicting with high accuracy the onset of iron deficiency anemia in pregnant women, taking into account the somatotype in the first trimester of pregnancy, and timely preventing the onset of pathology.

Journal of obstetrics and women's diseases. 2021;70(2):83-89
pages 83-89 views

Reviews

Potential role of vitamin D in the prevention and treatment of type 1 diabetes mellitus
Misharina E.V., Yarmolinskaya M.I., Abashova E.I.
Abstract

The incidence of type 1 diabetes mellitus is increasing worldwide, and the number of people with vitamin D deficiency in all age groups, including children and adolescents, is simultaneously growing in the world. Over the past decades, it has been found that vitamin D, in addition to participating in the regulation of calcium homeostasis and bone metabolism, has an anti-inflammatory and immunomodulatory effect. Epidemiological evidence suggests the involvement of vitamin D deficiency in the pathogenesis of type 1 diabetes mellitus. Polymorphisms in genes important for vitamin D metabolism also modulate the risk of type 1 diabetes mellitus. Several studies have evaluated the role of vitamin D as adjuvant immunomodulating therapy in patients with newly diagnosed type 1 diabetes mellitus. The purpose of this review is to present current data on the involvement of vitamin D in the pathogenesis of type 1 diabetes mellitus and to evaluate its role as a drug for the prevention of the disease and its use in treatment in addition to insulin therapy.

Journal of obstetrics and women's diseases. 2021;70(2):91-105
pages 91-105 views
Possibilities for predicting prelabor rupture of membranes
Mudrov V.A.
Abstract

Prelabor rupture of membranes occurs in 20% of all pregnancies, while in the structure of preterm labor it occurs in 40% of cases. Particular attention to prelabor rupture of membranes is primarily due to the risk of developing septic complications being increased as the duration of the anhydrous interval increases. Currently, there are no effective methods for preventing prelabor rupture of membranes. Therefore, the timeliness of prevention of fetal respiratory distress syndrome depends on the effectiveness of the prognosis of this condition. The aim of this study was to assess the possibilities for predicting prelabor rupture of membranes. This was achieved by using an analytical method including carrying out a detailed systematic analysis of modern domestic and foreign literature on predicting prelabor rupture of membranes. The study used databases such as eLIBRARY.RU, Scopus, PubMed, MEDLINE, ScienceDirect, Cochrane Library and FIPS from the creation until December 2020. An integrated approach to assessing the likelihood of prelabor rupture of membranes will allow optimizing the tactics of pregnancy and labor management, which in the future will reduce not only the incidence of maternal and perinatal morbidity, but also the frequency of operative delivery.

Journal of obstetrics and women's diseases. 2021;70(2):107-118
pages 107-118 views
Possibilities of using granulocyte colony-stimulating factor in reproductive medicine. A literature review
Nguyen C., Niauri D.A., Tapilskaya N.I., Gzgzyan A.M.
Abstract

Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic glycoprotein that promotes proliferation, differentiation and activation of myeloid lineage cells. The abundant presence of G-CSF receptors in the female reproductive system highlights its possible importance in oogenesis, ovulation, implantation, and pregnancy development. This literature review describes the main aspects of G-CSF use in reproductive medicine, such as ovulation induction in women with the luteinized unruptured follicle syndrome, the improvement of folliculogenesis, overcoming repeated implantation failures, therapy of thin endometrium and recurrent pregnancy loss.

Journal of obstetrics and women's diseases. 2021;70(2):119-128
pages 119-128 views
High-intensity focused ultrasound: opportunities and prospects in the treatment of uterine fibroid and deep infiltrative endometriosis
Sudakov D.S., Nikolayenkov I.P., Dymarskaya Y.R., Bubnova D.V.
Abstract

This literature review is devoted to the use of focused ultrasound in gynecological practice as an alternative to the traditional surgical treatment of uterine fibroids and deep infiltrating endometriosis. According to available data, the effectiveness of the treatment of uterine fibroids with focused ultrasound varies widely, ranging from 16.4% to 93.0%. Due to the lack of prospective studies, it is not possible to draw reliable conclusions about the effect of ablation of uterine fibroid with focused ultrasound on fertility. However, unplanned pregnancies after such treatment occurred up to 19.5%, and in 66.3% of cases, pregnancies ended with the childbirth. Research results demonstrate that in 87% of cases, treatment of retrocervical infiltrative endometriosis using focused ultrasound is feasible. Further data accumulation is required to determine the range of patients with uterine fibroids and deep infiltrating endometriosis, to whom the treating technique could be most effective and safe.

Journal of obstetrics and women's diseases. 2021;70(2):129-138
pages 129-138 views

Theory and Practice

Clinical case of feto-fetal transfusion syndrome development in dichorionic twin pregnancies with fused placentas
Mochalova M.N., Falko E.V., Mudrov V.A., Alekseyeva A.Y.
Abstract

This article analyzes a clinical case of feto-fetal transfusion syndrome development in dichorionic diamniotic twin pregnancies with fused placentas. Feto-fetal transfusion syndrome is a typical complication of the monochorionic type of placentation, but it is quite rare in the dichorionic type of placentation. In this case, the syndrome development became possible due to the close anatomical location of the placentas, which probably led to their fusion and the development of unbalanced interplacental anastomoses. During the observation of the patient in an antenatal clinic, no ultrasound signs of feto-fetal transfusion syndrome were detected. At a 25+5-week gestation period, the patient complained of cramping pains in the lower abdomen and liquid discharge from the genital tract. The patient was hospitalized at the second stage of labor and gave birth through the natural birth canal. The first fetus had polyhydramnios, the second one having extremely low water. The first was a premature boy in the occiput posterior position weighing 980 g and 32 cm in height in a state of severe asphyxia with an Apgar score of 1, 4 and 6 points. The second was a premature boy in breech position weighing 490 g and 32 cm in height, also in a state of severe asphyxia with an Apgar score of 1, 4 and 6 points. The first child developed severe multiple organ failure, which caused death on the twelfth day. The second newborn developed respiratory distress followed by death on the second day of the neonatal period.

Journal of obstetrics and women's diseases. 2021;70(2):139-144
pages 139-144 views

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