Vol 61, No 5 (2012)

In patients with prosthetic heart valves pregnancy and labor are associated with high risk. There are no established anticoagulation guidelines in pregnant women with mechanical heart valve prostheses. More often physiological hypercoagulable state during pregnancy can reveal acquired and/or inherited hemostasis abnormalities which were asymptotic before pregnancy. The presence in the history of patients the foetal loss syndrome, severe obstetric complications (severe preeclampsia, abruptio placenta, antenatal fetal death, feto-placental insufficiency), thrombosis events is an indication for the screening for genetic thrombophilia and antiphospholipid syndrome. The diagnosis of thrombophilia in patients with mechanical heart valve prostheses can explain the inefficiency of anticoagulation therapy, warfarin resistance, «floating» hemostasis markers and difficulties in adequate dose selection

In the represented article there has been analyzed the 7-year experience suburethral synthetic slings use in medical treatment of 424 women with incontinence. There has been worked out the diagnostic algorithm of investigation with the aim of making it more exact and choosing the optional method of medical treatment. The estimation of intra- and post- operational complications and the general index of successful sling operations has been revealed. The recommendations have been given for treating patients in case of neuromuscular dysfunctions of the urinary bladder

There were studied 122 cases of changes at the system of hemostasis of pregnant women that have mixed form of thrombophilia. The research shows the role of active herpes virus infection at the manifestation of the signs of chronic intravascular coagulation within mixed thrombophilia. The results reflect the fact that the complex therapy of mixed thrombophilia starting before the pregnancy provides credible reduction of complications during the pregnancy

Among recommendations of leading Russian experts on conducting patients with acute inflammatory diseases of appendages of a uterus (AIDAU) the indication to laparoscopic sanitations at young women occurs at availability of suspicion on purulent character of inflammation. Objective: to study of typical clinical practice among gynecologists in definition of readings to surgical sanitation at AIDAU in young women. Methods: the retrospective analysis of 62 cases of repeated hospitalization of 29 patients in the age of from 19 till 37 years. The automated technology of examination of quality of medical aid (QMA) is used. The group of defects QMA «it’s not applied, but it’s shown» in cases of refusal from lapariscopic sanitations are carried out. Results: operative treatment is undertaken at 24.1 % of patients at primary hospitalization and 9,1 % at repeated. In all cases surgical sanitations were undertaken at availability of complications AIDAU. It is established, that at repeated hospitalization the risk organremoving operations reliably increases (р = 0.033). QMA «it’s not applied, but it’s shown» it is revealed in 10,1 % of cases of primary hospitalization and 3,3 % at repeated. Conclusions: Contrary to existing recommendations gynecologists do not undertake a laparoscopy in noncomplicated purulent AIDAU in young not given birth women. Refusal of a surgical component of treatment at 10,1 % of patients with clinical signs of purulent adexitis can be the factor of insufficient efficiency of treatment at primary hospitalization and the reason of recurrent disease in the further

This review presents the existing literature on association between the presence of Chlamydia trachomatis antibodies in various biological materials and the success of IVF and ET treatment. This article discusses major mechanism of infertility within patients with previous exposure to C. trachomatis and the role of chlamydial heat shock protein in its pathogenesis

Clear Cell Endometrial Cancer is a rare nonendometrioid endometrial carcinoma detected in 1–6 %. The aim of the study was to determine clinical and morphologic features of Clear Cell Endometrial Cancer. Materials: All the cases with Clear Cell Endometrial Cancer treated in the N. N. Petrov Research Institute of Oncology (Saint-Petersburg) were identified from surgical pathology files from 1985 to 2010 years. Saint-Petersburg Population Cancer Registry data (2000–2005 years period) and N. N. Petrov Research Institute of Oncology Hospital Cancer Registry data (1985–2010 years period) were analyzed. The population based study included 3 224 cases of endometrial cancer patients, the hospital study — 3 345 patients. Results: A review of 3 345 cases of endometrial cancer revealed 73 cases (2.2 %) of Clear Cell Endometrial Cancer. Clear Cell Endometrial Cancer registered in elder women with late menopause and atrophic endometrium. The tumor is a highly malignant variant of endometrial carcinoma with deep myometrial invasion (42.5 %), high rate of metastasis (39.1 %) even in cases with superficial invasion (23.0 %) versus endometrioid endometrial cancer: 6.0 %, 14.2 % and 9.0 % respectively. Clear Cell Endometrial Cancer has a poor prognosis with 3-year observed survival 62.7 %, 5-year observed survival — 52.2 % (Saint-Petersburg Population Cancer Registry), 70.9 % (3-year survival) and 61.8 % (5-year survival) according to the N. N. Petrov Research Institute of Oncology Hospital Cancer Registry data. Whereas prognosis in patients with endometrioid endometrial carcinoma is much more favorable: 3-year observed survival 79.4 %, 5-year observed survival — 75.5 %

The review presents recent data on the biological properties of leptin and its involvement in the pubertal development and pathogenesis of various forms of ovarian failure

The article describes the features of the course of atopic dermatitis during pregnancy. The results of our investigation devoted to the state of the skin barrier in pregnant women with atopic dermatitis and healthy pregnant women are represented. We elucidate the advanced ideas of the feasibility of treatment atopic dermatitis during gestation

The problem of endometriosis terminology is discussed in the paper; the nosologic significance, expediency, and competence of use of the term «endometrioid disease» is shown. Clinicopathologic parallels are drawn by the example of the most frequent organ localizations of that pathology — adenomyosis, ovarian endometriosis, and extragenital endometriosis; the community of some components of pathogenesis, determining the process progress, clinical presentations, morphological structure of heterotopias, and directions of morphogenesis are shown. Introduction of the term «endometrioid disease» into practice determines the possibility to optimize the clinical and morphological diagnostics of endometriosis taking into account the organ localization, stage of the process, morphofunctional form, and directions of morphogenesis, which is necessary to select the adequate method of treatment and personal prognosis