Journal of obstetrics and women's diseases

Peer-review bimonthly medical journal


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.

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.

Abstracting and Indexing



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

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Current Issue

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Vol 72, No 4 (2023)

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Original Research

The role of polymorphisms in the genes of the hemostasis system and the folate-methionine cycle in the development of recurrent pregnancy loss
Belotserkovtseva L.D., Kovalenko L.V., Mordovina I.I., Donnikov M.Y., Babaeva A.E.

BACKGROUND: Recurrent pregnancy loss is a serious clinical problem that complicates about 2% of pregnancies. There is evidence that thrombophilia and disorders of folate-methionine metabolism may cause recurrent pregnancy loss.

AIM: The aim of this study was to evaluate the contribution of polymorphic variants of the genes of the hemostasis system and the folate-methionine cycle in women with recurrent pregnancy loss.

MATERIALS AND METHODS: Clinical examination of 406 pregnant women divided into two study groups was carried out. The main study group consisted of 206 women with two or more pregnancy losses known up to 12 weeks of pregnancy; the control group included 200 apparently healthy women with a known history of two or more live births, no spontaneous or induced abortions, infertility, or endometriosis. All patients underwent a molecular genetic study of 12 single nucleotide polymorphisms in the genes of the hemostasis system and the folate-methionine cycle performed by real-time polymerase chain reaction.

RESULTS: We studied single nucleotide polymorphisms in eight genes involved in the hemostasis system and in four genes of the folate-methionine cycle. An association of presence of alternative variants such as 1565C (rs5918) of the ITGB3 integrin beta-3 gene and A66G (rs1801394) of the MTRR methionine synthase reductase gene with the development of recurrent pregnancy loss was found. The frequency of their occurrence was 29.1 and 77.7% in the recurrent pregnancy loss group vs. 12.0 and 49.0% in the control group, respectively (p < 0.01). The combined carriage of the alternative variants 1565C (rs5918) of the ITGB3 gene and A66G (rs1801394) of the MTRR gene in the recurrent pregnancy loss group was diagnosed more often than in the control group and amounted to 47 (22.8%) vs. 12 (6.0%) cases (φ = 5.047; p < 0.01; odds ratio 3.631; 95% confidence interval 2.374–9.034). We have thus developed a three-locus model of the synergetic action of allelic variants of the above genes in the development of recurrent pregnancy loss in early pregnancy [10976 G>A (rs6046) of the F7, −455 G>A (rs1800790) of the FGB, 1565 T>C (rs5918) of the ITGB3] with reproducibility of 8/10, sensitivity of 65.6%, and specificity of 68.8% (χ² = 15.7415, p < 0.0001; odds ratio 3.341, 95% confidence interval 1.824–6.118).

CONCLUSIONS: This study allows for confirming the hypothesis that the status of genetic variants of the ITGB3 and MTRR genes and the association of three single nucleotide polymorphisms: rs6046 of the F7, rs1800790 of the FGB, and rs5918 of the ITGB3 may be used as predictors of recurrent pregnancy loss development.

Journal of obstetrics and women's diseases. 2023;72(4):5-14
pages 5-14 views
Efficacy of using progesterone as an immunosuppressant for the prevention of preeclampsia in pregnant women with iron-deficiency anemia
Djabbarova Y.K., Ismoilova S.T., Ziyaeva S.T., Mirzaahmedova K.T.

BACKGROUND: In previous studies, our data on the activation of pro-inflammatory cytokines at the systemic and local levels indicated an inadequate maternal immune response to fetal egg antigens against the backdrop of endocrine system restructuring and iron-deficiency anemia, which is a fundamental mechanism underlying the pathogenesis of preeclampsia. The above was the basis for the use of immunotherapy at a high risk of developing preeclampsia in pregnant women.

AIM: The aim of this study was to evaluate the use of micronized progesterone as an immunosuppressant for the prevention of preeclampsia in pregnant women with iron-deficiency anemia.

MATERIALS AND METHODS: We examined 44 pregnant women with iron-deficiency anemia in dynamics by trimesters of pregnancy: patients before and after taking micronized progesterone (main group, n = 25) and untreated pregnant women (comparison group, n = 19). We used general clinical and laboratory methods, assessing serum progesterone levels at 4–6, 25–28 and 32–36 weeks of pregnancy before and after the treatment, as well as statistical methods using evidence-based medicine approaches.

RESULTS: Taking micronized progesterone in pregnant women with iron-deficiency anemia from early gestation increased blood progesterone level by 1.5 times by 28 weeks of pregnancy (p < 0.05) and by 2.5 times by 32–34 weeks of pregnancy (p < 0.05) compared to that in women who did not take the hormonal drug. In case of progesterone deficiency in pregnant women with iron-deficiency anemia and mild preeclampsia, the administration of micronized progesterone elevated its blood level by 2.4 times (p < 0.05), but in severe preeclampsia in untreated women, the hormone concentrations were reduced. In women with iron-deficiency anemia, due to the inclusion of progestogen in standard antianemic therapy from early stages and throughout pregnancy, the incidence of severe preeclampsia and preterm birth was decreased in 93.3% of cases, which led to a live birth in most cases.

CONCLUSIONS: Micronized progesterone in pregnant women may be used to correct progesterone deficiency conditions, one of which is iron-deficiency anemia, and, as an immunosuppressant, to protect the fetus from an aggressive maternal immune response, manifested by the development of preeclampsia and other complications. The use of the gestagen therapy from early pregnancy is a promising tool for the prevention of preeclampsia in pregnant women with iron-deficiency anemia. Undoubtedly, further and more extensive research is needed to better understand this issue.

Journal of obstetrics and women's diseases. 2023;72(4):15-24
pages 15-24 views
The role of polymorphic variants of the kisspeptin gene in the pathogenesis of ovarian insufficiency in patients with type 1 diabetes mellitus, genital endometriosis and combination of these diseases
Misharina E.V., Osinovskaya N.S., Yarmolinskaya M.I.

BACKGROUND: Type 1 diabetes mellitus and genital endometriosis have a negative impact on female reproductive system. There is an opinion that kisspeptin plays an important role in the pathogenesis of ovarian insufficiency in patients with diabetes and endometriosis.

AIM: The aim of this study was to evaluate the role of the kisspeptin gene (KISS1) polymorphism in the pathogenesis of ovarian insufficiency in patients with type 1 diabetes mellitus, genital endometriosis and in women with combination of these diseases.

MATERIALS AND METHODS: The allele and genotype frequencies of the polymorphic variants rs5780218 (c.–145delT) and rs3924587 (c.–89G>A) of the KISS1 gene were evaluated in 258 women using polymerase chain reaction-restriction fragment length polymorphism technique. This study included 73 patients with type 1 diabetes mellitus, 83 patients with genital endometriosis, 35 patients with combination of type 1 diabetes mellitus and genital endometriosis, and 67 control subjects. The control group is represented by women of the population.

RESULTS: The analysis of the KISS1 gene showed that incidence rates of type 1 diabetes mellitus, genital endometriosis and combination of these diseases do not differ in the presence of the ins/del, del/del, and ins/ins (rs5780218) genotypes. Thus, the del allele and the ins/del and del/del genotypes are not associated with an increased risk of these diseases. It was found that in patients with type 1 diabetes mellitus, the frequency of normogonadotropic ovarian insufficiency was higher (odds ratio 15.955; 95% confidence interval 4,47–57,0; p < 0.05) in the presence of the G/A genotype according to the polymorphic variant rs3924587 compared to the G/G genotype.

CONCLUSIONS: The data obtained allow for explaining the high incidence of ovarian insufficiency in women with type 1 diabetes mellitus. In patients with type 1 diabetes mellitus with the G/A genotype who are planning pregnancy, even in case of regular menstrual cycle, it is advisable to perform hormone blood tests in dynamics for timely diagnosis of ovarian insufficiency and prescription of hormonal therapy.

Journal of obstetrics and women's diseases. 2023;72(4):25-36
pages 25-36 views
Clinical and immunological criteria for the use of intravenous immunoglobulins in women with reproductive failures
Agnaeva A.O., Bespalova O.N., Sokolov D.I., Mikhailova V.A., Chepanov S.V., Selkov S.A., Kogan I.Y.

BACKGROUND: In obstetrics and reproductive medicine, the use of intravenous immunoglobulin remains controversial. There are no clearly developed indications for immunoglobulins therapy. The search for immunological criteria for prescribing this therapy is an urgent task

AIM: The aim of this study was to evaluate the effectiveness of the use of intravenous immunoglobulins in the complex therapy of women with multiple reproductive losses associated with changes in the quantitative and functional parameters of natural killer cells.

MATERIALS AND METHODS: Group 1 consisted of 61 women with recurrent miscarriage; group 2 involved 40 women with two or more in vitro fertilization failures, while group 3 comprised 27 healthy fertile individuals. The activity of blood natural killer cells was assessed by CD107a expression before and after activation. Patients with altered natural killer cell activity received intravenous immunoglobulins therapy under the control of the dynamics of immunological parameters.

RESULTS: The number of natural killer cells that expressed CD107a before and after activation differed between the study groups. In patients receiving intravenous immunoglobulins, gestational complications were observed less frequently, with the incidence of biochemical pregnancy being higher.

CONCLUSIONS: In patients with early reproductive failures (such as recurrent miscarriage and in vitro fertilization failures) and immunological abnormalities in the form of altered Natural killer cell activity, the use of intravenous immunoglobulins has an immunomodulatory and clinical effect.

Journal of obstetrics and women's diseases. 2023;72(4):37-46
pages 37-46 views
Endometrial blood flow evaluation in women with uterine fibroids during in vitro fertilization treatment
Dzhemlikhanova L.K., Krikheli I.O., Potapov A.V., Ob'edkova K.V., Safarian G.K., Niauri D.A., Gzgzyan A.M.

BACKGROUND: Sufficient endometrial blood supply in the mid-secretory phase of the menstrual cycle is a key to a successful pregnancy achievement, and a decreased spiral artery blood flow resistance determined by the Doppler is known to be positively associated with successful in vitro fertilization outcome. Particular aspects of endometrial blood flow in women with uterine fibroids might affect the efficiency of in vitro fertilization and intra cytoplasmic sperm injection cycles.

AIM: The aim of this study was Doppler-based determination of the uterine and spiral artery blood flow resistance in women with uterine fibroids throughout controlled ovarian stimulation in in vitro fertilization cycles, depending on the clinical pregnancy rate.

MATERIALS AND METHODS: Doppler ultrasound spiral artery blood flow evaluation was performed in 83 women throughout the in vitro fertilization cycle. Intramural uterine fibroids were detected in 44 women, and 39 women with no uterine fibroids comprised the comparison group. All women underwent a Doppler study of spiral artery blood flow on the second or third day of the menstrual cycle (at the start of the in vitro fertilization protocol) and on the day of embryo transfer. The in vitro fertilization efficiency was determined by the onset of clinical pregnancy after visualizing the gestational sac in the uterine cavity during ultrasound examination on the 20–25th day after embryo transfer.

RESULTS: The values of the uterine and spiral artery blood flow resistance in the uterine fibroids group were determined to be significantly lower than those in the comparison group. Considering the identified influence of decreased spiral artery blood flow resistance on the results of in vitro fertilization cycles in the comparison group, we have analyzed the dependence of the efficiency of the cycles based on the rate of the spiral artery blood flow resistance decline. Thus, a significantly more reliable decline in the pulsatility index was revealed in pregnant women from the comparison group throughout the in vitro fertilization cycle compared to women with negative results. In women with uterine fibroids, the pulsatility index decline did not differ depending on the onset of pregnancy, and the decline rate differed significantly from that in the comparison group.

CONCLUSIONS: Uterine fibroids are associated with a stable decline in the uterine and spiral artery blood flow resistance. This leads in turn to increased endometrial vascularization throughout the stimulation cycle in in vitro fertilization programs and negatively affects the blastocyst implantation ability.

Journal of obstetrics and women's diseases. 2023;72(4):47-57
pages 47-57 views
Characteristics of liver function in patients with preeclampsia
Zhestkova N.V., Ailamazyan E.K., Kuzminykh T.U., Marchenko N.V.

BACKGROUND: Despite a significant number of studies devoted to the problem of preeclampsia, to date, a large number of issues related to the etiology, pathogenesis, and therapy for this pathology remain far from a final solution. That is why obstetricians always face the difficult task of developing rational tactics for the management and delivery of pregnant women with preeclampsia, one has to take into account all the risks to the health of both the mother and her unborn child. Therefore, relevant is the search for the most informative methods for diagnosing liver dysfunction with an increase in the severity of preeclampsia. The hepatobiliary system is known to carry a multifunctional load during gestation and is one of the first to respond to an increase in the severity of preeclampsia. It is, therefore, crucial to choose priority biochemical parameters of blood that reflect liver function in preeclampsia, which can be used as additional criteria for making an obstetric decision in order to prevent maternal and perinatal complications.

AIM: The aim of this study was to analyze alterations in liver function in preeclampsia, in order to determine the criteria for the development of hepatic cell insufficiency as indicators of the transition to severe preeclampsia and multiple organ failure.

MATERIALS AND METHODS: This study included 123 pregnant women, of which group I (n = 40) consisted of pregnant women with preeclampsia without changes in liver function, group II (n = 33) was made up of pregnant women with preeclampsia and impaired liver function, while group III (n = 50) only comprised pregnant women with normal pregnancy. All pregnant women underwent a biochemical blood test with the determination of the parameters of cytolysis (aspartate aminotransferase, alanine aminotransferase, glutamate dehydrogenase, De Ritis ratio), cholestasis (alkaline phosphatase, total and direct bilirubin, gamma-glutamyl transpeptidase, bile acids), and hepatic cell insufficiency (cholinesterase, total protein, albumin, urea, lactate dehydrogenase), as well as a clinical blood test and coagulation tests. Pregnant women with preeclampsia were observed in the intensive care unit, with vital functions monitored.

RESULTS: The leading syndrome complex with increasing severity of preeclampsia was the cytolytic one, in which the levels of transaminases increased moderately with a predominance of alanine aminotransferase over aspartate aminotransferase activities (the De Ritis ratio was lesser than 1.0). With the development of hepatic cell insufficiency, aspartate aminotransferase activity dominated over alanine aminotransferase one (the De Ritis ratio was greater than 1.33). We also found an increase in glutamate dehydrogenase and lactate dehydrogenase activities and, among the cholestatic parameters, in the level of direct bilirubin. Hepatic cell insufficiency was characterized by a decrease in the activity of cholinesterase and decreased total protein and albumin concentrations. In the group of pregnant women with preeclampsia, we found a decrease in hemoglobin and platelet counts.

CONCLUSIONS: Altered liver function in preeclampsia reflects an increase in the severity of the pathology and indicates the development of multiple organ failure. In its terminal stage, all syndrome complexes manifest themselves as cytolytic, cholestatic and hepatic cell insufficiencies.

Journal of obstetrics and women's diseases. 2023;72(4):59-69
pages 59-69 views


Vaginal microbiota stability as a marker of successful outcomes of pregnancy
Beliaeva N.R., Budilovskaya O.V., Savicheva A.M., Tapilskaya N.I., Kogan I.Y.

Overcoming the problem of miscarriage still remains relevant today. Its' significant contribution to the structure of premature birth is due to the invasion of conditionally pathogenic microflora from the lower parts of the genital tract into the amniotic cavity. It can thus trigger an inflammatory reaction, causing early termination of pregnancy. The microbiota of the genital tract is characterized by the least diversity and high stability over time compared to any other location of the body. The dominance of certain types of lactobacilli in the vaginal biotope may be a marker of well-being, or a harbinger of termination of pregnancy. The aim of this review article is to summarize the current understanding of the vaginal microbiota during pregnancy in order to determine the relationship between its composition and stability throughout pregnancy, as well as the risk of early termination of pregnancy.

Journal of obstetrics and women's diseases. 2023;72(4):71-80
pages 71-80 views
The role of serotonin in prenatal ontogenesis
Evsyukova I.I.

This review article summarizes current ideas about the role of serotonin in prenatal ontogenesis. We herein present the results of experimental and clinical studies that reveal the mechanisms of serotonin involvement in the establishment and development of the single “mother-placenta-fetus” system. The article highlights the key role of maternal serotonin in the genetic program for the morphological and functional development of fetal organs from the earliest stages of prenatal ontogenesis, in both normal and complicated pregnancy. We also discuss gestational factors that affect the production of maternal, placental, and fetal serotonin, as its deficiency or excess during pregnancy determines perinatal and long-term pathology programming in the offspring. The article substantiates the prospects for using serotonin as a biochemical marker of brain damage in a newborn for the timely application of neuroprotection and the prevention of adverse consequences.

Journal of obstetrics and women's diseases. 2023;72(4):81-92
pages 81-92 views
Epigenetic mechanisms of fetal programming in excessive intake of synthetic folates at the preconception stage
Pachuliia O.V., Dolgikh M.S., Zhernakova T.S., Bespalova O.N.

To date, there is no doubt that taking folic acid at the perigravid stage in an adequate dosage has a positive effect on fetal development and the course and outcome of pregnancy. There is extensive evidence that during pregnancy, folate deficiency is associated with spontaneous miscarriages, premature birth, and premature detachment of the normally positioned placenta, and it can cause intrauterine malformations of the nervous and cardiovascular systems of the fetus.

Understanding the need to reduce such severe complications, which have both medical and social significance, has contributed in a number of countries to the introduction of programs for food fortification and routine prescribing of folic acid preparations to pregnant women. The measures taken significantly reduced the incidence of fetal congenital malformations, but at the same time, this strategy had a negative effect, resulting in a chronic overdose of synthetic folic acid. Recent studies have shown that the accumulation of non-metabolized folic acid in a pregnant woman may be associated with obstetric pathology and impaired development of fetuses and newborns. There is growing evidence that prolonged folic acid overdose during pregnancy, especially in the presence of altered levels of other vitamins, may lead to such diseases in children as autism and multiple amyotrophic sclerosis. Thus, this issue requires in-depth study in order to move from the routine prescription of folic acid preparations to personalized nutritional support for women at the preconception stage and during pregnancy.

Journal of obstetrics and women's diseases. 2023;72(4):93-104
pages 93-104 views

Theory and Practice

Ovarian cysts in the fetus: diagnosis, observation and options for intrauterine correction
Ryabokon N.R., Ovsyannikov P.A., Sukhotskaya A.A., Malysheva D.A., Bairov V.G., Semibratova E.V., Zazerskaya I.E.

This article describes a clinical case of managing pregnant women with ovarian cysts in the fetus and further monitoring and treatment of the child. Ovarian cysts are the most common abdominal abnormalities diagnosed in female fetuses. We herein discuss the tactics in relation to the female fetus, intrauterine risks and prognosis of her survival in this pathology, as well as the possibility of choosing a method for correcting ovarian cysts in the fetus and their complications during pregnancy and after childbirth. In the case of complex and / or large ovarian cysts, timely prenatal diagnosis is extremely important, which significantly improves the prognosis and allows prenatal measures aimed at stabilizing the condition of the fetus and the pregnant woman. On the example of this clinical case, we assessed the possibility of preserving the unchanged ovarian tissue and reducing the risks of life-threatening complications in the case of a significant amount of cystic formation. This article describes in detail the stages of the management of pregnancy, childbirth and the neonatal period, as well as the therapeutic and surgical correction of this severe pathology with further early rehabilitation.

Journal of obstetrics and women's diseases. 2023;72(4):105-115
pages 105-115 views

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