Vol 62, No 2 (2013)

Articles
Prognoses of the pathological postpartum engorgement of the woman breast
Alekseyev N.P., Ilin V.I., Talalayeva N.Y.
Abstract
The results of this study demonstrate that premenstrual pain (“premenstrual engorgement”) the woman mammary gland may be the main index of the prognoses for pathological postpartum engorgement.
Journal of obstetrics and women's diseases. 2013;62(2):3-9
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Evaluation of the efficiency and safety of therapy with calcium for pregnant women with symphysiopathia
Dedul A.G., Mozgovaya Y.V., Oparina T.I., Tolibova G.K., Petrosyan M.A., Polyakova V.O.
Abstract
According to the modern concepts, symphysiopathia usually occurs in the second half of pregnancy as a result of mineral metabolism violations. This complication of pregnancy mainly manifested as a pubic bone diastasis, pain in the bone of the pelvis and of the lower limbs, and cramps in the calf muscles. There are clinical manifestations of the symphysiopathia; indicators of calcium, magnesium and phosphorus in the blood and daily excretion of these minerals in the urine compared with those which have healthy pregnant women in the second and third trimesters. There is histological and immunohistochemical evaluation of placentas of patients on background treatment. The vast majority of pregnant women with symphysiopathia found increase in urinary calcium and magnesium in the urine remaining in the normal performance of mineral metabolism. According to the studies, the preparation of magnesium, calcium, and the local ultraviolet irradiation of symphysis pubis may reduce the clinical symptoms of symphysiopathia. The use of calcium supplements together with magnesium does not lead to excessive deposition of calcium salts in the placental tissue and improve metabolic function of placenta.
Journal of obstetrics and women's diseases. 2013;62(2):10-16
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Ovarian aromatase activity in endometriosis
Denisova V.M., Potin V.V., Yarmolinskaya M.I., Timofeyeva Y.M.
Abstract
Aromatase is the key enzyme, which converts androgens into estrogens. To study the role of aromatase in pathogenesis of endometriosis 57 patients and 15 healthy women of reproductive age were examined. Aromatase activity was detected by reaction of estrogens on aromatase inhibitor letrozol intake. Ovarian source of detected aromatase activity was proved by suppression of reaction on letrozole intake during therapy with gonadotropin- releasing hormone agonist. Aromatase activity in recalculation on antral follicle in endometriosis patients withII–IV stages was higher than in healthy women, though total ovarian aromatase activity was not differed from control group because of low number of antral follicles in endometriosis patients. The disturbance of folliculogenesis in endometriosis is connected probably with hyperestronaemia, which has ovarian and extragonandal origin.
Journal of obstetrics and women's diseases. 2013;62(2):17-22
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Influenza A virus reproduction in humanendometrial cells
Durnova A.O., Kadyrova R.A., Danilenko D.M., Dyukov M.I., Martyntseva V.A., Smirnova T.D., Yeropkin M.Y., Kiselev O.I.
Abstract
Study of replication of influenza A viruses (IAV) of A(H3N2) and A(H1N1)pdm subtypes in human endometrial cells was performed. It was shown that endometrial infection with IAV strongly depends on the multiplicity of infection and causes substantial changes in functional activities of these cells. Moreover endometrial cells of proliferative phase (day 8) were more sensitive to IAV infection than cells from secretory phase of menstrual cycle on day 19th.
Journal of obstetrics and women's diseases. 2013;62(2):23-28
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Intraplacental blood flow features inphysiological pregnancy
Zakurina A.N., Pavlova N.G.
Abstract
The article presents data of intraplacental blood flow three-dimensional power Doppler indexes in different placental zones in the second half of physiological pregnancy. We described results of comparison three-dimensional power Doppler indexes of intraplacental vessels in different placental zones at odds.
Journal of obstetrics and women's diseases. 2013;62(2):29-33
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FOLATE METABOLISM IMPAIRMENT IN SMOKING PREGNANT WOMEN
Semenova T.V., Milyutina Y.P., Arutyunyan A.V., Arzhanova O.N.
Abstract
Tobacco smoking is one of the pressing issues of public health. Russia ranks among the countries with a very high smoking rate. Smoking frequency among pregnant women in St. Petersburg is about 26.4%, among which 18.9% of the women smoke every day, and the rest 7.5% of them on the occasion. Complications from pregnancy (threatening miscarriage, premature delivery, anaemia) and from labour and delivery (labour abnormalities) in the smoking women occurs at almost twice the rate in those non-smoking, threatening miscarriage and anaemia notably having a more severe clinical picture and being more reluctant to the therapy. Smoking is one of the risk factors of hyperhomocysteinemia, which is in turn a marker of the folate metabolism impairment in the organism. It has been shown that homocysteine plasma level increases in the smoking pregnant women. Besides, a significant decrease in folate plasma level has been found in the same women. It is a folate deficiency that most of all raises homocysteine level in blood plasma. It has been proved that elevated homocysteine level has a direct toxic effect on the endothelium. Microthrombosis and microcirculation loss result in a series of obstetric complications. In late pregnancy, hyperhomocysteinemia causes chronic fetoplacental insufficiency and chronic intrauterine hypoxia. Therefore, many complications from pregnancy, such as gestosis and fetoplacental insufficiency, are associated with hyperhomocysteinemia, which is most probably caused by the smoking derived folate metabolism impairment. Supplementary folate and vitamin B complex therapy may possibly improve the pregnancy and delivery outcome in the pregnant women with high homocysteine plasma level. This, however, requires supportive clinical trials. Smoking cessation at birth spacing and prevention of hyperhomocysteinemia must be an essential condition for favourable prognosis for pregnancy.
Journal of obstetrics and women's diseases. 2013;62(2):34-42
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The use of synthetic materials in urogynecology
Gvozdev M.Y.
Abstract
This review is dedicated to the use of synthetic materials in urogynecology. Presents historical data, as well as information about the chemical structure and the production of polymers, classification and their use in medicine and in particular in urogynecology at the present time. Shows the leading role of polypropylene in the treatment of urinary incontinence and pelvic organ prolapse.
Journal of obstetrics and women's diseases. 2013;62(2):43-50
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Modern approaches to the problem of genital prolapse by vaginal access use of syntheticmaterials in urogynecology
Guseva Y.S.
Abstract
The article represents the basic stages of appearance and improvement of genital prolapse correction techniques by vaginal access: from plastic ones using patient’s tissue to using mesh implants, from trocar techniques of correction to trokarless ones, from anchored mesh implants to emergence of nonanchored devices. The article highlights the main mesh-associated complications and shows their possible solutions by different authors. Great attention is given to the modern technique of genital prolapse correction with the usage of trokarless nonanchored ProsimaTM system and vaginal support device, which provides optimal results at minimal invasiveness.
Journal of obstetrics and women's diseases. 2013;62(2):51-62
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Endometrial receptivity: the molecularmechanisms regulation of implantation
Krylova Y.S., Kvetnoy I.M., Aylamazyan E.K.
Abstract
Presents current views on endometrial receptivity and the molecular mechanisms regulation of implantation. Examines the signaling molecules as potential markers of parameter estimation window of implantation in assisted reproductive technologies.
Journal of obstetrics and women's diseases. 2013;62(2):63-74
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Diabetic microvascular complications(retinopathy and nephropathy) and pregnancy
Borovik N.V., Potin V.V., Rutenburg Y.L.
Abstract
Dynamics of diabetic nephropathy and diabetic retinopathy in 134 women with diabetes mellitus type 1 was studied. It was shown that pregnancy doesn’t lead to aggravation of diabetic nephropathy and diabetic retinopathy. Manifestation of transit maculopathy in some women was related to higher hypoglycemic condition rate.
Journal of obstetrics and women's diseases. 2013;62(2):75-82
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Cesarean section at juvenile obstetrics
Zolotov I.S., Kutusheva G.F., Rukoyatkina Y.A.
Abstract
The features of pregnancy, childbirth and the postpartum period of young women, delivery by Caesarean section were discovered on the basis of a maternity hospital in St. Petersburg. The analysis of the data has identified the criteria for the negative impact on the reproductive potential of young people, the percentage of abdominal deliveries and their complications.
Journal of obstetrics and women's diseases. 2013;62(2):83-87
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Range of the rare chromosomal abnormalities diagnosed prenatally at fetuses with increased nuchal translucency
Zolotukhina T.V., Yudina Y.V., Shilova N.V., Minzhenkova M.Y., Kozlova Y.O., Markova Z.G.
Abstract
The data provided are given as an illustration of molecular-cytogenetic approach for improvement of prenatal cytogenetic diagnosis of rare chromosomal abnormalities. The main indication for prenatal karyotyping discussed herein presented with increased nuchal translucency at 10–14 weeks of gestation. The following rare chromosomal abnormalities were revealed by FIASH: microdeletion 22q11.2, r(13)(p11q22), dup(8)(p23p12), del (13)(q34), invdupY(q10), two sSNMCs of 5 and 20 chromosomes origin. The importance of improving and systematizing of the ultrasonographic diagnosis of “mild” developmental defects, providing of the expanded prenatal molecular studies and contemporary FISH-technique application is emphasized.
Journal of obstetrics and women's diseases. 2013;62(2):88-92
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Effect of labor stimulation on fetal cerebral hemodynamics
Ivshin A.A., Gumenyuk Y.G., Shifman Y.M., Kolybina P.V., Garloyeva Y.N.
Abstract
Article evaluates the state of the cerebral blood flow of the fetus in pregnant women with primary uterine dystocia, require correction oxytocin. The study included 52 mothers who had primary uterine dystocia. Cerebral hemodynamics in the fetus was studied by the method of Doppler ultrasound in the ultrasound scanner «LogiqBookXP». Correction of uterine activity, as measured by infusion of oxytocin concentration of 10 mU of oxytocin 1 ml of saline. These results reveal a violation of fetal cerebral perfusion.
Journal of obstetrics and women's diseases. 2013;62(2):93-100
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Hemostasis in pregnant women with gestational diabetes mellitus
Kapustin R.V., Arzhanova O.N., Shlyakhtenko T.N., Oparina T.I., Komarov Y.K.
Abstract
Been analyzed and studied the characteristics of hemostasis in pregnant women with gestational diabetes mellitus. Found that for women with disorders of carbohydrate metabolism characte-rized by increased activity of procoagulant, vascular-platelet hemostasis, and decreased activity of fibrinolityc system. It is shown that the violations of the haemostatic system is directly dependent on the degree of compensation of carbohydrate metabolism and require adequate correction of glycemia. Thus, GDM is an important predictor of hemostatic disorders and possible venous thromboembolism in pregnancy.
Journal of obstetrics and women's diseases. 2013;62(2):101-109
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Differentiation of memory cells in the T-helper subset during normal pregnancy andpreeclampsy
Kudryashova A.V., Sotnikova N.Y., Panova I.A., Kadyrova L.V.
Abstract
The amount of Th1и and Th2 cells in the peripheral blood increased in the first trimester and remained at the high level during all the process of gestation. Changes in the quantity of memory cells were defined: by the enhanced level of Temra in the CD4+ subset and of IFNγ+ cells in the population of CD4+ Temra in the second trimester; by restoring the balance of Tcm, Tem and Temra to the values of nonpregnant donors in the third trimester. In preeclampsy pregnancy the level Th1, Th2 and IFNγ+ cells in CD4+ population of Temra was significantly higher then in normal pregnancy.
Journal of obstetrics and women's diseases. 2013;62(2):110-116
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Array-based comparative genomic hybridization (ARRAY-CGH) in analysis of chromosomalaberrations and CNV in blighted ovum pregnancies
Lebedev I.N., Kashevarova A.A., Skryabin N.A., Nikitina T.V., Lopatkina M.Y., Melnikov A.A., Sazhenova Y.A., Ivanova T.V., Yevtushenko I.D.
Abstract
Application of modern molecular cytogenetic technologies in research and clinical practice provides unprecedented possibilities for high resolution molecular karyotyping in different areas of clinical cytogenetics. In this study the oligonucleotide-based array-CGH data about unbalanced chromosomal aberrations and copy number variations (CNV) in blighted ovum pregnancies are presented. Analysis of genes content of involved chromosomal regions was done. Scopes, perspectives and limitations of aCGH application into analysis of early pregnancy losses are discussed.
Journal of obstetrics and women's diseases. 2013;62(2):117-125
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Using of three-dimensional power Dopplerultrasonography of women in late reproductive age with the suspicion of endometrial hyperplasia
Lysenko O.V.
Abstract
We examined a total of 53 cases in late reproductive age with suspicion of endometrial hyperplasia according to 2D ultrasonography data. Three-dimensional power Doppler sonography was made for all women. We have offered the endometrial-uterine vascularization coefficient, endometrial-uterine flow coefficient, endometrial-uterine vascularization-flow coefficient for the improvement of ultrasonic diagnostics of intrauterine pathology.
Journal of obstetrics and women's diseases. 2013;62(2):126-132
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DIAGNOSTICS OF CHROMOSOMAL ABBERATIONS BY arrayCGH
Malysheva O.V., Baranov A.N., Pendina A.A., Shabanova Y.S., Baranov V.S.
Abstract
ACGH is a modern and highly efficient approach for full-genomic scanning of wide spectrum of chromosomal disbalance. Here, we discuss diagnostic capabilities of aCGH and give examples of diagnostic cases.
Journal of obstetrics and women's diseases. 2013;62(2):133-138
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Methods of osteopathy in complex preparation for labor
Mozgovaya Y.V., Mishina S.V., Vinogradova O.A., Patrukhina N.A.
Abstract
The efficiency of osteopathy methods is carried out by preparation of pregnant organism for labor. 65 pregnants were included in research with full-term pregnancy, without heavy somatic and obstetric complications. Pregnants at whom as complex preparation for labor along with medicine therapy (spazmolytics, laminarias, antygestagenes, physical therapy) were applied osteopathic methods were included In the main group (n = 36). In group of comparison (n = 29) only medicine therapy was applied. At women in labor who have received complex preparation for labor with the use of osteopathic techniques in comparison with group, receiving only medicine therapy, the increase in speed of uterine cervix dilatation at 0.2 cm/h in latent and active phases of labor, reliable decrease in frequency of uterine activity anomalies and fetal hypoxia, and, as a result, decrease by 3 times of emergent Cesarean section frequency is detected. Decrease in frequency of perineotomiya and ruptures of uterine cervix are noted.
Journal of obstetrics and women's diseases. 2013;62(2):139-143
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To the question about the influence of regional anesthesia on the contractile function of the uterus
Pervak V.A.
Abstract
Was held a retrospective analysis of 215 histories parturient women undergoing caesarean section under spinal anesthesia and under general anesthesia in combination with artificial ventilation of the lungs. For both methods of anesthesia maintenance was held compared signs, who indirectly characterizing the contractile function of the uterus ( the amount of blood loss, the amount and the quality of uterotonic therapy, the dynamics of the preoperative and postoperative indicators of hemoglobin, hematocrit, and erythrocytes). As a result of the conducted research it was shown that the amount of blood loss, the amount of and qualitative composition of uterotonic therapy, the dynamics of the preoperative and postoperative indicators of hemoglobin, hematocrit, red blood cells in caesarean sections performed under spinal anesthesia and under General anesthesia in combination with artificial ventilation of the lungs authentically did not differ.
Journal of obstetrics and women's diseases. 2013;62(2):144-150
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Rol' kletok vrozhdennogo immuniteta v obespechenii uspekha beremennosti na rannikh srokakh gestatsii
Sotnikova N.Y., Antsiferova Y.S., Kroshkina N.V., Voronin D.N.
Abstract
The innate immunity plays an important role in the development and maintenance of the immune balance at the fetal-maternal interface. NK and macrophages dominate in decidua at early stages of pregnancy. Interaction of innate immunity cells and invasive cytotrophoblast is a key factor defining regulation of maternal immune response and the development of placental tissues at early gestation period.
Journal of obstetrics and women's diseases. 2013;62(2):151-159
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3D Doppler imaging of placental blood flow in prediction of fetal
Fomina M.P.
Abstract
Placental blood flow was studied in 103 women with singleton pregnancies at 7–15 weeks of gestation by 3D power Doppler. Reduced placental vasculature was revealed using 3D power Doppler at 7–15 weeks of gestation and it was defined as a diagnostic criterion of placental dysfunction and prognostic marker of fetal growth retardation.
Journal of obstetrics and women's diseases. 2013;62(2):160-165
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Medico-psychological monitoring of the family in the period of expectation of the child
Shikhova Y.P., Malgina G.B.
Abstract
The author, using interdisciplinary approaches, explores the peculiarities of interaction in families, waiting for the child. The changes affect all members of the family, and they are associated with changes in the physiological, psychological and socio-cultural status. They occur on the background of the biological and neuroendocrine restructuring of the woman's body that is associated with the expectation of the child.
Journal of obstetrics and women's diseases. 2013;62(2):166-171
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Possibilities and limits of modern metods of diagnosis of distant metastases locallyadvanced cervical cancer
Kargopolova M.V., Maksimov S.Y., Berlev I.V., Khadzhimba A.S., Chepik O.F., Novikov S.N., Gershfeld E.D., Vyshinskaya Y.A.
Abstract
A retrospective study of 245 cases of recurrent cervical cancer, in every third case was detected metastases in paraaortic lymph nodes. Given these results, a prospective study aimed at optimizing the staging of cervical cancer Ib1–IIIb stages. Analyzed 48 clinical cases of patients with locally - common forms of cervical cancer, which before the combined treatment paraaortic lymphadenectomy was performed through laparoscopy with subsequent histological examination of surgical specimens. At the preoperative stage, to identify distant metastasis in para-aortic lymph nodes, patients were examined by various methods of radiation diagnosis. The sensitivity of MRI was 75 %, specificity 79 %, sensitivity and specificity of ultrasonography – 75 % and 93 %, respectively. The positive predictive value of the test was 25 % MRI, ultrasound – 50 %. Performing paraaortic lymphadenectomy with the greatest possible to individualize treatment policy and, as a consequence, to improve the results of combined treatment of patients with locally-common forms of cervical cancer. The use of laparoscopic approach, given the short period of rehabilitation, has not led to the postponement of chemoradiotherapy.
Journal of obstetrics and women's diseases. 2013;62(2):172-178
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Features of Asthma Treatment while Pregnancy
Lavrova O.V., Shapovalova Y.A., Petrova M.A., Dymarskaya Y.R., Sablina A.V.
Abstract
The goal of the study was the comparison pregnancy duration, delivery and height-weight ratio of newborns in females with different severity of Asthma duration and various basic therapies. Materials & methods. Study group was compounded with 1010 Asthmatic females aged 17–43 years, followed up by our staff together with gynecologists since early terms of their pregnancy. All patients were performed physical exam and functional study. As a result individual prophylaxis and treatment plan was generated for every pregnant. Results: Pulmicort-turbuhaler and SABA administration was significantly less effective in patients with moderate and severe asthma duration in comparison with fluent persistent asthma pregnants. The lowest frequency of gestoses (twice lower in comparison with Pulmicort-turbuhaler treated patients) was fixed in patients, treated with Seretide. Preterm delivery jeopardize was twice higher in Pulmicort-turbuhaler treated group. Frequency of Caesarian section was significantly higher in Pulmicort-turbuhaler treated females in comparison with females, treated with Simbicort. Average height-weight ratio in case of severe Asthma duration was lowest in patients with severe Asthma, who were administered Pulmicort-turbuhaler. Аverage weight value of kids, born by Seretide administered females, was above median value of BA females in total.
Journal of obstetrics and women's diseases. 2013;62(2):179-185
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