Vol 63, No 4 (2014)

Articles
Modern concepts of tactics delivery of pregnant women with gestational diabetes mellitus
Kapustin R.V., Arzhanova O.N., Bespalova O.N., Kovaleva T.G.

Abstract

The article presents the current literature devoted to the problem of delivery of pregnant women with gestational diabetes mellitus (GDM). Analyzed issues related to the definition of the optim-al timing and mode of delivery of women with GDM. On the basis of these data revealed that the principles of tactics and delivery of pregnant women with GDM worldwide ambiguous and require further research. Thus, the development of common standards for best tactics, methods and timing of delivery of pregnant women with gestational diabetes mellitus is a challenging and important task for modern medicine and requires further investigation.
Journal of obstetrics and women's diseases. 2014;63(4):4-16
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The integrated evaluation of different types surgical treatment of myomes effectiveness
Kamilova M.Y., Akobirova S.A.

Abstract

The dates of comparative integrated evaluation of conservative myomectomia by different accesses and different amount was presented. There were shown preferences of laparoscopic myomectomia compared laparotomic myomectomia compared laparotomic myomectomia. More significantchanges of psychoemotional states on woman after laparoscopic myomectomia testify that it is necessary to make the evaluation of their psycho-emotional status.
Journal of obstetrics and women's diseases. 2014;63(4):17-21
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The role of hormonal and vascular dysregulation in the genesis of early reproductive losses
Gaziyeva I.A., Chistyakova G.N., Remizova I.I.

Abstract

The Purpose. To study the role of hormonal and vascular dysregulation for the genesis of early reproductive losses without fetus chromosomal abnormalities. Materials and methods. The study involved 150 pregnant women: 38 women with early reproductive losses in this pregnancy (main group) and 112 women with delivery of live full-term infant (comparison group). Determination of factors characterizing the function of fetoplacental complex, indicators of the endothelial function and regulators of angiogenesis was performed in the first trimester of progressive pregnancy. Results. It is established that the mechanisms of abortion in the first trimester is associated with reduced production of hormones and proteins, which are indicators of the formation and function of fetoplacental complex and mediating immunomodulatory, tolerogens and angiogenic effects: β-HCG, PAPP-A and trophoblastic β-1-glycoprotein. Impair of hormonal control of gestational remodeling of the maternal body is associated with endothelial dysfunction and dysregulation of angiogenesis. Markers of endotheliopathy are: increased levels of endothelin-1, propeptide big-endothelin and homocysteine, decreased production of total and endogenous nitrite, and the changing of release of soluble adhesion molecules. Disbalans of stimulators and inhibitors of angiogenesis is characterized by the increased level of proangiogenic vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) as well as by the reduction of level of antiangiogenic soluble receptor of VEGF (sVEGF-R1), protein 1, binding insulin-like growth factor (IGF-BP1), and placental growth factor (PlGF). Conclusion. The determination of factors of hormonal and vascular dysregulation in the early pregnancy contributes to the timely identification of women with risk of miscarriage.
Journal of obstetrics and women's diseases. 2014;63(4):22-33
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Clinico-immunohistochemical aspects of recovery of reproductive function of women with chronic endometritis
Kolmyk V.A., Nasyrov R.A., Kutusheva G.F.

Abstract

20 female patients aged 18-40 years old with a complicated anamnesis have been examined. Besides the regular clinical analysis the Pipel-byopsy was carried out with the immunohistochemical and histological investigation of the material. The expression level of estrogen and progesterone receptors has been determined. As well as the antigens of HSV, CMV and Epstein-Barr virus. In the case when chronic endometritis was diagnosed with the appearance of any of the viruses, the immunomodulating and antiviral therapy was administered. In the treatment of chronic endometritis associated with herpes simplex virus is advisable to administer an antiviral drug cour at least 3 months.
Journal of obstetrics and women's diseases. 2014;63(4):34-38
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Effectiveness and outcomes of embryo cryopreservation programs in assisted reproductive technologies
Kravchuk Y.N., Kalugina A.S., Bystrova O.V., Shlykova S.A.

Abstract

Background. Embryo cryopreservation is an essential part of ART programs today. In recent years vitrification method is used increasingly widely. Purposes and tasks. To compare the effectiveness of ART programs using vitrified and fresh embryos, as well as different endometrial preparation regimes for frozen\thawed embryo transfer (modified natural cycle (MNC) and the preparatory hormone therapy(PHT)). To analyze the course of pregnancy and perinatal outcomes after vitrified embryo transfer. Materials and methods. We prospectively assessed the ART programs effectiveness and perinatal outcomes in 153 patients (I group), who underwent vitrified embryo transfer in 2011-2013 year. To prepare the endometrium for thawed embryo transfer in 83 patients PHT (Ia subgroup) and MNC in 70 patients (Ib subgroup) were used. Control group consisted of 70 patients, who underwent fresh embryo transfer. Results. The clinical pregnancy rate, birth rate and “take home baby” rate were not significantly different between the I (47,5 %; 30,9 %; 30,9 %) and II (53,0 %; 34,9 %; 32,5 %) groups, and between Ia (48,3 %; 28,4 %; 28,4 %) and IIb (46,6 %; 34,1 %; 34,1 %) subgroups. Complications during pregnancy and delivery, birthweight, length, Apgar score, congenital malformation rate did not differ significantly after vitrified and fresh embryo transfer. Conclusion. Vitrification is an effective method to achieve clinical results, comparable to native cycles. Application of PHT and MNC results in similar clinical outcomes. Transfer Vitrified embryo transfer does not have a negative impact on obstetric and perinatal outcomes when compared with native cycles.
Journal of obstetrics and women's diseases. 2014;63(4):39-46
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Comparative characteristic of pregnancy and delivery in adolescents and women of average reproductive age
Mikhaylin Y.S., Ivanova L.A., Savitskiy A.G.

Abstract

The article provides a comparative characteristic the main clinical parameters of pregnancy and delivery in adolescents and women of average reproductive age. The results of this study generally confirm the literature data on the greater frequency of complications of pregnancy and childbirth in juvenile women than in women of average reproductive age. Thus, significantly more frequently in pregnant adolescents dated anemia, preeclampsia, fetal malnutrition, during delivery more frequently dated premature rupture of membranes, perineotomy and newborn injury. At the same time, significant differences in the incidence of weakness of labor activity, hemorrhage, neonatal asphyxia and maternal injury was not observed according to our data, which is not consistent with the known literature data.
Journal of obstetrics and women's diseases. 2014;63(4):47-53
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In vitro fertilization outcome in women with tubal factor of infertility and previous chlamydial infection
Myuller V.S., Kogan I.Y., Savicheva A.M.

Abstract

In order to examine the results of IVF and IVF/ICSI programs in women with tubal infertility (TFI) and previous exposure to chlamydial infection a total of 242 women were enrolled in the study. Materials and methods. Sera and follicular fluid samples were tested using EIA for antibodies to chlamydial antigens: the major outer membrane protein (MOMP - IgG, IgA) and heat shock protein chsp60 (IgG). Prevalence of antichlamydial antibodies in sera was 50,4 % (122/242), 10,7 % (26/242) and 5,8 % (14/242); in follicular fluid - 30,2 % (73/197), 3,7 % (9/197) and 4,5% (11/197) coordinaly. Patients were divided to two groups: main group (with IgG to C. trachomatis MOMP in sera, N = 122) and comparison group (absence of antibodies, N = 120). Results. The miscarriage rate after conventional IVF or IVF/ICSI cycle in main group patients was 28 % (7/30), compared to 3,3 % (1/30) in comparison group, р = 0,018. Pregnancy and live birth rate in women from main group was 40 % (22/55) and 30,9 % (17/55); in patients of comparison group - 22,2 % (16/72) and 15,3 % (11/72); р = 0,03 and р = 0,035, coordinaly. Results showed no difference in efficiency of IVF/ICSI programs for the examined groups of patients. Conclusion. Antibodies to C. trachomatis antigens are detected in blood serum of half, in follicular fluid - of every third patient with tubal factor of infertility. Serological evidence of previous exposure to chlamydial infection in these women is associated with decreased IVF success - lower pregnancy and live birth rates and higher risk of miscarriage.
Journal of obstetrics and women's diseases. 2014;63(4):54-59
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Morphological and immunohistochemical especially of stilled pregnancy the first trimester
Tral T.G., Tolibova G.K.

Abstract

Results of histological examination showed that stilled pregnancy occurs not only when the incomplete transformation of endometrial stroma, but also in terms of its full maturation regardless of hormonal support to maintain pregnancy. With increasing gestational age, regardless of hormonal support of pregnancy complete transformation of the endometrium occurs significantly more frequently. Furthermore, role hormonal drugs is not critical for the formation of endometrial glandular system. Increased expression of estrogen receptor in the glands and stroma of endometrium during pregnancy indicate the pathology of the first phase of the menstrual cycle. The reduction of the expression of KISS1 in endometrium during pregnancy was observed by the end of the first trimester of pregnancy due to the fading of the first stage of trophoblast invasion.
Journal of obstetrics and women's diseases. 2014;63(4):60-68
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A case of spontaneous splenic rupture in pregnancy
Mikhaylin Y.S., Ivanova L.A., Savitskiy A.G., Kucheryavyy S.G., Krasnolobov R.A., Krasnolobova P.Y.

Abstract

The article provides an observation case of spontaneous splenic rupture in 33/34 weeks of pregnancy. The patient was under active-expectant management, because of premature rupture of membranes at term of 33 weeks. Suddenly, against a background of well-being, emerged clinical signs of massive intra-abdominal bleeding. During the revision of the abdominal cavity the rupture of the capsule of the spleen was detect. Cesarean section and splenectomy were performed. The postoperative period was uncomplicated, the patient was discharged home with the baby.
Journal of obstetrics and women's diseases. 2014;63(4):69-73
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Chemoprevention as a way to control epigenetic changes (Analytical review of the literature)
Kiselev V.I., Ashrafyan L.A., Bezhenar V.F., Tsypurdeyeva A.A.

Abstract

Epigenetic alterations have been identified as promising new targets for cancer prevention strategies as they occur early during carcinogenesis. Therapy is mainly focused on reversion of DNA methylation by inhibiting DNA-methyltransferases and low level of acetylated histones by inhibiting histone deacetylases. DIM and epigallocatechin-3-gallate (EGCG) substances are believed to be an anticancer agent in part through its regulation of epigenetic processes. These agents demonstrate efficacy in cancer chemopreventive action and have potential to be used to current cancer therapies.
Journal of obstetrics and women's diseases. 2014;63(4):74-79
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Complex research of the functional status of fetal in labour
Kucherjavyy S.G.

Abstract

The review presents recent data on assessment of the functional status of fetal in labour, disadvantages of the methods and benefits their integrated use.
Journal of obstetrics and women's diseases. 2014;63(4):80-90
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The contribution pulsating pressure component of the breast pump mechanism on process milk expression from mammary gland lactating women
Alekseyev N.P., Ilin V.I., Talalayeva N.Y.

Abstract

The aim of this study was to determine the contribution pulsating compression component of the breast pump in total volume milk ejection by vacuum and compression stimuli. It was found that volume milk ejection together with vacuum and compression stimuli was on 10-46% more than expressing only vacuum stimuli. Average values 40,5 ± 5%, for expression only vacuum stimuli and 59,5 ± 5% for expression vacuum with compression stimuli. It was conclude that compression stimuli increase the efficacy of the breast pump is not only due to the effective formation milk ejection reflex, but also directly by an additional squeezing the milk from the breast.
Journal of obstetrics and women's diseases. 2014;63(4):91-97
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Diagnostics and laboratory monitoring of gestational diabetes mellitus in Russia. The authors' view of the problem and controversial issues
Dorofeykov V.V., Androsova N.E.

Abstract

Despite the existence of the Russian Consensus on gestational diabetes mellitus (GDM) since 2012 in the Russian Federation, its implementation into clinical practice has been slow, partially because its creation took place without the participation of laboratory services. In this review issues of preanalytical and analytical considerations of such laboratory tests as the blood glucose test, oral glucose tolerance test (OGTT), glycosylated hemoglobin test are discussed. If the presence of prandial hyperglycemia from 5.1 to 5.6 mmol/l is identified, testing should be repeated to confirm the diagnosis of GDM. OGTT must be performed using venous blood samples with fluoride in a specialized laboratory with fast transportation of samples.
Journal of obstetrics and women's diseases. 2014;63(4):98-103
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