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Vol 63, No 5 (2014)


Modern strategy of abdominal delivery

Aylamazyan E.K., Kuzminykh T.U., Andreeva V.Y., Selkov S.A., Tral T.G., Tolibova G.H.


In recent decades, increasing rate of cesarean section became one of the most prominent problems of obstetrics, that raises a problem of management of the labor in women with uterine scar, related with high risk of maternal and fetal complications. Complete reparation of the myometrium after cesarean section is an actual issue. Development and implementation of materials influencing the reparative processes in the myometrium is the problem of current interest of modern obstetrics. «Collost» is one of the new generation materials based on unreconstructed type I collagen, which contributes to fibroblast activation and migration, new collagen fibers formation, migration of immunocompetent cells and endothelial cells, providing the formation of vasculature of operation wound zone, excluding chaotic growth of scar tissue.
Journal of obstetrics and women's diseases. 2014;63(5):4-13
pages 4-13 views

Analysis of features gene polymorphism ABCB4 by NGS sequencing method in women of reproductive age with cholelithiasis

Ailamazyan A.N., Semenov D.U., Pakin V.S., Danilova M.M., Glotov A.S., Baranov V.S.


Analysis of ABCB4 gene in young women with cholelithiasis and relative story of gallstone disease was performed by NGS sequencing. The discovered “risk alleles” of this gene and their adverse haplotypes testify to ABCB4 participation in the development of cholelithiasis.
Journal of obstetrics and women's diseases. 2014;63(5):14-21
pages 14-21 views

The characteristics of personal and psychological factors and mental condition of pregnant women with early toxemia

Vishnevskaya E.E., Mozgovaya E.v., Petrova N.N.


The results of the study of the psyche of pregnant women with early toxicity as compared with healthy pregnant women. The connection between the development of nausea and vomiting of pregnancy with the presence of unresolved intrapersonal conflict, unfavorable types PKGD and immature psychological defense mechanisms. The contribution of the mental characteristics of the development of this obstetric pathology
Journal of obstetrics and women's diseases. 2014;63(5):22-28
pages 22-28 views

Correction of vaginal dysbiosis with cavitated solution of chlorhexidine in the 1st trimester of pregnancy: effectiveness and safety

Voroshilina E.S., Zornikov D.L., Plotko E.E.


Aim. The aim of this study was to evaluate changes of vaginal microbiocenosis composition of pregnant women in first trimester after irrigation of the vagina with cavitated 0.05% solution of chlorhexidine and to find out if the following dotation of Lactobacillus spp. was needed. Materials and methods. 104 women planning induced termination of pregnancy in first trimester by vacuum aspiration were examined in order to estimate efficiency of vaginal microbiocenosis correction using irrigation of the vagina with cavitated 0.05% solution of chlorhexidine and to find out if the following dotation of Lactobacillus spp. was needed. All women had undergown irrigation of vagina and exocervix with 0.05% solution of chlorhexidine in order to prepare them for surgical abortion. Vaginal microbiocenosis before and after this procedure was evaluated by microscopy and real-time PCR (test Femoflor-16, DNA-Technology LLC, Moscow). Results. It was established that in patients with normocenosis the amount of Lactobacillus spp. decreased accordingly to the decrease of general bacterial load in the vagina at that the proportion of Lactobacillus spp. in microbiota stayed almost the same and was more than 90% in all examined women. In women with dysbiosis the decrease of general bacterial load in the vagina after irrigation with cavitated 0.05% solution of chlorhexidine happens mostly due to absolute and relative content of opportunistic microflora in microbiome. However initially low level of Lactobacillus does not allow reaching their optimal level after the first treatment stage. In these cases, the necessity of dotation of Lactobacillus spp. on the second stage of treatment is practically assured. Conclusions. The data demonstrated safety of use cavitated 0.05% solution of chlorhexidine for irrigation of the vagina in first trimester of pregnancy, that allow apply the method for prevention of infected complications before invasive procedure independently of primary composition of vaginal microbiota. Also this method demonstrated high effectiveness as approach for treatment of vaginal dysbiosis. However the continuing deficiency of lactobacilli requires their dotation on following stage.
Journal of obstetrics and women's diseases. 2014;63(5):29-37
pages 29-37 views

Advantages of intraperitoneal chemotherapy in treatment of ovarian cancer peritoneal carcinomatosis

Vyshinskaya E.A., Bespalov V.G., Vasilyeva I.N., Semenov A.L., Stukov A.N., Belyaeva O.A., Kireeva G.S., Maidin M.A., Gershfeld E.D., Belyaev A.M.


The purpose of research is a comparison of the combined antitumor effects of cytotoxic drugs used in the treatment of ovarian cancer, when administered intraperitoneally, with the effects of these drugs in mono-treatment. The study was conducted in 132 Wistar female rats inoculated intraperitoneally with ascitic tumor of the ovary. At 48 hours after inoculation of the ovarian tumor rats were administered once intraperitoneally with drugs at maximum tolerated doses, dioxadet 1.5 mg/kg of body weight, cisplatin 4 mg/kg, cyclophosphamide 100 mg/kg, paclitaxel 5 mg/kg, gemcitabine 50 mg/kg, or a combination of these drugs in half doses. Antitumor effects of the treatment were estimated by increase in survival time comparing median survival time of rats in different groups. Combinations dioxadet with cisplatin”, dioxadet with cyclophosphamide, and dioxadet with paclitaxel” have additive antitumor effects in comparison with the effects of these drugs administered separately. Combination dioxadet with gemcitabine did not increase the antitumor activity of the drugs.
Journal of obstetrics and women's diseases. 2014;63(5):38-45
pages 38-45 views

Clinical and morphological characteristics of chronic endometritis in women with hysteromyoma

Dolgushina V.F., Troshina N.A., Nadvikova T.V.


The aim of our research was to identify clinical, morphological features of chronic endometritis among women of reproductive age with a hysteromyoma. 150 patients of reproductive age were surveyed. After which women were divided into three groups. The first group consisted of women at whom the hysteromyoma was combined with a chronic endometritis. The second group - chronic endometritis without hysteromyoma. The third group consisted of apparently healthy women who have addressed to the doctor with questions of contraception and pregnancy planning. It is established that the clinical and morphological picture of a chronic endometritis doesn’t depend on existence at such women of a hysteromyoma. At the women surveyed in both the first and second group almost equally often found inflammatory diseases of the pelvic organs, the bottom department of the genitals, hyperplastic process of endometrium, abnormal uterine bleeding. Special difference in activity of inflammatory process in an endometriya depending on the availability at these women hysteromyoma is not revealed. The combination of chronic endometritis with hysteromyoma is more common for women of late reproductive age, in the anamnesis whicht had childbirth, induced abortion.
Journal of obstetrics and women's diseases. 2014;63(5):46-50
pages 46-50 views

Intraplacental blood flow in third trimester of placental insufficiency pregnancy

Zakurina A.N., Pavlova N.G.


Background. Serious perinatal, most of all, neurological consequences of placental insufficiency condition necessity further search it’s markers for optimal delivery time. Methods. At third term of pregnancy we examined 16 singleton physiological pregnant women (first group) and 27 placental insufficiency patients (second group). We standard obstetrical examined, ultrasound fetometry, basic arteries of functional system mother-placenta-fetus Doppler and three-dimensional power Doppler in central, two paracentral and two periphery placenta areas. We processing images by VOCAL and analyzed vascularisation (VI), flow (FI) and vascularisation-flow indexes (VFI). Results. In placentae correlated groups FI differ in size reliable in central (t=4,03; p<0,001 и U=240,00; p<0,001) and paracentral (t=2,61; p<0,05 и U=348,00; p<0,05) areas. Patients second group indexes were relative on 17% and 8% less than patients first group indexes. Patients second group VFI was on 35% less than patients first group VFI (t=2,08; p<0,05 и U=337,00; p<0,05). We described results of comparison three-dimensional power Doppler intraplacental blood flow indexes from patients second group with different degree hemodynamic disorder. Conclusion. In placental insufficiency presence reduction blood circulation, particular in central placenta area, conditioned by reduction blood flow in initial vessels number. Central placenta area FI may be regarded new additional criterion of placental insufficiency at third term of pregnancy.
Journal of obstetrics and women's diseases. 2014;63(5):51-57
pages 51-57 views

Expression of antimicrobial peptides in the epithelium of the cervix uteri after caesarian section and vaginal birth

Lebedeva O.P., Ivashova O.N., Pakhomov S.P., Churnosov M.I., Samborskaya N.I., Fedorenko E.A.


The Background: Antimicrobial peptides are first line of defense for mucosa against viruses, bacteria, protozoa and fungi. Meanwhile, expression of antimicrobial peptides in postpartum period has not been studied. Objective: To estimate the expression of mRNA of antimicrobial peptides in epithelium of the cervix uteri after caesarean section and vaginal birth 3 or 4 days after delivery. Materials and methods: The data-sample consisted of 17 women after caesarean section and 46 women after vaginal delivery examined on days 3 or 4 of postpartum period. Quantitative reverse transcription PCR method was used to study mRNA expression of antimicrobial peptides. Statistical analysis was performed using Mann-Whitney criteria. Results: It was shown that higher level of expression of SLPI, HNP3, HD6 and HBD4 in the endocervix was present in women who delivered via caesarean section compared with those who had vaginal delivery. Conclusion: Women who underwent caesarean section exhibited increased expression of antimicrobial peptides compared to those who had vaginal birth. This increased expression can be attributed to multiple reasons such as differences in vaginal microflora restoration, different changes in hormone levels and also due to surgical trauma after operative delivery. The use of antimicrobial peptides can give new opportunities for prophylaxis and treatment of septic complications that occur in postpartum period.
Journal of obstetrics and women's diseases. 2014;63(5):58-63
pages 58-63 views

Clinical characteristics and obstetrical principals at HIV-infected women in Saint Petersburg

Niauri D.A., Yakovlev A.A., Penchuk T.E., Rad´kova Y.V., Kukol´nikova Y.A., Musatova E.V., Khubulava N.V.


Objective: to determine the clinical course of HIV infection, pregnancy and delivery in HIV-infected women. Materials and Methods: the analysis of 1483 clinical records of the HIV-infected women, who were delivered in specialized infectious and obstetric department in Clinical infectious diseases hospital named after S.P. Botkin in 2011-2013. Results: Average age of patients - 28,2 ± 1,2 years. Vast majority of women (78,5 %) knew about the diagnosis “HIV-infection” before pregnancy. The sexual way of transmission dominated (67,6 %) among patients with the detected mechanism of HIV-transmission. Full three-step ARV prevention was performed in 82,4 % (1222) cases. The average amount of patients with 4th stage of HIV infection was 49,2 % (730), thus the number of women in labor with the 4th stage of HIV infection increased from 19,4 to 55,6 % in 2011-2013. There is a high percentage of the coinfection of HIV infection and chronic viral hepatitis C or B + C (50,8 %). The most frequent complications of pregnancy and labour at the HIV-infected women are: iron deficiency anemia, chronic placentary insufficiency, eclampsy, premature discharge of amniotic fluid. Every third pregnant has a combination of these pregnancy complications. Frequency of premature birth was 23,5 %. The majority of pregnant women had vaginal labors (67,3 %) Cesarean sections were performed in 32,7 % cases. Conclusion: In St. Petersburg in 2011-2013 significantly increased the number of women with clinically significant manifestations of HIV infection on the 4th stage of secondary diseases. The most frequent clinical manifestations of 4A stage of HIV infection were fungal (candidiasis) lesion of the mucous genitals, mouth and viral (HSV) lesions of the skin and mucous membranes. The major complications of pregnancy in HIV-infected women are anemia and chronic placental insufficiency. Almost one in four pregnancies ends premature birth. Remains high percentage of cesarean sections, including those caused by infectious indications.
Journal of obstetrics and women's diseases. 2014;63(5):64-72
pages 64-72 views

Antimicrobial peptides in the pathogenesis of infectious complications in obstetrics and gynecology

Ivashova O.N., Lebedeva O.P., Pakhomov S.P., Rudyh N.A., Seliverstova M.S.


Antimicrobial peptides (AMP) are cationic peptides of innate immune system with antiviral, antibacterial and antiprotozoal activity. AMP act as immunomodulators, promote bacterial opsonization, inhibit proteases activity, have anti-endotoxic and angiogenic effect. The review describes main types of AMPs, features of their expression in female reproductive tract depending from menstrual cycle and during pregnancy. Data about the role of AMPs in defending from sexually transmitted infections (HIV, genital herpes, HPV, gonorrhea), in pathogenesis of extrauterine pregnancy and preterm birth are described. Possibility of practical application of AMPs as alternative to antibiotics and as contraceptives is estimated.
Journal of obstetrics and women's diseases. 2014;63(5):73-81
pages 73-81 views

Clinical characteristics and obstetrical principals at HIV-infected women in St. Petersburg

Dolidze M.Y., Usynin M.V., Treshcheva N.D., Baranov A.N.


The paper presents an overview of current russian and foreign literature considering fetal monitoring in labor. Special attention is paid to the methods of invasive diagnostics of fetal condition, such as direct fetal electrocardiography with ST-segment analysis and fetal scalp blood sampling. A comparison of the effectiveness of these methods is performed, the incidence of complications is provided. Measurement of pH and lactate in fetal scalp blood samples is discussed.
Journal of obstetrics and women's diseases. 2014;63(5):82-88
pages 82-88 views

Clinical and immunological aspects of treatment women with repeated in-vitro fertilization failure

Krivonos M.I., Zaynulina M.S., Chepanov S.V., Selutin A.V., Selkov S.A., Mysik O.L.


This review presents the existing literature concerning repeated implantation failure in assisted reproductive technologies. There are also discussed the role of immune pathology in the occurrence of repeated implantation failure in assisted reproductive treatment and the prospects of improving implantation rates with intravenous immunoglobulin in women with different immune pathologies.
Journal of obstetrics and women's diseases. 2014;63(5):89-95
pages 89-95 views

Preobrazhensky Vasily Vasilyevich

Andreyeva A.V., Baranov A.N., Revako P.P., Sizyukhina N.N.


The article provides information on the life and work of the prominent Russian obstetrician-gynecologist Vasily V. Preobrazhensky (1874-1944). The paper reflects years of scientists’s career from the resident physician to a renowned scholar, as well as his work as the head of obstetrics and gynecology clinics in Saint Petersburg and Arkhangelsk.
Journal of obstetrics and women's diseases. 2014;63(5):96-100
pages 96-100 views

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