Vol 65, No 1 (2016)

Articles
Features of labor induction with patients with the premature rupture of membranes associated with the lack of biological readiness for deliveri in case of full-term pregnancy
Bolotskih V.M., Afanasieva M.H., Kuzminykh T.U.
Abstract
The comparative analysis of outcomes of term delivery has been performed in this paper depending on the approach to labor induction affected by the premature rupture of membranes (PROM). A significant improvement in obstetric indicators has been revealed in case of prescription of Mifepristone 6 hours before the labor induction. The deterioration of obstetric indicators with patients with PROM when inducing labor in connection with the lack of biological readiness for delivery has been shown.
Journal of obstetrics and women's diseases. 2016;65(1):4-8
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Comparative evaluation of hormonal-metabolic status of endometrial cancer patient´s over the past five decades
Baltrukova A.N., Berlev I.V., Berstein L.M.
Abstract
Comparative analysis of changes in hormonal-metabolic status of patients with endometrial cancer seen in the Research Institute of Oncology named after N.N. Petrov for over 50 years is presented. Over the past half century there was a gradual evolution of some indicators characterizing patients with endometrial cancer: increased age at the time of diagnosis from 57,43 ± 0,91 years in 1965-1967 to 60,66 ± 0,73 years 2012-2015 and changes in the anthropometric characteristics (in addition to increasing growth, increased body weight, circumference of waist and hip, the proportion of women with high body mass index). Also, increased manifestations of disorders of lipid and carbohydrate metabolism, including triglyceride levels, blood glucose and insulinemia were revealed. Reflecting the dynamics of processes occurring with the female population in general, the revealed changes, at the same time, represent an important component of conditions conducive to the increase in the incidence of endometrial cancer.
Journal of obstetrics and women's diseases. 2016;65(1):9-16
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Informative capacity to assess cytokine status in predicting placental abruption
Grebneva O.S., Zilber M.J., Agajan H.G., Volkova A.A.
Abstract
The purpose - to define a predictive role of the content in serum of blood of pregnant women of factor of a necrosis of a tumor - an alpha and interleykin-10 in development of a premature abruption of placenta. Technique. The main group (n = 14) - patients from a premature abruption of placenta in terms of gestation of 22-41 week. Group of comparison (n = 30) - the patients who entered into group of risk on development of a premature abruption of placenta, but pregnancy and which childbirth proceeded without this pathology. Conclusions: 1. At patients from a premature abruption of placenta the contents the FNO-alpha in terms of pregnancy of 21-22 weeks and in 27-28 weeks prevails. Distinction in the contents Il-10 in the compared groups statistically isn’t reliable. 2. The assessment of the predictive importance of definition of cytokin in terms of gestation of 21-22 weeks revealed that for AUC 0,77 FNO-alpha that testifies to high quality of this diagnostic indicator as a predictor of a premature abruption of a placenta. For IL-10 AUC 0,65 - average quality of diagnostic test. In the analysis of predictive value of cytokin in the term of a gestation of 27-28 weeks it is defined that AUC for the FNO-alpha is equal 0,79 - high quality of diagnostic test. AUC for IL-10 0,54, is an unsatisfactory quality of diagnostic test.
Journal of obstetrics and women's diseases. 2016;65(1):17-25
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Features of the morphological structure of endometrial infiltrates in women with chronic pelvic pain syndrome
Efimenko T.O., Kogan I.Y., Tral T.G., Molotkov A.S., Tolibova G.K.
Abstract
Background. There is no clear idea of what factors determine the characteristics of pain in endometriosis. Scientific data on the relationship between morphological and functional features of heterotopic tissue, and the intensity of the pain syndrome is extremely small. Purposes and tasks. To determine the features of the morphological structure of endometrial infiltrates in women with chronic pelvic pain syndrome. Materials and methods. We examined 32 patients with infiltrative endometriosis. Pain intensity was determined in accordance with a 10-point visual analog scale (VAS). Preparation of material for histological study was carried out during the execution of the operating laparoscopy. Histological sections stained with hematoxylin and eosin. The study was conducted with increasing ×100. Histological examination was carried out a descriptive and semi-quantitative assessment of glandular-stromal component biopsy, infiltration of inflammatory cells number, as well as the presence of blood vessels (arterioles, venules). Statistical analysis of the material was carried out using the Microsoft Excel 2013 and Stastistica 10.0 for Windows. Results. During the correlation analysis of the relationship between the intensity of pain and the severity of the vascular component revealed a strong correlation (Rs = 0.71, p < 0.05). With the severity of glandular-stromal component biopsy revealed moderate correlation (Rs = 0.49, p < 0.05). With the severity of the inflammatory infiltration of a number of cells revealed that there is no correlation (Rs = -0.1, p > 0.05). Conclusions. In severe degree of pain severity predominated infiltrates a lot of glands and stroma expressed vascular component, multiple foci of hemorrhage and severe degree of infiltration of inflammatory cells number. When pain syndrome of moderate severity, as in mild, was found mostly poorly and moderately pronounced glandular-stromal component, and infiltration of inflammatory cells number.
Journal of obstetrics and women's diseases. 2016;65(1):26-33
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Comparative study of the clinical parameters of pregnancy and childbirth in teenagers and women of the optimal reproductive age
Laryusheva Т.М., Istomina N.G., Baranov A.N.
Abstract
Objective. Pregnancy in teenagers is still frequent, while notions about the level of it’s safety and risk of specific obstetrical complications is controversial. Materials and methods. On the basis of interview and medical charts analysis in 500 minors (13 to 18 years) and 1500 women of the optimal reproductive age (20 to 25 years) for the years 2011-2014, social status, main clinical parameters of pregnancy and labor were examined. Results. The average age of young pregnant women was 17,2 ± 0,89 years. Among pregnant teens the students of schools and specialized secondary schools (57.8 %) were dominated, while majority of 20-25-year-olds (66.9 %) were employed. In adolescents, sexual debut was on average two years earlier than in the control group of women. Primigravida were 94.4 % of adolescents and 74.4 % of women aged 20-25. Among most common complications of pregnancy were anemia, threatened abortion, fetal hypoxia, gestational hypertension and preeclampsia. The risk of complications was slightly greater in young women. In 92.2 % of adolescents and 94.4 % of controls, pregnancy was finished with term delivery. The average duration of labor was similar in both groups. The rate of caesarean section was 13 % in minors and 17.6 % in 20-25 years-old women. Conclusions. Pregnancy in adolescents is usually unplanned and occurs in early onset of sexual relations, “socio-adjective position” and low professional status. Among minors precipitate delivery and preterm birth were more common as well as greater percentage of low birth weight newborns in comparison with 20-25 year old women.
Journal of obstetrics and women's diseases. 2016;65(1):34-42
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Experience in the implementation of the single subtotal hysterectomy laparoscopic approach
Marinkin I.O., Odintsov V.A., Shevela A.I., Anischenko V.V.
Abstract
A comparison of the results of subtotal hysterectomy performed by various surgical procedures (SILS, laparoscopy). Indications for these types of surgical techniques, identified the advantages and disadvantages of each method of economic feasibility. It is shown that single-port surgery is characterized by the best cosmetic effect and less postoperative pain than with classical laparoscopy. It defines the single-port surgery as a safe method of choice for endoscopic treatment of uterine pathology.
Journal of obstetrics and women's diseases. 2016;65(1):43-47
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Vaginal flora in bacterial vaginosis - the criteria Amsel
Nazarova V.V., Shalepo K.V., Menukhova Y.N., Savicheva A.M.
Abstract
The article presents the results of a survey of 84 women diagnosed with bacterial vaginosis on the basis of criteria of Amsel. The frequency of detection of various microorganisms/groups of microorganisms present in the vaginal microbiocenosis when different diagnostic criteria for bacterial vaginosis Amsel. Structure and diversity vaginal microbiocenosis assessed using molecular PCR in real time. Bacterial vaginosis is polyetiology syndrome. However, the search for individual bacteria and their combinations in bacterial vaginosis is an actual problem of modern researchers.
Journal of obstetrics and women's diseases. 2016;65(1):48-53
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Methodological approaches to the definition of ovarian aromatase in polycystic ovary syndrome
Timofeeva E.M., Misharina E.V., Nikolaenkov I.P., Samoylovich Y.A., Tkachenko N.N.
Abstract
In order to study ovarian flavor ase activity in polycystic ovary syndrome (PCOS) examined 49 patients with PCOS and 33 healthy women of reproductive age. Aromatase activity determined using estradiol/number of antral follicles in both ovaries ratio (Е2/n). Values ovarian aromatase positively correlated (p < 0.05) with the results of its determination by a test with the aromatase inhibitor letrozole in PCOS. Reduced aromatase activity of antral follicles was present in 59 % of patients with PCOS. These data indicate that Е2/n ratio allows to evaluate ovarian aromatase and that an absolute or relative deficiency of ovarian aromatase underlies the pathogenesis of PCOS.
Journal of obstetrics and women's diseases. 2016;65(1):54-61
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Endometrial stem cells expansion capability for local and systemic routes of administration in a model of experimentally injured endometrium
Usoltceva E.O., Dzhemlikhanova L.K., Niauri D.A., Kogan I.Y., Gzgzyan A.M.
Abstract
Endometrial stem cells due to their therapeutic characteristics could to be an effective tool of cell technologies in reproductive medicine. The aim of the study was to determine the most therapeutically effective route of administration for endometrial stem cells suspension. The study was conducted in approved animal model of injured endometrium. To create the experimental model tissue pieces of autologous endometrium were implanted on the anterior abdominal wall peritoneum using general surgical techniques. Experimental group animals were treated with endometrial stem cells suspension; in the control animal group a placebo was used. Local and systemic routes of endometrial stem cells administration were compared. The direct injections of stem cells suspension in the endometrial implants were used as the local route of administration, the intravenous injections of stem cells suspension were used as a systemic route. Endometrial stem cells expansion didn’t depend on the routes of administration, whereas therapeutic effects of stem cells was more obvious in tissue pieces after local injection of stem cells.
Journal of obstetrics and women's diseases. 2016;65(1):62-68
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Current feasibilities of early ovarian cancer detection
Khadzhimba A.S.
Abstract
We analyzed results of laparoscopic surgical treatment of 349 patients with ovarian tumors. Before surgery besides standard examination ultrasonography of pelvis and Ca-125 estimation was performed. After comparing of preoperative diagnosis with histopatological report was identified low sensitivity and specificity of ultrasonography and Ca-125 for assessment of tumor malignancy potential (32,35 %, 31,82 % and 72,55 %, 68,36 % respectively). It was concluded that nowadays the only method of early ovarian cancer detection is surgical treatment of patients with ovarian tumors, who have ultrasonography malignancy markers and increased Ca-125 level.
Journal of obstetrics and women's diseases. 2016;65(1):69-74
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Insulin resistance and hyperinsulinemia
Misharina E.V., Borodina V.L., Glavnova O.B., Nicolaencov I.P., Potin V.V., Tarasova M.A.
Abstract
Resent data concerning the role of insulin resistance, hyperinsulinemia and ovarian aromatase deficiency in pathogenesis of polycystic ovary syndrome are presented.
Journal of obstetrics and women's diseases. 2016;65(1):75-86
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The Damages from Unwanted Birth in the Italian Legal System: Between Law and Social Consciousness
Genovese U., Lombardo C., Akulin I.M., Chesnokova Е.А.
Abstract
In Europe, the modern legal systems, as a rule, provide for the right of citizens to a free and informed choice in matter of family planning and procreation, and therefore the right of women to resort to abortion in case of medical and social indications, or even in case of the mother’s request to terminate an unwanted pregnancy. However, being abortion not only a legal issue, but also a social and moral one, different legal systems adopt a wide range of normative models, which take into account, among other things, the existing cultural traditions and the influence of Church on society. Many states recognize the mother and other relatives’ right to compensation arising from the birth of an unwanted child. Much more controversial is the recognition of the rights of a child with a congenital pathology to indemnity from unwanted birth as a result of medical error. In the present article it is examined the experience of Italy, a country where family traditionally represents a considerable cultural and symbolic value. The paper reviews the main normative acts governing the performance of abortion. The research investigates the issues concerning the legal regulation of the compensation for damages arising in connection with the birth of an unwanted child. The present study examines the trend, emerging in the judicial practice, towards the recognition of the physically challenged child’s rights to compensation for the damage deriving from the birth as a result of medical errors.
Journal of obstetrics and women's diseases. 2016;65(1):87-94
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