Vol 65, No 2 (2016)

Articles
Ovarian germ cell tumors - a modern approach to the problem
Solopova A.E., Sologub Y.N., Makatsariya A.D., Solopova A.G.
Abstract
The article discusses epidemiology, the morphological, clinical features and modern principles of treatment of ovarian germ cell tumors (OGCT). New immunohistochemical markers are presented, and also the role of tumor markers is shown in the differential diagnosis of OGCT.
Journal of obstetrics and women's diseases. 2016;65(2):4-15
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Pre-eclampsia. Selection of obstetric tactics
Dobrokhotova Y.E., Makarov O.V., Lysyuk E.Y., Olenev A.S., Kouznetsov P.A., Djokhadze L.S., Osmanova A.P.
Abstract
Relevance. At the present time, despite the large number of studies, the root causes of pre-eclampsia remain unknown. In recent years, attention is paid to the study of the role of vascular growth factors in the pathogenesis of various obstetric pathologies, including pre-eclampsia. The aim of our study was to examine the features of the angiogenic imbalance in determining the severity of pre-eclampsia, and further tactics of conducting pregnant women. Matherials and Methods. 135 pregnant women were examined: I group - 50 pregnant women with preeclampsia moderate; II group - 36 pregnant women with preeclampsia-severe; Group III - 49 pregnant women with physiological pregnancy. All patients special methods of investigation have been carried out - the definition of levels of pro-angiogenic (PlGF) and anti-angiogenic (sFlt-1, sEng) factors in the serum in 28-34 weeks gestation. In our study we found significant differences in the content of vascular growth factors in patients in the three comparison groups. Results. With an increase in the severity of pre-eclampsia decrease pro-angiogenic placental vascular factors to a greater extent than other vascular factors points to the aggravation of the pathological process and can be used as an additional criterion of pre-eclampsia severity. The level of vascular growth factors and their relationship with a certain probability, reflects the extent of endothelial dysfunction that predicts the best time of prolongation of pregnancy in patients with pre-eclampsia. Conclusion. Use of vascular growth factor in the diagnosis and determining the severity pre-eclampsia, along with traditional clinical and laboratory research will optimize the obstetric tactics in these patients.
Journal of obstetrics and women's diseases. 2016;65(2):16-23
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The structure, nature and intensity of painin various forms of external genital endometriosis
Efimenko T.O.
Abstract
Background. The study of the relationship of severity of endometriosis, localization and intensity of pelvic pain is a significant scientific interest. Aim of the study was to determine the structure of pain in women with external genital endometriosis (EGE) varying forms of distribution. Materials and methods. 124 patients were examined. Degree exam proliferation was assessed by endoscopy. Recovered: superficial endometriosis; endometrioid ovarian cysts; infiltrative forms of endometriosis; combined forms of endometriosis. Pain intensity was determined in accordance with a 10-point visual-analogue scale. Pain Detect scale was used to determine the nature of the pain. Statistical analysis of the material was carried out using the Microsoft Excel 2013 (Microsoft Corp., USA) applications and Stastistica 10.0 for Windows. Results. Light degree of pain intensity in patients with superficial forms EGE (92.11 %, 35 cases) is 21 times higher than that in patients with infiltrative forms (4.35 %, 1 case). Severe degree of pain intensity and with the same frequency is found at infiltrative (56.52 %, 13 cases), combined forms of endometriosis (57.14 %, 8 cases) and in patients with bilateral endometrioid cysts (47.37 %, 9 cases). Nociceptive pain is typical for patients with superficial forms EGE (73.68 %, 28 cases). Neuropathic pain occurs 4.5 times more frequently in patients with infiltrative (86.96 %, 20 cases) and combined forms of endometriosis (92.86 %, 13 cases). Conclusions. Light degree of pain intensity corresponds to the surface form of endometriosis, moderate and severe degree of pain equally common in infiltrative forms and endometrioid ovarian cysts, severe degree of intensity of the most common in infiltrative endometriosis and associated forms. By the nature of pain in superficial forms of endometriosis is dominated by complaints typical for nociceptive pain, neuropathic pain is more common in infiltrative endometriosis and associated forms.
Journal of obstetrics and women's diseases. 2016;65(2):24-30
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Modification ultrasonic methods estimating expected fetal weight
Mudrov V.A.
Abstract
Selection of the optimal tactics of pregnancy and childbirth greatly depends on the expected weight of the fetus. Frequency of perinatal mortality and morbidity increased in grоup with growth retardation and fetal macrosomia. The aim of the study was a modification of ultrasonic methods for determining the expected fetal weight. Materials and methods. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 210 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected fetal weight by ultrasonic methods used formula of Hadlock, Shephard and Demidov. The error in determining fetal weight standard methods more than 250 g, which identified the need to establish new precise formula. The increase in the error in determining fetal weight at border gestation due to the lack of assessment of fetal tissue density. On the basis of mathematical and 3d-modeling of the body’s volume, depending on its mass determined pattern change of the average density of fetal tissue, depending on the gestational age, which is expressed by the formula: ρ = 0,833 + 0,004475GA, where ρ - the average density of tissue, GA - gestational age. Through a comprehensive analysis of ultrasound data’s fetometry and medium-density tissue defined fetal weight formula: M = (0,2777 + 0,001492 × GA) × OFD × AC × (Fe + Ti + Hu + Ra), where GA - gestational age (weeks), AC - abdominal circumference (cm), OFD - occipitofrontal diameter (cm), Fe - femur’s length (cm), Ti - tibia’s length (cm), Hu - humerus’s length (cm), Ra - radius’s length (cm), 0.2777 and 0.001492 - digital prognostic factors. In calculating the weight of the fetus according to the proposed formula ultrasonic average error does not exceed 150 g. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine fetal weight in II and III trimester of pregnancy.
Journal of obstetrics and women's diseases. 2016;65(2):31-37
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Application of the method of broadband radio wave surgery in operative obstetrics
Oboskalova T.A., Glukhov E.J., Butunov O.V.
Abstract
An assessment of the effectiveness of integrated technology cesarean section using the methods of broadband radio wave surgery (SHRH) was taken, argon-plasma coagulation, namely (APC) in tissue anterior abdominal wall and uterus to prevent chronic inflammatory, and other intra-and postoperative complications. The study included analysis of cesarean section outcomes, these results are about women operated without the use of argon-plasma coagulation and the use of APC. Studies have shown that the proposed modification of the cesarean section using methods SHRH reduces the amount of wound exudate and helps to improve microcirculation and tissue repair, formation of a wealthy uterine scar.
Journal of obstetrics and women's diseases. 2016;65(2):38-43
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Renal ionoregulation function in incontinent women
Osipova N.A., Niauri D.A., Gzgzyan A.M.
Abstract
Renal ionoregulation function was studied in 143 women with stress incontinence, in 43 with urge incontinence and in 91 with mixed incontinence. Total polyuria was diagnosed in 8,7 ± 1,7% and nocturnal polyuria in 21,7 ± 2,5% incontinent wonen. Changes in kidney function in total and nocturnal polyuria appear to be due not to a decrease in water reabsorption in the renal collecting duct but to reduction of ion reabsorption in the thick ascending limb of the Henle loop. Due to this defect, reabsorption of ions and water is decreased; as a result, lager volumes of fluid enter the collecting ducts.
Journal of obstetrics and women's diseases. 2016;65(2):44-53
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Medical law in obstetrics
Atlasov V.O., Yaroslavsky V.K., Ballo A.A., Yaroslavsky V.K.
Abstract
The article presents information on the legal regulation of medical practice in obstetrics, assesses the existing legal relationship between the doctor and the patient, the necessity of improving the civil legal relations between subjects of medical law in obstetric institutions. Discusses the question of the right doctor for error, and the estimation of medical error from a medical and legal standpoint, suggested ways to reduce the likelihood of defects in rendering medical aid in obstetrics.
Journal of obstetrics and women's diseases. 2016;65(2):54-63
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Formation of fetal opioid system
Yakovleva A.A.
Abstract
The article presented literature review about of endogenous opioid system (EOS) formation consist of opioid receptors complex and its ligands (endogenous opioid peptides) in different tissues including placenta. It was shown that formation of fetal EOS is going with anatomic and functional development of the central nervous system and EOS expression begins in the placental tissues as soon as implantation and starts till the end of the pregnancy. Influence of opioid peptides on secretion progesterone, prolactin family peptides, growth hormone, placental lactogens and prolypherine from the trophoblast tissue is discussed.
Journal of obstetrics and women's diseases. 2016;65(2):64-69
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Achievements, sensations and problemsof molecular prenatal diagnostics
Baranov V.S., Kascheeva T.K., Kuznetzova T.V.
Abstract
Some novel molecular and cell methods implicated into assistant reproductive technology and prenatal diagnostics are reviewed. Special attention is paid to new generation sequencing (NGS) technique, arrayCGH, genome editing (CRISPR/Cas9 method), cell and gene therapy of embryos as well as to non-Invasive prenatal diagnostics and preconception testing. Benefits, drawbacks and problems accompanying massive invasion of these technologies into PD and ART are discussed.
Journal of obstetrics and women's diseases. 2016;65(2):70-80
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