Vol 54, No 1 (2005)

For more than 40 years Scientific Research Institute of Obstetrics and Gynecology named after V.I. D.O. Otta RAMS is the leading institution for the problem "Ecology and reproductive health of women" of the Scientific Council (NS) for Obstetrics and Gynecology of the RAMS and the Ministry of Health of the Russian Federation (M3 RF)

Ecological genetics plays a major role in protecting reproductive health and prevention of inherited and inborn disorders. Protection of reproductive health in women poses special problems as because of long period of oogenesis damaging of female gametes is feasible during several successive generations. Recent achievements in predictive (preventive) medicine render opportunities for presymptomatic diagnostics and efficient prevention of inherited and inborn disorders as well as severe and common diseases in postnatal life. Testing of genetic polymorphisms creates solid genetic background in predictive medicine. Thorough studies are needed to evaluate predictive value of already existing genetic tests. Necessities for solid legislative background and comprehensible medical evaluation of genetic tests results are also quite urgent tasks of current medicine. Widespread population genetic testing with subsequent relevant interpretation of the results might pave the way for more objective evaluation of unfavorable action of ecological factors in humans. These studies in conjunction with already elaborated Genetic Chart of Reproductive Health might help a lot in protecting of reproductive health as well as in prevention of inherited and inborn disorders.

The aim of this study was to investigate of effect of pregnancy on the thyroid sizes and function at the patients with diffuse non-toxic goiter in a region of marginal iodine deficiency. Materials and methods: 132 pregnant women in the age of 18-39 years, including 110 with diffuse non- toxic goiter and 22 pregnant women with a normal thyroid gland, were examined. 30 patients with diffuse non-toxic goiter of the first degree received 200 мкг per day of KI (iodid- 200), 40 patients with diffuse non-toxic goiter of the second degree received a 25-75 micrograms/day thyroxine (euthyrox). 25 patients with diffuse non-toxic goiter had not received regular therapy. The autoimmune thyroiditis is revealed for 15 women with diffuse non-toxic goiter. They received a 75-100 micrograms/day euthyrox. We estimated volume of the thyroid gland by ultrasound, serum TSH and serum thyroid hormone in each trimester of pregnancy. Results: At the healthy women during pregnancy the percentage increase of volume of a thyroid gland has constituted 24,3±0,2%. At the patients with diffuse non-toxic goiter, not receiving therapy, the thyroid gland was authentically increased at 37,1±1,1%. At the pregnant women receiving iodidum the percentage increase of volume of a thyroid gland has constituted 12,3±0,7%. After of a euthyrox therapy there was a relative decrease of the thyroid volume by 13,7±0,5%. In the group of healthy women a TSH level has increased inconsiderable from l,3±0,6mU/l to l,6±0,2mU/l to the end of pregnancy. During pregnancy in the group of women with diffuse non-toxic goiter without treatment rising the TSH values in a blood from l,4±0,3mU/I to 2,3±0,2 mU/l was revealed. The mean TSH levels of the goitrous pregnant group, receiving iodidum, essentially did not vary during pregnancy. In the goitrous pregnant group, receiving euthyrox, a TSH level has decreased considerably from l,8±0,5mU/l to 0,6±0,2 mU/l to the end of pregnancy. TSH values and free T4 in all the pregnant women were within the reference range in a blood of the healthy nonpregnant women. Was not observed of differences of pregnancy course and term delivery in compared groups. The high frequency of complications of pregnancy is connected to availability of the not diagnosed autoimmune thyroiditis. Conclusion: These results recommend to usage of iodine at the women with a not enlarged thyroid gland and with diffuse non-toxic goiter of the first degree and nonsupressic doses of thyroxine at the women with diffuse non-toxic goiter of the second degree during pregnancy.

The actual problem of our time is the deterioration of the reproductive health of the population, which in turn, to a certain extent, determines the demographic processes.

The article describes the harmful factors causing violations of the processes of reproduction of professional and ecological genesis. Indicators of the incidence of pregnant women and their offspring are given, depending on the technogenic load of the area of residence.

Summary: Diurnal rhythms of the activity of a number of monoaminergic systems of the hypothalamus (norepinephrine and serotonin in PA and ME-ArN, as well as dopamine in ME-ArN) have been shown to depend on the functioning of an endogenous circadian oscillator in SCN of the hypothalamus. Light modifies the diurnal rhythms of the neurotransmitters. Enhancement of the activity of the noradrenergic systems with sex steroids in proestrus is an important mechanism of the forming of the preovulatory surge of GnRH and gonadotropines’ secretion, which initiates ovulation. Consideration of our own experimental data and literature allow the supposition that the change of diurnal rhythms of norepinephrine in PA and ME-ArN could result in profound disturbances of hypothalamic regulation of reproductive cycles and be one of key reasons for negative effect of xenobiotics on reproduction.

Supported by RFBR grant 04-04-49204.

The presence of high air concentrations of hydrogen cyanide vapours in the workplace, the exposure of which stipulates high morbidity rates with a temporary work capacity loss, complications of pregnancy development and births, working losses while nursing the sick children in the women workers of the factories above compared with a control group was found to be a feature of work conditions at the Gold Extraction enterprises. Pathogenetic links of chronic exposure to hydrogen cyanide which lead to reproductive health disturbances may be considered to be forming the picture of hystooxical hypoxia, detoxication mechanisms based on binding CN-ions with methemoglobin, thiocyanate cumulation, hormone T3 and T4 synthesis disturbances.

The complex research of a condition of health of the women and their children in conditions of the Volgograd region in dynamics of 25-year’s supervision has revealed authentic dependence of infringements somatic, reproductive and neonatal health from size and duration of ecological loading in area of residing. Is established, that with increase of duration of influence of a high level of ecopollution of atmospheric air the condition of health of the women and their children is worsened, i.e. the effect of the saved adverse action ecopollutants is revealed. It is confirmed received by regression models of the high statistical importance which has proved authentic connection between size and duration of ecological loading in area of residing and the basic parameters of health female and neonatal populations. These models are a basis for forecasting frequency of the revealed infringements from a degree of ecological loading.

The submitted work is a part of the contribution in the decision of a very urgent problem — ecological reproductology at a level of the Volgograd region having purpose to improve somatic, reproductive health of the women and health of their children, that will promote, at the end, stabilization of a demographic situation.

After hearing and discussing messages from various regions of the Russian Federation, the participants of the Plenum state: despite the fact that the level of anthropogenic pollution of the environment according to the parameters of sanitary and hygienic monitoring in the 2000s decreased or in a number of territories did not undergo significant changes, and qualitative indicators of the health status of pregnant women, newborns and children.

In article outcomes of a research of 96 premenopausal women with continuous menstrual cycle and any diseases. BMD screened for all patients in hip, vertebrals and arm by DEXA Hologic QDR 4500 Elite. Osteopenia reveled in 41,7% women in lumbal spine. The main risk factors of low BMD are: low level of progesterone, anovulation, slow physical activity, low weight.

Disorders of urination in women, manifested by various disorders of the accumulative and evacuation functions of the lower urinary tract, are stated in 46% of all visits to the urologist. Among the numerous complaints in patients suffering from endometrioid disease, a large place is occupied by complaints of disorders of the act of urination. Currently, there is a significant increase in the number of these patients.

The reform of the Armed Forces of the Russian Federation (RF Armed Forces) in the current unfavorable demographic situation is accompanied by the involvement of a significant number of women in all types and branches of the armed forces in various positions associated mainly with the specialties of military humanitarian, medical, engineering, legal and other profiles.

Ethical and legal issues related to artificial insemination (AI) are considered. The psychological problems of children conceived with the help of AI with donor sperm according to an anonymous or open program are discussed. Attention is drawn to the peculiarities of the legal aspects of preliminary cryopreservation of sperm of young cancer patients who are to undergo chemotherapy or radiation therapy, as well as military personnel of “special risk”. The article describes the legal difficulties of posthumous reproduction that arise when AI is performed with the sperm of a deceased husband. The position of the Orthodox Church on the issues under consideration is stated.

The proportion of pregnant women hospitalized for burns is small and amounts to 0.5% of the number of patients in burn centers, while most often, up to 50% of cases, patients receive superficial burns with an area of 10-30% of the body surface. Few literature data indicate that burns on an area of up to 10% of the body surface do not have a significant effect on the course of pregnancy.

The International Scientific Congress "Operative Gynecology - New Technologies", dedicated to the 150th anniversary of Professor Dmitry Oskarovich Ott, will be held on November 22-24, 2005 in St. Petersburg. Organizers of the conference: Russian Association of Obstetricians and Gynecologists, Society of Obstetricians and Gynecologists of St. Petersburg and the Leningrad Region, Research Institute of Obstetrics and Gynecology named after I. BEFORE. Otta RAMS, North-West Branch of the Russian Academy of Medical Sciences, "Journal of Obstetrics and Women's Diseases".