Vol 66, No 5 (2017)

The use of suggestive methods, including hypnotherapy, in obstetric practice
Vishnevskaya E.E.

Labor pain leads to various undesirable clinical and psychological complications. The mental aspect of pain is actively being studied, as well as non-drug methods of influence. Expedient is the use of psychological preparation of women for childbirth and the use of the analgesic effect of hypnosis on the stage of preparation to labor and during childbirth.

Journal of obstetrics and women's diseases. 2017;66(5):7-10
Labor pain relief and postpartum depression. Is there a correlation?
Riazanova O.V., Aleksandrovich Y.S., Reznik V.A., Gorkovaya I.A., Korgozha M.A., Ioskovich A.

The article is dedicated to the evaluation of the effect of labor pain relief by using epidural analgesia during vaginal delivery on the frequency of postpartum depression. Materials and methods. 159 women were included in the study. The average age of the patients was 29 years, the average gestation period was 39.7 weeks. In the first group, in order to relief the pain while vaginal birth, an epidural analgesia was administered. A continuous patient-controlled infusion was used along with 0.08% solution of ropivacaine hydrochloride in the capacity of a local anesthetic. Patients of the second group gave birth without any anesthesia. Evaluation of the depression progress was carried out several times: before birth, 6 hours after delivery, 3 days and 6 weeks after delivery. Results of the study. Usage of epidural analgesia during vaginal delivery leads to a significant pain syndrome relief, but does not reduce the probably of postpartum depression.

Journal of obstetrics and women's diseases. 2017;66(5):11-20
Effect of the combined preparation Terzhinan® on microorganisms isolated from the urogenital tract of women. In vitro experiment
Savicheva A.M., Spasibova E.V.

Introduction. The study is in vitro experiment, aimed to determine antibiotic susceptibility of microorganisms isolated from the urogenital tract of women to the combination of substances included in the preparation Terzhinan.

Methods. In total, 516 microorganism strains isolated from the vagina of reproductive age women have been tested: Candida spp. (n = 83), bacteria of the family Enterobacteriaceae (n = 138), Streptococcus agalactiae (n = 72), Enterococcus spp. (n = 147), Staphylococcus spp. (n = 37), Actinomyces urogenitalis (n = 7), Gardnerella vaginalis (n = 27), Atopobium vaginae (n = 5). Suspensions of each strain in a volume of 0.5 ml (0.5 according to McFarland) were applied onto culture medium (Muller-Hinton Agar or 5% Blood Muller-Hinton Agar). Furthermore, serial dilutions of Terzhinan were applied with a calibrated loop onto three sectors. Petri dishes were then incubated at 37 °С for 24 h. The results were evaluated visually, by measuring growth inhibition zones.

Results. The majority of Candida albicans isolates were susceptible (S) to the preparation, using both undiluted and diluted (10 and 100 times) preparation. Terzhinan without dilution and in the dilution 1:10 was 100% effective against all tested bacteria of the family Enterobacteriaceae. Susceptibility of gram positive bacteria to the antibiotics included in Terzhinan, was 74.1%. All isolates of staphylococci, including Staphylococcus aureus, were susceptible. The frequency of susceptible strains of Streptococcus agalactiae and Enterococcus spp. was 70%. All clinical isolates of Gardnerella vaginalis and Atopobium vaginae were susceptible to the combinations of antibiotics included in the preparation Terzhinan, which is in agreement with data on its high efficiency in the treatment of bacterial vaginosis.

Conclusions. In in vitro experiment, the combined preparation Terzhinan showed high activity against major groups of microorganisms isolated from the vagina including pathological conditions, such as bacterial vaginosis and vulvovaginitis of different etiology.

Journal of obstetrics and women's diseases. 2017;66(5):21-26
Pathophysiological and genetic changes in the body of a pregnant with gestational diabetes
Akhmetova E.S.

Currently, the reduction of perinatal morbidity and mortality is a key challenge of maternity care in the world. An important role in the structure of perinatal pathology plays a gestational diabetes mellitus (GDM). High incidence of gestational diabetes mellitus (1-14%) and the associated perinatal mortality have not only medical but also social value. The aim of the study was to study the pathophysiological processes that occur in the body of the pregnant woman with GDM and lead to obstetric and perinatal complications, and possible genetic markers that increase execution risks of impaired glucose metabolism in pregnancy at the present stage of scientific development. Materials: literature data of domestic and foreign studies over the period 2006 to 2016. Methods: synthesis of literature data. Conclusion. It is necessary to identify the major genetic predictors of the development of gestational diabetes, with the aim of its prediction and timely prevention of obstetric and perinatal complications.

Journal of obstetrics and women's diseases. 2017;66(5):27-36
Treatment of infertility in women with polycystic ovary syndrome using assisted reproductive technology
Danielyan R.M., Gzgzyan A.M.

The article recent data concerning the pathogenesis, diagnostic criteria and hormonal disorders in the polycystic ovary syndrome are presented. A sequential step-by-step treatment of this disease is also described. Pаrticulаr аttention is pаid to the treаtment of infertility in women with PCOS using аssisted reproductive technology.

Journal of obstetrics and women's diseases. 2017;66(5):37-45
Aromatase P450 activity in the natural menstrual cycle and during controlled ovarian stimulation
Yakovlev P.P.

The Aim of the study was to assess modern considerations about the role of aromatase P450 enzyme in female reproductive system and the effect of its activity on the protocols of in vitro fertilization (IVF).

Materials: foreign and Russian literature data from 1978 to 2016.

Methods:review and synthesis of publications has been performed.

Conclusions: Ovarian aromatase is the key steroidogenesis enzyme of the female reproductive system. Its activity depends on many factors, both of intraovarian and extragonadal origin. The ovarian follicular response and oocyte quality in IVF may depend on aromatase activity.

Journal of obstetrics and women's diseases. 2017;66(5):46-55
Anemia in pregnancy: cliniсо-pathogenetic approaches to the management of pregnancy
Atajanyan A.S.

The review article defines iron deficiency anemia, the mechanisms determining iron deficiency in pregnancy, the complications of pregnancy, childbirth and the postpartum period, the methods of correction and prevention of iron deficiency, including a modern alternative to oral iron intake-its intravenous forms, which contribute to a rapid increase of iron levels. And also do not have toxicity and are easily tolerated.

Journal of obstetrics and women's diseases. 2017;66(5):56-63
A case of heterotopic pregnancy with selective reduction of the ovum cervical localization and preservation of intrauterine pregnancy
Romanova M.L., Nesterov I.M., Dyachuk A.V., Chirskiy V.V.

Failure of implantation with the formation of heterotopic pregnancy is, unfortunately, continues to accompany the IVF. This may be due to the inability of the impact on endometrial receptivity. Changing characteristics of endometrial receptivity in conducting IVF determines the probability of formation of this kind of complications. The lack of standards for the conduct of heterotopic uterine and cervical pregnancy include the woman to the group at high risk for bleeding, a subsequent hysterectomy and loss of fertility. Promptly detection of ectopic localization of the ovum by means of methods of ultrasonic diagnostics allows in some cases to carry out organ-sparing surgery. Currently, there is a need for improved approaches to preimplantation training. The article describes a clinical case of heterotopic pregnancy with successful selective reduction of cervical localization of one of the two fertilized eggs and preservation of intrauterine pregnancy.

Journal of obstetrics and women's diseases. 2017;66(5):64-68
Pregnancy in epilepsy: management and delivery
Tsivtsivadze E.B., Petrukhin V.A., Novikova S.V., Vlasov P.N., Ryazantseva E.V., Klimova I.V.

We evaluated 129 epileptic pregnant women between 2014 and 2016. Demographic features of the patients, along with type and duration of epileptic seizure, time of diagnosis, date of last seizure prior to pregnancy, number and duration of seizures during pregnancy, type of antiepileptic drugs, result and week of termination of pregnancy, and birth weight were registered, and also, we evaluated perinatal complications and fetal malformations.

Journal of obstetrics and women's diseases. 2017;66(5):69-79

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