Vol 52, No 2 (2003)

The position of the unity of the human body and the environment was obvious already in the "pre-scientific" antique period, when a holistic, harmonious perception of the world prevailed. In the future, in full accordance with the evolution of human knowledge and the predominance of the elementary approach to the study of biological phenomena (primarily, the dominance of morphological and functional analysis of cells, organs and tissues of the body) and individual environmental factors (physical, chemical, mechanical, biological, social), the principle of unity organism and environment for a long time left the field of vision of researchers.

The review summarizes the original data concerning involvement of some genes participating in Phase I and Phase 2 of detoxification systems in the origin, progression and treatment efficiency of such common multifactorial diseases as endometriosis, bronchial asthma, alcoholic cirrhosis, habitual miscarriages, gestosis, lung cancer, chronic bronchitis etc. Of special theoretical and practical value of these studies is an identification of highly nonrandom association of particular functionally inferior alleles of the genes belonging to glutathione-S- transferase super-gene family (GSTM1 (0), GSTT1 (0), GSTPi (s) as well as N-acetyl transferase - NAT-2 (s) with these diseases. Thus molecular testing of these alleles might be recommended as feasible predictive test for personal predisposition evaluation, for estimation of remote prognosis and for the treatment strategy in at least some of these diseases. Somewhat about 5-7% of all population in the North-West of Russia possess the most unfavorable combinations of GST genes genotypes (GSTM10/0; GSTTI0/0, GSTPi s/s). Early identification of these individuals by means of genetic screening supplemented with subsequent adequate social and medical care should be considered as feasible social program for efficient prevention of these diseases at the national level. Relying on these data as well as on the polymorphism studies and common mutation identification of other genes the idea of Genetic Form for the pregnant women is suggested and briefly discussed. Implementation of new sophisticated and highly productive molecular techniques amenable for the widespread population gene polymorphism screening becomes highly advisable.

The polymorphism of the genes involved in the regulation of endothelial function - PLAT, PAI-1, ACE, eNOS and TNF-α - was studied in 122 pregnant women with pure and concomitant preeclampsia of varying severity and in 73 healthy puerperas. It was revealed that mutant genotypes of the studied genes are associated with more pronounced clinical and laboratory indicators of the severity of preeclampsia and the greatest increase in the level of markers of endothelial dysfunction. It is noted that the frequency of mutant genes and alleles varies depending on the severity of preeclampsia and the presence of background diseases characterized by the presence of endothelial dysfunction. The data obtained confirm the opinion that gestosis is a multifactorial disease with several, possibly independent, developmental pathways. The study of the polymorphism of genes regulating endothelial function contributes to the early identification of a risk group for the development of preeclampsia.

This article contains own and literature data on stimulating influence of constant light illumination on the risk of the development of anovulation, hyperplastics processes and cancers of the female reproductive system organs (mammary gland, endometrium, and ovaries) in the laboratory animals and women. Contrary, the light deprivation obstacles to the cancer development. The ata on the key role of the inhibition of production of pineal hormone melatonin in the pathology that developed under the effect of light-at-night as well as on the possible prevention of this pathology with melatonin and pineal peptides are reported.

The article examines the attitude of women to the problem and the abortion procedure and the organization of the work of the gynecological service to provide assistance in connection with an unplanned pregnancy. The questionnaires of women who decided to terminate a pregnancy were analyzed, as well as the qualitative indicators of the activities of institutions.

It was shown that the main reason for the termination of pregnancy was dissatisfaction with the financial situation (28.1%). 96.3% of women knew that abortion is fraught with serious complications. 48.6% of women prefer to terminate pregnancy by mini-abortion, 33.7% by medication. Less than half of the patients are satisfied with the quality of care for termination of pregnancy. Risk groups are adolescents and women of older reproductive age. 67.6% of the respondents need advice on methods of contraception. Satisfied with the quality of consulting 38.8%.

Along with educating the population about the dangers of abortion and teaching family planning methods, it is necessary to create comfortable conditions for abortion, ensure maximum safety of the procedure, conduct rehabilitation after an abortion in order to eliminate negative consequences, advise on the prevention of unplanned pregnancy in the future, and select adequate contraception.

Pregnant women in last trimester of pregnancy living in 2 districts of Moscow were clinically examined. The immunology researches show that 69 % of all pregnant have the changes in humoral immunity: decrease of IgG, increase of IgM,CIC,and IgE.

It was also found that somatic health of women pregnancy complications and corresponding immunological changes found in last trimester of pregnancy negatively influenced on health of new-born and formation of health during first year of age. So diagnosis of intrauterine fetus hypoxia. Low Apgar score (6 points and lower), brain circulation disorders of hypoxia genesis diagnosis of hypertensional syndrome was significantly more frequent between new-born of ecologically polluted district.

The study conducted permitted to substantiate the immunological indices of risk for reproductive health of women and health of their offspring. These are: a) decrease of IgG concentration in blood, b) increase of CIC along with rise of overall IgE, c) presence of antihapten antibodies to environmental pollutants. These indices are recommended for inclusion in social and hygienic monitoring, ordinances of Health Ministry in the sphere of maternity and childhood protection.

The article presents literary review about fetal CNS development and its disorders, own investigation results of pathogenesis, diagnostic methods of fetal neurological disorders in different obstetrical and extragenital pathology in pregnant women.

The article represents the data of screening carried out on 905 women attended the outpatient departments of gynecologic clinics of Saint Petersburg and Leningrad region.

Infectious diseases of genital-urinary system were diagnosed in 65.5% of the women, 53.5% having asymptomatic course, which must be important in epidemiological respect. Risk factors and characteristic symptoms of the diseases were taken into account while analyzing the questionnaires. The valuable risk factors were young age, early debut of sexual intercourse and occasional sexual contacts, the history of STI as well as the pregnancy.

The paper clarified the effectiveness of a monophasic estrogen-progestogen preparation of an individual with an individual selection of dosages for the treatment of climacteric syndrome in postmenopausal women. All observed had a good effect of therapy and good tolerability of the drug.

The lecture provides information on approaches to the assessment of fetal cardiotocography during pregnancy and childbirth. Assessment of the functional state of the fetus during pregnancy and childbirth remains one of the most difficult tasks of perinatology and obstetrics. The question of the state of the intrauterine fetus has been of interest to obstetricians for a long time. For the first time, the possibility of auscultation of fetal heart sounds was reported in 1818.

The haemorrhage continues to be the most serious problem in obstetrical practice. The modern arsenal of means for prevention and therapy of obstetrical bleeding, organization and subsequence of emergency care in maternity departments allowed to decrease the common amount of haemmorage in intrapartum and postpartum periods. However, the full prevention of poor pregnancy and delivery outcomes is still not achieved. Two main factors determine the mortality level in obstetrical bleeding: late non-adequate haemostasis and incorrect infusional-transfusional therapy. The article is devoted to clinical management of haemorrage in preterm placenta abruption, uterine rupture, anomalies of placenta attachment and placement, uterine hypotony, and principles of infusional-transfusional therapy.

Pathological preliminary period (PPP) is represented real obstetric problem, patogenesis with which up to the end stay not clear. In study of features of its occurrence and current the opportunity of a prediction serious pathology in labour (anomaly of patrimonial activity, hypoxia of a fetus etc.). Distinguish hypotonic variant PPP, at which activate fasic a component of uterus contraction, and the hypertonic variant, at which characteristic increase tonus of myometrium. At any variant similar pathology requires treatment, for what is made regularize contructionf activity of the uterus by tocolitical preparations, are arranged for the accelerated maturing cervix (prostoglandins of group E), is normalized a psyxo-somatic condition of the pregnant women (medicine dream, fysiotherapy). It is necessary to carry out a dynamic estimation uteroplacentaly hemodinamics and condition of a fetus. In case of long current PPP (more than 5 day) and unsuccessful of medical measures is recommended labor by operation section of cesarea. The further study of problems of occurrence and current PPP with attraction of modern diagnostic techniques is required, that will allow prediction of complication in labour.

In the 300-year history of our city, 900 days of the Leningrad blockade were and will remain for centuries in the memory of the people. “The war could not but affect all aspects of life, even in the most remote areas from the front in our country. But its influence on the life of Leningrad is especially great because the population of our city experienced in these months not only the hardships of wartime, but also all the consequences of a severe blockade "

The Dissertation Council is allowed to accept dissertations in the specialty 14.00.01 for defense. - obstetrics and gynecology and 14.00.40 - urology.

For the period 2001-2002. The Council reviewed 4 doctoral and 15 master's theses. Of these, in obstetrics and gynecology: 3 - doctoral and 8 - master's theses.

From June 29 to July 2, 2003 in the Northern capital of Russia within the framework of the International Ecological Forum "Environment and Human Health" the International Congress "Environment and Perinatal Medicine" will take place.

The contribution of St. Petersburg scientists to the development of domestic obstetrics, gynecology and perinatology is generally recognized. St. Petersburg is associated with the beginning of training midwives in Russia (1757), the first scientific obstetric-gynecological society in Russia was created here (1866), and the Journal of Obstetrics and Women's Diseases began to be published (1887).