Vol 49, No 1 (2000)

The aim of the investigation was the assessment of humoral immunity in neonates and their mothers, who had genital chlamydiosis during pregnancy in correlation with results of immunomorphological and histological investigation of placenta with the significance of these disturbances for the development of perinatal pathology. 48 tern neonates and their mothers, who had genital chlamydiosis during pregnancy composed the main group, 16 healthy neonates and their mothers composed a control group. Decreasing in adaptation and. immunoresistive processes were found in 60,4% neonates from mothers with chlamydiosis. It was shown that the condition of neonates correlates with placental changes. In placentas of sick neonates, the highest level of fixed immune complex with excessive contents of C3b fraction of complement and IgM were seen. Our investigation showed that perinatal pathology in neonates from mothers with chlamydiosis could be a result of intrauterine C. trachomatis infection, and a consequence, of immunity disturbances in the system “mother-placenta-fetus”.

The data on frequent combination of chronic inflammatory diseases of vagina and adnex can give the evidence for connection betzveen these pathologic processes.

The frequency of Mycoplasma hominis findings in patients with bacterial vaginosis points to their possible ethioloic role in the pathology. At the same time, vaginal smears presenting Ureaplasma urealyticum in patients zvith bacterial vaginosis indicates their role in formation of pathology.

One can suggest ethiologic mean of U.urealyticum in nonspecific bacterial vaginitis patients.

In order to improve the quality of prenatal diagnostics we have evaluated and optimised the indications to the complex investigation of revealing fetal abnormalities and chromosomal diseases. Taking into account a couple of extra-factors we succeeded to prevent the birth of abnormal children in 10% cases. To assess the possibility of pregnancy complications prognosis we have ultrasonographically studied the features of extraembryonal structures development in 1st trimester pregnancy. We have observed the high prognostic value of chorionic and amniotic cavities volumes and yolk sac pathology in predicting the preterm delivery and IUGR.

The study was earned out to investigate effect of Progesterone 's agonist Dydrogesterone in the treatment оf the miscarriage. Thus, it was seen that Dydrogesterone 's treatment (10 mg/daily per os) zvas more effective than Progesterone for prophylactic miscarriage.

Despite the abundance of drugs used to treat gestosis, the lack of sufficient effect of the therapy is one of the most frequent causes of premature delivery in this type of pathology. Therefore, the search for effective methods of late gestosis treatment remains one of the most pressing problems of modern obstetrics. In addition, the use of a large number of potent drugs can cause uncontrollable side effects, allergy in pregnant women and adversely affect the fetus, and therefore there is a need to search for safe and at the same time effective enough means for monotherapy.

Patients' complaints depend on the localization of the infection. When the urethra is affected (the most common localization), the usual symptoms are painful sensations during urination: stinging, burning, itching; dysuric phenomena: frequent urination, urination with small portions of urine, feeling of incomplete urination. Patients may self-report the occurrence of purulent discharge from the urethra. However, the complaints may disappear within a short time.

There is still a problem in modern obstetrics - traumatic injuries during pregnancy- that plays the leading role in perinatal mortality and maternal lethality. In the given review the historical data and modem presentation about the diagnostics and treatment peculiarities in mechanical trauma during pregnancy are concerned.

The difficulty of the problem of fistulas genital treatment is covered in the article given. Though there are certain success, the recurrent fistulas are frequent complication after treatment. There are more than 150 ways of fistulas reconstruction. The results, analysis of 29 surgery procedures in genital fistulas treatment are considered. Authors suggest their original operative method using transvaginal approach, monocry I and PDS use, postoperative bladder drainage consisting of 2 urethral tubes, preventing a spike in bladder pressure. They report about 7 successful results on fistula closure using original technique.

At the age of 20 Patient K. passed the operation of laparotomy and excision of rudimentary gonads and uterine tubes due to dysgenesis of the gonads (46XY). Histological identification found cells of Leidig type whose existence proves presence of Y- chromosome in the patient’s karyotype. As a result of the treatment the recipient got pregnant with a triplet. As a result, she delivered a boy with the weight of 2750 gr. and height of 49 cm and a girl with the weight of 2850 gr. and height of 49 cm. The recipient’s lactation in the postnatal stage was sufficient.

Takayasu's disease belongs to the group of so-called systemic vasculitis, which is based on generalized vascular lesions, in particular aorto-arterial trunks with inflammation and necrosis of the vascular wall and secondary involvement of various organs and systems.

In the article, the summary on the 20-years’ experience on labor management in high- risk pregnant is given. The prospective for the alternative labor management in diabetes mellitus, fetoplacental insufficiency, elder nullipara, uterine scar after previous cesarean sections, breach or pelvic presentation are covered.

The article reviews modern mammalogy aspects, the classification of breast diseases, peculiarities of diagnostic, management and prophylaxis of the pathology are given.

“The most valuable Stroganov’s role is in eclampsy treatment. Many thousands of women all over the world own their lives because of him, as he with his immense efforts and energy, feeling himself right, fought against cesarean section in eclampsy. The biggest consolation for him was that he strove for acknowledgement of the method all over the world” Prof. Lurie R.G. (1947)

The results of the thesis research can be recommended for implementation in specialized obstetric hospitals equipped with modern ultrasound devices; in the educational and pedagogical activity of the departments of obstetrics, pediatrics, and pathological physiology of medical universities; and in the lectures for specialists in obstetrics, perinatology, and pathological physiology of the postgraduate medical education academies of Russia.