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Vol 50, No 2 (2001)

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Iraida Ivanovna Semenova


Iraida Ivanovna Semyonova turns 80 years old. She devoted fifty of them to the undivided service of man, science, and the upbringing of the younger generation of doctors. Working as an obstetrician-gynecologist for more than half a century is a real labor feat

Journal of obstetrics and women's diseases. 2001;50(2):1-1
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Current public health problems

Genetic factors of predilection for habitual noncarrying of pregnancy at early stages

Bespalova O.N., Arzhanova O.N., Ivaschenko T.E., Aseev M.V., Ailamazyan E.K., Baranov V.S.


By means of the method of polimerase chain reaction the frequency of blank allele of genes GSTP1, GSTM1, and the frequency of polymorphous alleles of gene GSTP1 in 40 pairs with habitual noncarrying of pregnancy at early stages were studied. The results of the investigation testify to the high rate of gomozygotes GSTT1 0/0 in pairs with habitual noncarrying of pregnancy in comparison with indices in general population of North-West region of Russia (37,7% and 23,3% correspondingly).

The genes GSTM1, GSTT1, GSTP1 code enzymes, which take part in the second phase of xenobiotic detoxication system. Taking into consideration that protein products of these genes to significant extent determine the effectiveness of 2nd phase of detoxication (neutralization of xenobiotics by glutathione binding), we are to suppose that unfavorable environmental factorsplay the important role in etiology and genesis of habitual noncarrying of pregnancy at early stages.

Journal of obstetrics and women's diseases. 2001;50(2):8-13
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Clinical signs of genital papillomavirus infection

Shaimardanova G.I., Savicheva A.M., Maximov S.Y.


702 women were observed: the basic group consisted оf 450patients with sexual-transmitted infections (STI); control group included 252 women without STI. 19 women with oncological diseases of reproductive system were specially examined.
The women with genital papillomavirus infection complained of itch, burning, and warts of anogenital area. The most widespread diseases in STI patients were cervical pseudoerosion and endocervicitis. In presence of HPV of high oncogenic risk in these women endocervicitis, vaginal warts and vulvovaginitis were diagnosed.
High oncogenic risk of HPV was noticed in all women with the established diagnosis of cervical cancer.

Journal of obstetrics and women's diseases. 2001;50(2):14-19
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Original Research

The influence of mother's diseases and complications of pregnancy on the development of allergic reactions in neonates and infants

Evsyukova I.I.


The article reviews the materials dealing with the role of mother’s diseases, complications of pregnancy, and unfavorable environmental factors in formation of immunological reactions in neonates. The author emphasizes the role of disturbances of afterbirth state in case of gestosis, infections, mother’s smoking.
Peculiarities of immune mechanisms of neonates compared with those of elder children determine their reactivity and early development of allergic diseases.

Journal of obstetrics and women's diseases. 2001;50(2):20-26
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Contemporary view of m ultifetal pregnancy management at early stages

Koroteev A.L., Mikhailov A., Konstantinova N.N.


The present review gives a wide coverage on the problems of etiology and management of multifetal pregnancy during first trimester. Particular attention is paid to multifetal pregnancy reduction, which aims at improving prenatal outcomes in case of multiple gestation. On the basis of literary data the issues of the operation are generalized and analyzed, clinical aspects are considered and potential directions of future investigations are determined.

Journal of obstetrics and women's diseases. 2001;50(2):27-32
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Reproductive health of the fem ale athletes

Sazykina E.I., Ailamazyan E.K., Niauri D..., Evdokimova T.A.


Physicians, including gynecologists, who deal with sportswomen, do not always consider in their everyday practice the changes in female reproductive function caused by severe physical exercises. A t the same time, this problem is so important, that in 1992 American College of Sports Medicine introduced the term “Female Athlete Triad”, describing interrelationships between eating disorders, amenorrhea and osteoporosis. It is well known that menarche in athletes occur later than in sedentary women, 5-50% o f athletes are amenorrheic, anovulation takes place in 16%, luteal phase deficiency -in 4 2 % of female athletes. The high rate of ovarian insufficiency among athletes and theirprobable unfavorable sequelae require the problems in treatment andprevention of reproductive disorders in female athletes to be solved. This must be done within the modem standards of reproductive medicine.

Journal of obstetrics and women's diseases. 2001;50(2):33-37
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Early mechanical stimulation of the nipple-areola receptors complex promotes the mammary milk ejection function in women delivered by cesarean section

Alekseev N.P., Omelyanjuk E.V., Talalajeva N.E.


Mechanical stimulation and milk ejection from mammary gland in women delivered by caesarean section since 1 day post partum by the breastpump with vacuum and compression stimuli promotes milk ejection function. On the third day postpartum the stimulated mothers had significantly more milk flow reflex peaks than those who were not subjected to stimulation during the 10 min milk ejection session.

Journal of obstetrics and women's diseases. 2001;50(2):38-41
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Hypothalamic regulation of reproduction under the chronic influence of toluene and melatonin

Kerkeshko G.O.


Experiments on chronic administration of melatonin with and without chronic inhalation of toluene dosed at both maximal permissible concentration (50 mg/ml) and limited chronical range (500 mg/m3) have been carried out on female rats to discover their effects on biogenic amines system in hypothalamic structures related to gonadoliberin synthesis and secretion - preoptic area (PA) and median eminence (ME). Contents of biogenic amines in ME and especially in PA have been shown to have circadian variations with maximum in the morning in control group of rats.
The chronic effect of synchronizing agent melatonin (administered dissolved in drinking water in concentration of 10 pg/m l, at night during 2 months) on neotransmitters and their circadian variations in both hypothalamic structures proved surprisingly to be much alike the effect of toluene. Both chemicals cause the disturbances of normal circadian variations o f norepinephrine, dopamine and serotonine in PA and dopamine in ME. The simultaneous administration of toluene and melatonin showed likewise no synchronizing ability of the latter under the conditions described.

Journal of obstetrics and women's diseases. 2001;50(2):42-46
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Peculiarities of reproductive function in women who have contact with lead in working conditions of plants

Patutin V.N., Kostyuchek D.F.


The article analyzes the course of gestation, delivery and the state of neonates of 483 women who suffer from the influence of different lead concentrations in working conditions of plants. The main complications of pregnancy were gestosis, anemia, and the threat of miscarriage. Women who have contact with the lead should be included into the risk group during the gestation.

Journal of obstetrics and women's diseases. 2001;50(2):47-49
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Fetal growth retardation in multiple pregnancy: anthropometrical and haemodynamic criteria of early antenatal diagnosis

Prokhorova V.S., Pavlova, N.G., Kozlov V.V., Novikova A.V.


Ultrasound investigation o f feta l biometry and haemodynamic indices in fetoplacental system during pregnancy since 14 weeks was carried out in 53 women havingtwins as a result o f spontaneous pregnancy or using o f assisted reproductive technology methods. The frequency and possible reasons oflU G R development in multiple pregnancy were analyzed. To predict the possibility o f IUG R in II and III trimester o f multiple pregnancy the mathematic model was worked out based on the standard fetometric indices measuring at 14-16 weeks o f pregnancy.

Journal of obstetrics and women's diseases. 2001;50(2):50-54
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The phenomenon of reversible myometrial dysfunction and delayed rehabilitation of uterine contractive ability

Abramchenko V.V.


The author introduces the conception o f potentially reversible myometrial dysfunction with unaffected main physiological function o f myometrium («viability» o f myometrium). This dysfunction is connected with the disturbances o f uterine haemodynamics. The phenomenon o f reversible myometrial dysfunction reflects the process o f prolonged decreased contractile ability o f the uterus.
The therapy o f reversible myometrial dysfunction phenomenon should be directed to blood flow restoration under the conditions o f uterine hypoperfusion.
The special treatment is not required fo r myometrium with reserved main physiological functions (tonus, excitability) because restoration o f myometrial contractile ability improves spontaneously in case o f blood flow restoration.
With the aim o f prophylaxis o f myometrial dysfunction and delayed rehabilitation o f the uterine contractile function administration o f Ca antagonists, beta-adrenomymetics, antioxidants and preparations, which improve myometrial metabolic processes, is recommended before the expected delivery.

Journal of obstetrics and women's diseases. 2001;50(2):55-57
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Puerperal form ation of vaginal microbiocenosis using various eubiotic preparations

Martikainen Z.M., Derkach O.I., Golovacheva S.N., Zatsiorskaya S.L., Rybina E.V., Omeljaniuk E.V., Koroliuk A.M., Savitcheva A.M.


The results of determination of the efficiency of liquid eubiotic preparations, such as Lactobacterin, Bifidumbacterin, Bificol, Colibacterin applied for the normalization of genital microflora in women after labor are presented in the article. The use of a combined eubiotic preparation containing both lactobacilli and bifidobacterii may be recommended.

Journal of obstetrics and women's diseases. 2001;50(2):58-61
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Influence of the relative insulin deficiency of the mother on the functional state of the central nervous system of the fetus in the third trimester of pregnancy

Kovalchuk M.V.


85 women from the 28-th to the 40-th week of pregnancy were examined.
Nineteen women with impaired glucose tolerance in the third trimester of pregnancy formed the control group. Forty women had gestational diabetes and 26 insulin­ independent diabetes. The data reveal negative influence of relative insulin insufficiency in expectant mothers on formation of the central neural system of the fetus that is displayed in shortening or even absence of quiet state phase, prolongation of the intermediate state, decrease of motor-cardiac reflex. The intensity of these disturbances depends upon the diabetes type and the rate ofits compensation.

Journal of obstetrics and women's diseases. 2001;50(2):62-65
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Clinical-sonographical and dopplerometric criteria of determining the obstetrician's tactics in cases of the umbilical cord entanglement of the fetal body

Khamadyanov U.R., Ivakhah V.I.


The complex method of antenatal diagnostics of the cord entanglement round the body of the fetus is elaborated. It includes echography, color Doppler mapping, dopplerometry and actocardiography. On the basis of the data received the system of prognosing and estimating the severity of feta l hypoxia in the end of the third trimester pregnancy is suggested, that allows to choose the correct tactics of pregnancy and delivery management in different rates ofcord entanglement. The use o f this method made it possible to rise the effectiveness of antenatal diagnostics of this gestational complication from 23,5% to 79,4%, to decrease the frequency of postnatal asphyxia to 46,1% and, therefore, to avoid intra- and postnatal loss.

Journal of obstetrics and women's diseases. 2001;50(2):66-71
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Clinical aspects of morphological investigation of fetal thyroid glands

Khmelnitskii O.K., Ivanova A.J., Evsyukova I.I.


The investigation of 121 thyroid glands offetuses and neonates of mothers who live in Saint-Petersburg was carried out. The paper analyzes intra and postnatal fatal outcomes taking account оf gestational andpostnatal age. The role of thyroid gland’s adaptive function emaciation in thanatogenesis in case of asphyxia was demonstrated. On the basis of the study practical recommendations are suggested.

Journal of obstetrics and women's diseases. 2001;50(2):72-75
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Hydrolytic enzymes in therapy of gestosis

Gabelova K.A.


The clinical effectiveness o f complex enzymotherapy with preparation Vobenzim in treatment o f gestosis was studied in comparison with traditional therapy. The author analyzes the course оf gestation and delivery, and the state оf neonates in women with nephropathy o f I degree, who got common treatment (28 patients) and complex treatment including Vobenzim (17patients). Positive clinical effect o f complex enzymotherapy in case o f nephropathy is displayed in decreasing of edematic syndrome, eliminating or decreasing o f proteinuria, lowering o f blood pressure and impairment o f fetalhypoxia in labors. It goes along with the reduction o f immune complexes fixed in placenta.

Journal of obstetrics and women's diseases. 2001;50(2):76-79
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Fetal adrenal cortex function in pregnancy, complicated by maternal insulin-dependent diabetes mellitus

Shelaeva E.V., Mikhailov A.V., Borodina V.L., Oparina T.I.


Fetal adrenal cortex glucocorticoid andfetal hypophysial adrenocorticotropic function in normal pregnancy and pregnancy, complicated with maternal insulin­ dependent diabetes mellitus were examined in the present study. Statistically significant feta l hypercortisolemia was observed in pregnancies, complicated by insulin-dependent diabetes mellitus. Correlations between vascular complications o f maternal insulin-dependent diabetes mellitus and fetal cortisol andACTG levels were revealed during the investigation. Severe vascular lesions o f maternal diabetes have been associated with delayed feta l lung maturity. Fetal pulmonary maturity was significantly associated with fe ta l cortisol levels.

Journal of obstetrics and women's diseases. 2001;50(2):80-84
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Blood flow in the umbilical vein of the fetus in first half of pregnancy

Ailamazyan E.K., Polyanin A.A., Michailov A.V., Kogan I.J., Konstantinova N.N., Kozlov V.V.


The present investigation aims at studying the blood flow in the umbilical vein in the first half of normal pregnancy. It was shown that the establishing of hemocirculation passes through 4 periods: 8- 10th, 11-12th, 13-16th and after the 16th week of pregnancy. Besides that, statistically verified changes in maximum blood flow speed and index of pulsation in this vessel were revealed. Constant bloodstream spectrum reflects stability of oxygenic bloodsupply of the fetus.

Journal of obstetrics and women's diseases. 2001;50(2):85-89
pages 85-89 views

To the problem of pregnant women's cholestasis

Timofeeva T.V., Petrishchev N.N., Zainulina M.S., Mukhina I.N.


Liver disease andpregnancy usually aggravates each other. It’s rather difficult to differentiate pregnant women’s cholestasis from gestosis accompanied with chronic liver disease preceding pregnancy. 60 pregnant women were examined, the first group with cholestatic hepatosis, the second group with gestosis and liver disease. The practical aim o f the study was to choose righttactics o f pregnancy management, method and date o f confinement.
Pregnant women’s hepatosis turned out to be a complex concept: it may embrace different types o f pathological pregnancy under the single clinical diagnosis.

Journal of obstetrics and women's diseases. 2001;50(2):90-93
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The state of estrogen-dependent organs of women with surgical menopause and hormone replacement therapy

Serebrennikova K.G., Chumakova N.V., Konev М.V.


The research aims at studying the dynamics and character o f disorders in the target-organs and appraisingthe quality оf life in women with surgical menopause (SM ) on the background o f hormonal replacement therapy (HRT).
Application o f Femoston as the preferable preparation was determined by functional state оf estrogen-dependent organs (cardiovascular system, bone tissue, and mamma) and accompanying extragenital diseases.
Hormonal replacement therapy effectively reduces early climacterics disorders connected with menopause and promotes prophylaxis o f late complications o f menopause development (cardiovascular disease and osteoporosis). Femoston is the preparation o f choice fo r women with surgical menopause as it exerts minimum influence on the metabolism and doesn’t have anabolic or glucocorticoid effects.

Journal of obstetrics and women's diseases. 2001;50(2):94-99
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Cranial bones mark hormonal disturbances in patients with gonadal dysgenesis

Uvarova E.V., Volobujev A.I., Rudneva T.V., Rudnev S.V.


The data on roentgenologic peculiarities o f cranial bones including sella turcica in patients with gonadal dysgenesis are drawn in the paper. Besides that, the authors analyze the changes in size and configuration o f sella turcica under hormonal replacement therapy.

Journal of obstetrics and women's diseases. 2001;50(2):100-102
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Information message about the scientific-practical conference "New approaches to screening, diagnosis and treatment of ovarian tumors", Veliky Novgorod, May 17-18, 2001


From 17 to 18 May 2001, a scientific and practical conference "New approaches to screening, diagnosis and treatment of ovarian tumors" was held at the Novgorod Regional Oncological Dispensary.
The conference was organized with the joint participation of the Ministry of Health of the Russian Federation, Research Institute of Oncology named after V.I. prof. N.N. Petrov, Novgorod Regional Oncological Dispensary, Moscow Oncological Institute. P.A. Herzen, Research Institute of Obstetrics and Gynecology, Russian Academy of Medical Sciences. BEFORE. Ott.
For the first time in our country, a representative forum of specialists in the field of oncology, obstetrics and gynecology, endovideosurgery was held. More than 200 leading experts from St. Petersburg, Moscow, Veliky Novgorod, Rostov-on-Don, Minsk, Kiev took part in the conference. Following the results of the conference, the following resolution was adopted

Journal of obstetrics and women's diseases. 2001;50(2):103-103
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Some troubles and complications while using transfusion therapy

Vetrov V.V.


In the review the literary data on some troubles and complications o f blood transfusion are drawn.

Journal of obstetrics and women's diseases. 2001;50(2):104-109
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The treatment of pseudoerosion of the cervix uteri (Second report)

Kupert A.F.


On the basis оf the present researchpathogenetically substantiated conception o f cervical pseudoerosion treatment is elaborated. The paper describes the schemes o f treating uncomplicated pseudoerosion with Tri-regol and complicated one - with complex method, which includes application o f the native prolonged enzyme Profezime. Relapses and complications o f the disease under different methods o f treatment are studied in comparison. The method i f applied promotes the efficiency o f the treatment, makes it possible to decrease the rate o f complications and the recurrence frequency.

Journal of obstetrics and women's diseases. 2001;50(2):110-112
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