Vol 51, No 3 (2002)

Betadine can be recommended for the treatment of vaginitis in pregnant women in order to improve the microbiocenosis before childbirth and for the prevention of postpartum infectious complications.

In this article, the basic existent methodics of myometrium biopsy for adenometriosis identification are considered. The authors say their opinion with regard to these methodic defects and advantages. Perspective directions for biopsy technology improvement are discussed.

The problem of endometriosis has been widely discussed over the past century in the medical literature, at conferences, congresses and symposia. She still worries doctors and patients. It should be noted that there has been a noticeable increase in interest in endometriosis not only among obstetricians-gynecologists, but also among surgeons, oncologists, urologists, radiologists, pediatricians and other doctors.

The role of laparoscopy in diagnostics of the outside genital endometriosis at infertility is indicated on the base of 548 clinical observations. It was made an assessment concerning dependences on clinical appearing the outside genital endometriosis in respect of the grade of process extension. The article contains the algorithm of female patients with infertility treatment on suspicion to the outside genital endometriosis.

It were studied some aspects, detecting the role of genetic factors in the genesis of hyperplasic illnesses of reproductive system organs (uterus myoma, inside endometriosis, ovaries endometriosis) on the base of complex investigation of 145 patients with such diseases.

Obtained data allow consider the absence in allele PL-All of women the gene GPIII is a risk factor in origin and development of hyperplasic illnesses in reproductive system.

In this article, the analysis of laparoscopic curing 64 patients with external endometriosis is presented. For the assessment of internal genitalia state in the late after-operational period in 41 female patients one performed second-look laparoscopy when that disease recidivating has been revealed in 36% observations. It was marked that the anti-recidive therapy in the after-operational period allows decrease the recidivating quantity from 46.8% (intervention only) upto 25% (combined cure).

The authors elaborated and formulated indications for performing second- look laparoscopy in female patients with endometriosis.

Endometnosis is not a disease of individual organs and systems, but of the whole organism, the treatment of which requires complex action. The effect of all drugs used to treat endometriosis is to suppress growth factors and the development of pathological implants at different levels of the system - from the hypothalamus to target organs. The problem of restoring reproductive function in patients with endometriosis-associated infertility remains very urgent at the present time. This is due to the prevalence of this pathological process - in the structure of female infertility, endometriosis is about 50%.

Methodics of the operational treatment of patients with widespread endometriosis forms were elaborated. The surgical conception for curing patients with widespread forms of genital endometriosis consist in need to detect and then to remove radically all endometriosis seats, thoroughly perform stages and sequences of surgical techniques on genital and next organs, also to correct intra- operational operations and to make their prophylactics.

The article presents the results of the investigation of cytokine production by endometrioid heterotopias in organotypic cultivation in comparison with the cell secretory activity of peritoneal fluid and endometrial tissue in women with external genital endometriosis.

The obtained results show systemic changes of regulation of cytokine production in the process of external genital endometriosis development.

Peritoneal endometriosis and infertility in most of patients (in 80%) are pathogenetically conjugated. Both peritoneal endometriosis and infertility are based in ovarian failure. These women have a low endometrial receptivity for blastocyst“s implantation (retardation development of glands, vessels, and stroma; changes in the microrelief of the epithelium). Even at the beginning of the menstruation patients with peritoneal endometriosis and infertility have cells with a great adhesive and proliferative potential in the endometrium. This kind of cells have an ability for long autonomous existence. Ovarian failure in these women is a promotion factor for development of the «retrograde menstruation». In these conditions the endometrial cells with adhesive potential are frequently bringing in the abdominal cavity. Active endometrium heterotopias support the ovarian failure and create conditions for «uterine infertility» (implantation disorders).

The data about efficiency of various types of trans-dermal HST of aged and after-surgical deficit estrogen syndrome are given in this article. The advantage of intra-dermal way estradiol input at necessity of the longtime use HST and especially in persons with accompanying external genital pathology. The comparing specifications of ointment trans-dermal form input (Divigel) and put in plaster (Estraderm), modes and indications for their use are presented.

The results of clinical femoston use, which is the choose preparation in the late climacteric disorder therapy are presented in this article. This preparation occupies according to extent of gestagen charge the intermediate site between cycle-progine (divine) and climin. The increased gestagenic component of femoston provides this preparation advantage in therapy of early POES symptoms, especially in patients being subjected to the intervention in connection with hyperplasic processes in genitalia.

Thirty females suffering from sterility were examined. Fertility disorders were accompanied by hyperandrogeny. Hormones FSH, LH, testosterone and progesterone in blood were studied. Besides, an activity of enzymes GPO, GTD, GST, G-6-PD in washed erythrocytes and tissue homogenate of ovary was investigated. Findings obtained demonstrate noticeable disorders in glutathione detoxication processes in females with infertility and they are related to hormones’ level, in particular androgens. An increase of GPO in females with hyperandrogeny showed deepupdates in metabolism processes of steroid hormones in ovary. It manifests beforehand for development of follicle that is predictive sign of unovulation in the beginning of menstrual cycle.

On the basis of the Department of Operative Gynecology of the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences from 1992 to 2002. examination, treatment and monitoring of 1234 patients with endometriosis was carried out, which served as material for the study of morphofunctional, endocrine, immune, biochemical, genetic aspects of endometriosis. Our clinical and scientific experience allowed us to determine our own positions and a circle of discussion questions corresponding to the main directions of further research on this problem, which are: is endometriosis a disease or not ?; development mechanisms; classification; diagnostic criteria; features of histological characteristics; endometriosis and genetics; endometriosis and the immune system; endometriosis and adenomyosis; retrocervical endometriosis; endometriosis and pelvic pain; endometriosis and adhesions; endometriosis and infertility; traditional and non-traditional approaches to diagnosis and treatment.

Comparative results of abscessed keen purulent processes treatment of the small pelvis in women by means of longtime proteolysis with immobilizing ferment imozimaza and sanative processingthe abscess cavity with antiseptic chlorhexidine bigluconate. The advantages of imozimaza use are marked. These kinds of treatment were performed by laparoscopic way; its efficiency was assessed according to trans-draining abscessoscopy.

Ivan Pavlovich Lazarevich, a professor at Kharkov University, was a prominent representative of the distinctive Russian obstetric school, a brilliant teacher and a progressive public figure. The heyday of the scientific work of I.P. Lazarevich falls on the 70s - 80s of the 19th century. His works contributed to the development and progress of domestic obstetrics and gynecology. It is generally accepted that in the second half of the 19th century in Russia there were two outstanding obstetricians: A. Ya. Krassovsky and I. P. Lazarevich, who created independent schools. What do we know about his activities, what is still of value in his writings?

In 2003 St. Petersburg celebrates its 300th anniversary. The International Environmental Forum is included in the official calendar of events to celebrate this significant event.