Vol 67, No 4 (2018)

Articles
Lower urinary tract dysfunction in women with pelvic organ prolapse: diagnostic problems
Rusina E.I.
Abstract

Lower urinary tract dysfunction (LUTD) is often the main reason for patients with pelvic organ prolapse (POP) to see a doctor. LUTD can be caused by a variety of pathophysiological reasons that are underestimated in preoperative examination and are not taken into account when planning treatment. Application of examination algorithms using modern urodynamic methods in patients with LUTD and POP can lead to an improvement in the functional results of treatment.

Journal of obstetrics and women's diseases. 2018;67(4):4-12
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Role of pregravid diet and metformin in the prophylaxis of gestational diabetes and its complications
Komarov E.K., Pluzhnicova T.A., Nicologorskaya E.V., Alabieva E.A.
Abstract

The aim of this study was to improve the method for diagnosing insulin resistance (IR) and to assess the effect of pregravid diet alone or dietary supplementation in combination with metformin on the development of gestational diabetes mellitus (GDM) and its complications in patients with pre-diabetes. At the first stage of the study, glucose level was determined in the capillary blood of 61 women and, in the second stage, in the venous blood plasma of 60 individuals. The 75 g oral glucose tolerance test was performed in all patients. Plasma insulin level and IR index were determined basal (HOMA-IR) and two hours after the glucose load. The presence of IR was found in 68 women. All of them were treated with a diet, with 34 patients additionally treated with metformin at a dose of 1500 mg per day. The duration of therapy was 3–6 months.

It has been shown that the evaluation of IR index two hours after the glucose load significantly (p < 0.05) increases the diagnosis of the IR status, as in 56.5% of women with IR, the fasting IR (HOMA-IR) values were normal. The use of metformin combined with diet therapy in patients with IR, with easily assimilated carbohydrates excluded at the pregravid stage, is accompanied by a more significant loss of body weight with the achievement of a normal body mass index for pregnancy, when compared to diet therapy alone. In patients with IR after pregravid treatment with diet or diet with metformin, the frequency of obstetric complications, as well as of gestational diabetes mellitus, is comparable with that in normal women. In addition, such pregravid treatment protects patiens with IR from superfluous weight gain and fetal macrosomia.

Journal of obstetrics and women's diseases. 2018;67(4):13-18
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Prevalence and biochemical markers of postpartum depression
Reznik V.A., Kozyrko E.V., Ryazanova O.V., Aleksandrovich Y.S., Rukhliada N.N., Tapilskaya N.I.
Abstract

Postpartum depression (PPD) is a significant mental health and social problem. A prospective cohort single-center study was conducted in Saint Petersburg, Russia from March 2015 to October 2016 to assess the prevalence of PPD and possible serological markers associated with PPD. After exclusion of patients with a corresponding premorbid background and/or significant risk factors, prevalence rates were 9.6% on days P2 to P5. When comparing biochemical markers in patients with PPD (n = 37) and in healthy individuals (n = 72), a significant increase in the level of thyroid-stimulating hormone (3.36 ± 0.52 vs 1.98 ± 0.71 μIU/ml, p < 0.05), an increase in the level of marinobufagenin (0.928 ± 0.156 vs 0.462 ± 0.111 nM, p < 0.05), and a decrease in the activity of red-blood-cell Na+/K+-ATPase (1.68 ± 0.192 vs 2.39 ± 0.19 μM fn/ml/h, p < 0.03) were found.

Journal of obstetrics and women's diseases. 2018;67(4):19-29
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Dopplerometric renal blood flow assessment in pregnant women with pyelonephritis
Khudovekova A.M., Nagorneva S.V., Prokhorova V.S., Mozgovaya E.V.
Abstract

This article presents the results of searching for specific ultrasound criteria for diagnosis of pyelonephritis in pregnancy. The data obtained confirm low specificity of echographic criteria and show the possibilities of Doppler using in the diagnosis of pyelonephritis.

Journal of obstetrics and women's diseases. 2018;67(4):30-33
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Emergency contraception among doctors and people without higher medical degree
Aganezov S.S., Morotskaya A.V., Aganezova N.V.
Abstract

Background. In Russia, adherence to planned highly effective methods of contraception is still at a low level; therefore, emergency contraception (EC) can be the option for protection against unplanned pregnancy.

Study design, materials and methods. The current analysis was undertaken to determine the frequency of EC use among women with and without higher medical degree (MD) and to find out the level of awareness about EC among women and men of the same categories. In order to this, the method of anonymous voluntary questioning was used. The questionnaire included items about the theoretical aspects of EC (filled in by both men and women) and data on the gynecological history and experience of EC application (filled in by women only).

Results. Half of respondents (49.8%) had experience of EC use, 80% of them used EC only if unprotected sexual intercourse occurred in the middle of the menstrual cycle. Every forth (24.6%, n = 29) obstetrician-gynecologist mistakenly believes that repeated application of EC can lead to infertility. 45% (n = 64) participants without MD and 42% (n = 61) of doctors of other specialties have the same opinion. The use of EC is considered justified by 86% (n = 227) of doctors and 65% (n = 94) participants without MD. Every tenth responder, irrespective of education level, mistakenly believes in not using EC due to severe negative side effects.

Conclusion. Almost a third (30%) of obstetrician-gynecologists do not possess complete information on EC. Awareness about EC is extremely inadequate and comparable to that of doctors of other specialties and people without MD.

Journal of obstetrics and women's diseases. 2018;67(4):34-39
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Сystatin C potential use in the diagnosis of various diseases
Glavnova O.B., Yarmolinskaya M.I., Suslova S.V., Borovik N.V.
Abstract

The prevalence of chronic kidney disease (CKD) is increasing worldwide. It leads to a high risk of cardiovascular disease, early disability and mortality. The severity of CKD is determined by the level of reduction in glomerular filtration rate (GFR). Modern formulas for calculating GFR based on serum creatinine give errors. The search for new informative methods of evaluation of GFR is an urgent task. A number of studies have shown the effectiveness of cystatin C determination in serum as a more sensitive indicator of GFR decline for early detection of renal pathology. The timely detection of diabetic nephropathy and the administration of nephroprotective and cardioprotective therapy is an important task in reducing the risk of cardiovascular disease and mortality. This review article discusses the possibility of using cystatin C as a marker of renal function decline, diagnosis of cardiovascular disease, and the development of preeclampsia.

Journal of obstetrics and women's diseases. 2018;67(4):40-47
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Challenges and prospects of preterm birth prediction in multiple pregnancies
Kosyakova O.V., Bespalova O.N.
Abstract

For today, twins make up about 1.5% of the population of our planet. It is more than one hundred million people, which in number corresponds to the population of two Frances. The number of twins born relative to the total number of newborns in different countries and on different continents is different, but the overall trend is that it continues to grow. In recent years, the percentage of multiple pregnancy has increased almost 2.5 times, which is associated with the widespread use of assisted reproductive technologies.

At the same time, pregnancy in multiple births is an extremely important problem in modern obstetrics, as it is accompanied by a high level of complications for both the mother and the fetuses. Multiple pregnancy contributes significantly to the formation of adverse perinatal outcomes, which is primarily due to the high rate of preterm birth. Premature twins are at high risk of neurological and neuropsychiatric disorders, respiratory distress, endocrine and metabolic disorders, which subsequently become the cause of disability and social maladaptation of children.

In this regard, the reduction in the number of premature births is today a priority task, the solution of which is possible only through timely and correct forecasting. The multifactority of pathogenic mechanisms determines the necessity of diagnostic search strategies that can identify markers of various pathogenetic ways of preterm birth.

Journal of obstetrics and women's diseases. 2018;67(4):48-59
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Endometrium and polycystic ovary syndrome
Yakovlev P.P., Kogan I.Y.
Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Patients with PCOS present with several endometrial abnormalities possibly explaining some of the adverse endometrium-related outcomes in these women. PCOS is inconsistently associated adverse pregnancy outcomes and an increased risk of endometrial cancer. The purpose of this review is to systematize the available data on endometrial dysfunction associated with PCOS.

Journal of obstetrics and women's diseases. 2018;67(4):60-66
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