Vol 68, No 1 (2019)

Structural transformation of the endometrium during the menstrual cycle is a genetically determined process and is provided by complex molecular-biological interactions aimed at the onset and development of pregnancy. Sex steroid hormones play a key role in endometrial morphogenesis, which mediate or directly affect angiogenesis and immunogenesis.

Hypothesis/aims of study. Hormonal changes in a woman’s body impacts many systems and organs, therefore the spectrum of menopausal symptoms varies greatly. The current analysis was undertaken to investigate the relationship between the severity of the menopausal syndrome, depending on the personality traits and typological characteristics of women, and the frequency of emotional and affective disorders.

Study design, materials and methods. A study was conducted based on V.A. Almazov National Medical Research Center in which 50 women aged from 44 to 56 years participated, the average age of menopause being 50.4 ± 0.5 years and the average duration of estrogen deficiency 3.3 ± 0.3 years. The study used: 1) Cooperman Index as modified by E.V. Uvarova; 2) Zung Self-Rating Depression Scale; 3) Zung Self-Rating Anxiety Scale; and 4) “The Level of Social Frustration” questionnaire.

Results. Climacteric complaints are most characteristic of married women with a high educational level and a prosperous financial state. When entering menopause (in women with preserved menstrual cycle), endocrine and metabolic complaints came to the fore, weight fluctuations prevailing among all the symptoms. 72% of women reported a weight increase of three and more kilograms, Dyshormonal hyperplasia of the mammary glands and pain in muscles and joints occurred equally often (62%). At the same time, for postmenopausal women, the most characteristic complaints were of the genitourinary syndrome. The neurovegetative syndrome was expressed in all women, regardless of the duration of the estrogen-deficient state and the severity of the menopausal syndrome. When studying the severity of the psycho-emotional syndrome, it was found that patients most often complained of fatigue and decreased performance (99%). Manifestations of depression were not characteristic of women with milder symptoms of menopause, while a high level of anxiety was typical for women with a moderate degree of the climacteric syndrome. For 12% of those women, the depth of depressive disorders corresponded to mild severity. Besides, a high level of anxiety and an average level of depressive manifestations were characteristic of women with severe severity of the menopausal syndrome.

Conclusion. The data obtained show that the more severe the manifestations of the menopausal syndrome, the higher the severity of affective disorders.

Neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) levels in umbilical cord blood in full-term newborns with asymmetrical intrauterine growth retardation resulted from chronic placental insufficiency have been studied. Not only a 2.0–2.5-fold increase in the blood NSE level, but also a reduction in BDNF levels were observed, indicating brain damage combined with the lack of adequate compensatory capabilities. With an increase in the duration of intrauterine fetal development under conditions of chronic hypoxia, the degree of damage to neuronal structures increases. This article discusses the mechanisms of the revealed changes, as well as the diagnostic and prognostic significance of the use of biochemical markers.

Hypothesis/aims of study. Endometriosis is the main cause of infertility and social maladjustment in women, caused by the presence of inflammatory endometriotic implants outside the uterus. A number of chemokines, including interferons, compromise the immune response on the development of endometriosis raising the interest to the investigation of interferons in this context. Based on this, the purpose of this review was to study the role of interferons in the pathogenesis of external genital endometriosis and to assess the possibility of their application within comprehensive pathogenesis-based therapy.

Study design, materials and methods: literature data of national and international investigations for the period from 1996 to 2018; systematic analysis and evaluation of the literary data.

Conclusion. Type I interferons seem to be promising agents for understanding of the pathogenesis of endometriosis, and can be considered as targeted therapy for this disease. The mechanisms of their functions require a further study. Type II interferons may be used in the future as diagnostic markers for the assessment of the disease severity.

The article presents current literature on proteomic profiling and the role of proteomic technologies in the diagnosis of various obstetric and gynecological diseases. Proteomic analysis is a promising research method, as it allows for a comprehensive study of protein expression and its regulation in the biological systems, which opens up new opportunities for a more in-depth and detailed study of the etiology and pathogenesis, as well as timely diagnosis and treatment of obstetric and gynecological pathology.

This article is devoted to the treatment of uterine fibroid in patients planning pregnancy. The role of uterine fibroid as a cause of infertility, indications for performing myomectomy in patients with infertility, features of pregnancy and childbirth in pregnant women with uterine fibroid are discussed. Attention is also paid to the technical issues of performing myomectomy and the use of pre-surgery drugs that reduce the size of the uterine fibroid nodes. In addition, the article highlights the features of pregnancy and labor in the presence of a scar on the uterus after myomectomy, after uterine artery embolization and focused ultrasound ablation of the nodes.