Vol 64, No 4 (2015)

Articles
The optimization of reparative processes after cesarean section (clinical-experimental research)
Aylamazyan E.K., Andreeva V.Y., Kuzminykh T.U., Sokolov D.I., Selkov S.A., Tral´ T.G., Tolibova G.H., Yakovleva A.A.

Abstract

Development and introduction of materials influenced on reparation process in a myometrium is actual direction of modern obstetrics in connection with the increase of cesarean section rate. One of such preparation is «Collost», it stimulates the processes of neoangio- and myogenesis and excludes the disorderly growth of scars tissue. Aim: To study the influence of bioplastic material «Collost» on the reparation process in myometrium after cesarean section. Objectives: to estimate the morpho-functional state of scar on uterus after cesarean sections depending on implantation of collagen membrane. Material and methods: There were included 13 female rabbits in experimental part of the study. In clinical part of the study there were included 20 pregnant woman with intraoperative application of «Collost» (main group), 30 pregnant woman without «Collost» implantation (comparison group) and 10 pregnant with vaginal delivery (control group). Results: histological, immunohistological and immunological findings of postoperative uterine scars of female rabbits showed significant differences of expressions of miosin, vascular endothelial growth factor and collagen I type. The myometrium was significantly thicker in the area of uterine scar in main group (with collagen membrane implantation) than in comparison group. Conclusions: bioplastic material «Collost» leads to full formation of muscular wall and vascular ture in the area of postoperative uterine scar.
Journal of obstetrics and women's diseases. 2015;64(4):4-12
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To the matter about operational treatment of benign neoplasms of ovaries during pregnancy
Barinov S.V., Lazareva O.V., Korneev B.V., Shkabarnya L.L., Grebenuk M.V., Roshchupkina E.A., Belokopytova A.V., Sorokin P.I.

Abstract

Purposes and tasks. To improve the result of treatment of benign ovarian tumor during pregnancy using information of a complex comparative analysis of surgical interventions performed by laparoscopy and laparotomy. Materials and methods. We examined 69 pregnant women who undergoing treatment of benign ovarian tumors by laparoscopic and laparotomic surgery. The analysis of clinical data, postoperative pain, postoperative complications and statistic assess were performed. Results. The average age of pregnant women in laparoscopy group was 26 ± 0,5 years and 29 ± 0,7 years in laparotomy group. The main indications for intervention were threatened miscarriage and ovarian torsion. All women received therapy for saving pregnancy in postoperative period. The laparoscopy was associated with a significant reduction in time compared to laparotomy (54,7 ± 2,6 and 64,5 ± 2,5 - appropriate, р = 0,003). The blood loss was 46,67 ± 29,9 ml in laparoscopy and 108,7 ± 58,6 ml in laparotomy group (р < 0,001). Postoperative pain was less in women who undergoing laparoscopic surgery. 29 (76.3 %) women had vaginal delivery in laparoscopy group, 22(70.9 %) - in laparotomy group. Conclusion. In pregnant women undergoing surgery for benign ovarian tumours, laparoscopy was associated with less operation time, postoperative pain, blood loss compared with laparotomic surgery. The optimal time for intervention is before 24 week of pregnancy.
Journal of obstetrics and women's diseases. 2015;64(4):13-20
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The results of the use of new criteria for the diagnosis and treatment of gestational diabetes mellitus
Borovik N.V., Tiselko A.V., Arzhanova O.N., Kapustin R.V., Potin V.V., Androsova N.E.

Abstract

Taking into consideration the high rate of perinatal complications in women with gestational diabetes, we need to develop the efficient algorithm for the diagnosis and treatment of this disease. We have analyzed the specificity of the course and pregnancy outcomes for 500 women who used the new clinical guidelines of diagnosis and treatment of gestational diabetes mellitus (GDM). The control group includes 100 women with GDM (criteria of V. G. Baranov, 1977). Analysis of the results is necessary to optimize the tactics of the treatment for this group of patients.
Journal of obstetrics and women's diseases. 2015;64(4):21-25
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Breech presentation as a genetic-psychological phenomenon
Brekhman G.I.

Abstract

The author considers breech presentation(BP) of an unborn child as a genetic-psychological phenomenon. BP can be result: a) of genetic anomalies touching fetal organs and systems, b) of maternal sharp emotional stress capable to overcome the genetic program of the child at absence of anomalies in it, c) in a case, when the emotional stress promotes realization of genetic predisposition to BP. The preventive maintenance BP consists in avoid of sharp stressful situations by the pregnant women. If the BP as a result of emotional stress is occurred - specific psychotherapy can appear rather effective.
Journal of obstetrics and women's diseases. 2015;64(4):26-31
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Laparoscopic ureteroneocystostomy in iatrogenic injuries of ureter after gynecoloc operations
Guliev B.G.

Abstract

The Objective. To evaluate outcomes of laparoscopic ureteroneocystostomy in patients with iatrogenic strictures of distal part of ureter, caused by gynecologic interventions. Materials and methods. From 2010 to 2014, 10 female patients with iatrogenic injuries of distal part of ureter underwent laparoscopic ureteroneocystostomy. Seven had previous open or laparoscopic hysterectomy, two - removal of endometrioid nodes and 1 - ovarial resection. Surgery was performed using transperitoneal approach with inserting of 4 trocars. Ureter was mobilized and transected above the stricture with subsequent extravesical implantation to the bladder. Results. We had no conversion cases and in all patients ureteroneocystostomy didn’t fail. In 3 cases intervention included ureteroneocystostomy with psoas-hitch, in 2 - Boari flap and in 5 - direct anastomosis of ureter with bladder. Average surgery time was 140 min (ranged between 110 and 215min), average blood loss was estimated as 160 ml (125-240 ml). Cystoureteral reflux was noted in 2 patients. Conclusion. Laparoscopic ureteroneocystostomy is less invasive and reliable surgical treatment modality efficient in cases of iatrogenic ureteral injuries due to gynecological interventions.
Journal of obstetrics and women's diseases. 2015;64(4):32-38
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Clinical course of childbirth and pathomorphological features of the myometrium in discoordinated labor activity
Kozonov G.R., Kuz´minykh T.U., Tolibova G.H., Tral´ T.G.

Abstract

Features of the labor of patients with discoordinated and physiological labor activity are analysed and studied. Clinical features are compared with the data received at morphological research of myometrium. It is shown that the structural organization of myometrium the lower segment of the uterus during labor characterized by common morphological patterns both in norm and pathology. A clear sign of a discoordinated labor activity is basal hypertonicity.
Journal of obstetrics and women's diseases. 2015;64(4):39-48
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Elective caesarean section and the risk of respiratory distress in preterm infants
Maslyanyuk N.A., Evsyukova I.I.

Abstract

The incidence of respiratory disorders and their risk factors in 349 full-term newborns, extracted by planned cesarean section at various stages of pregnancy. It was found that respiratory disorders (transient tachypnea) observed in 16.5 % of newborns, gestational age of 37 weeks, 4.6% - 38 weeks and 1.6% - ≥39 weeks. The risk of respiratory disorders in children whose mothers have a combination of chronic functional systems (gastrointestinal tract, cardiovascular system, respiratory system) and pregnancy complication preeclampsia mild.
Journal of obstetrics and women's diseases. 2015;64(4):49-56
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Coprostasia and pregnancy (clinical observation)
Mikhaylin E.S., Ivanova L.A., Savitskiy A.G., Minina A.G., Zhibura L.P., Sleptsova D.S., Kas’yanova D.S.

Abstract

The article presents the case of the formation of a giant fecal stone in 34 weeks of pregnancy, which demanded the differential diagnosis of tumors originating from the pelvis. The patient was conducted multistage finger fragmentation of the fecal stone, alternating with the enema. The patient was discharge home with progressing pregnancy.
Journal of obstetrics and women's diseases. 2015;64(4):57-61
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Role of kidney function change in development of low urinary tract during pregnancy
Osipova N.A., Niauri D.A., Gzgzyan A.M., Ziyatdinova G.M.

Abstract

Background. During pregnancy many women suffer from lower urinary tract symptoms (LUTS). The etiology and pathogenesis of urinary loss during pregnancy remain still unclear. Normal pregnancy is known to be associated with functional changes in various physiological systems. Changes of kidney function, on the one hand, are the part of physiological changes during pregnancy, on the other hand - can promote urinary incontinence. Purposes. The purpose of this study was to estimate the role of kidney function changes in development of LUTS during pregnancy. Materials and methods. A total of 270 women with the physiological course of pregnancy (83 in the I first trimest, 78 - in the II trimester and 109 - in the III trimester) aged from 18 till 44 years, with no LUTS before the current pregnancy were examined. Blood serum and urine osmolality was determined with MT-4 milliosmometer (“Burevestnik”, Russia); the concentration of serum and urine creatinine, sodium, potassium and magnesium ions were determined with automatic Abbott Architect 8000 analyzer. LUTS are revealed in 81.9 ± 2.3% of pregnant women. Urinary loss in pregnant women is combined with increase in diuresis. Grater diuresis is due to increasing osmotically active substances excreation, precisioly sodium. Rise in nocturnal diuresis does not lead to inversion of circadian rhythm of urine production. A direct correlation has been found between urine output and glomerular filtration rate.
Journal of obstetrics and women's diseases. 2015;64(4):62-68
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Endometrial dysfunction: an algorithm for histological and immunohistochemical studies
Tolibova G.H., Tral´ T.G., Kleshchov M.A., Kvetnoy I.M., Aylamazyan E.K.

Abstract

It is advisable to conduct a comprehensive study of the morphological assessment of the expression of endometrial estrogen and progesterone receptors, inflammatory markers in the second phase of the menstrual cycle in patients with impaired reproductive function (infertility, miscarriage, failed IVF attempts). The optimal period for investigation of endometrial dysfunction via endometrial biopsy is the second phase of the cycle (the period of “implantation window”). Creating a diagnostic algorithm, histological and immunohistochemical studies in the endometrial dysfunction will allow to justify the optimal choice of therapy.
Journal of obstetrics and women's diseases. 2015;64(4):69-77
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Clinical and bacteriological feature postpartum purulent-inflammatory diseases
Korobkov N.A.

Abstract

This review summarizes the literature of recent years and the results of their research on the etiology of postpartum infection at this stage. Highlighted aspects of complications of pregnancy, childbirth and the postpartum period due to the action of opportunistic organisms and obligate pathogens.
Journal of obstetrics and women's diseases. 2015;64(4):78-84
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Pathogenesis of Trousseau’s syndrome
Vorobev A.V., Makatsaria A.D., Chabrov A.M., Savchenko A.A.

Abstract

Malignancies and thrombosis have common pathogenetic features that was shown by A. Trousseau in 1865. There is now no doubt that the cancer patients occur much more frequently thromboembolism, and migratory venous thrombosis is a manifestation of paraneoplastic syndrome in cancer patients. In general, any manifestation of thrombohemorrhagic complications in cancer patients called Trousseau’s syndrome. While thrombotic complications such as venous thromboembolism are most frequent in cancer patients, may also experience severe bleeding symptoms due to systemic coagulopathies, including disseminated intravascular coagulation, haemolytic thrombotic microangiopathy, and hyperfibrinolysis. The basis of the pathophysiology of Trousseau’s syndrome, except the classic triad of Virchow, is overproduction of tissue factor (TF), the main initiator of extrinsic coagulation pathway. Thus a significant release of microparticles from tumor cells bearing tissue factor is critical not only for the formation of a blood clot, but the growth and progression of tumors. Tumor cells activate the coagulation cascade or fibrinolysis system, providing conditions for its further spread, stimulation of angiogenesis, increased vascular permeability, which in turn promotes metastasis.
Journal of obstetrics and women's diseases. 2015;64(4):85-94
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Experience of use of the combined medication Vagiferon® for topical application in the treatment of bacterial vaginosis
Metelkina S.A., Averina D.M., Kuptsova L.V., Guryev D.L.

Abstract

Objective: To assess the efficacy of the combined medication Vagiferon® for topical application, containing antimicrobial, antifungal, antiviral and immunomodulatory components in the treatment of non-pregnant women with bacterial vaginosis. Study design: This paper presents the experience of use of the medication Vagiferon® in the treatment of 29 non-pregnant women aged 22-45 with bacterial vaginosis. The medication Vagiferon® was administered vaginally as 1 suppository 1 time per day at bedtime for 10 days. The patients underwent a standard pelvic exam, which included the study of their vaginal microflora content by the microscopic method (Gram staining). The study was undertaken before therapy, in 14 days after its start, and in three months after its completion. Results: According to our observations of patients with bacterial vaginosis, in 93,1 percent of cases complete clinical remission was noted. Microbiological efficacy of the treatment was 86,2 percent. The signs of disease recurrence as well as any side effects or rejection of the use of the medication were not registered. Conclusion: Based on the combination of high efficacy and safety of Vagiferon®, this medicine can be recommended for wide use in the gynaecological practice.
Journal of obstetrics and women's diseases. 2015;64(4):95-98
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Case report of the successful uterine fibroid embolization via transradial approach
Khayrutdinov E.R., Vorontsov I.M., Tsygankova O.Y., Kravchenko E.N., Ignatiev Y.T., Vorontsova M.S.

Abstract

We represent the first clinical case of the successful uterine fibroid embolization via transradial approach. The technical aspects and the main advantages of this type of the procedure compared to the uterine fibroid embolization via transfemoral approach are described.
Journal of obstetrics and women's diseases. 2015;64(4):99-102
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The Scientific School of academician G. E. Rein(to the 160th anniversary of birth)
Kira E.F., Kozovenko M.N., Kazieva Z.M.

Abstract

For the first time in the history of obstetrics and gynecology gives information about the structure and activities of the scientific school of academician G. E. Rein, implemented in the first half of the 20th century not only in Russian Empire, the RSFSR and the USSR, but at the medical faculty of Sofia University (Bulgaria). The best of the students, who founded their own schools in the USSR are identified. They included professors, headed the departments of obstetrics and gynecology in Russian, Soviet and Bulgarian universities (medical schools): G. G. Bruno, V. L. Lozinsky, A. P. Neelov, G. F. Pisemsky, A. A. Redlikh, K. K. Skrobansky, I. V. Sudakov, A. P. Yakhontov, also D. Stamatov and B. Trichkov. Under the guidance of academician G. E. Rein they not only acquired practical skills or solved scientific problem of his time, but continued to develop their own original ideas and research directions suggested by his teacher, sharing and improving the proposals in obstetrics and gynecology. During the Civil War (1918-1920) scientific school of academician G. E. Rein suffered significant losses: in Kiev was killed professor G. G. Bruno (1919), Petrograd professor A. A. Redlikh (1919), the founder of the school, emigrated from Russia... To this day, its activity has not been the object of research, although prominent members of this school have achieved outstanding success, becoming one of the first academicians of the USSR Academy of Medical Sciences in specialty “Obstetrics and Gynecology” (K. K. Skrobansky) or the founder of the national Obstetrics and Gynecology in Bulgaria (D. Stamatov). Hence, further research in the field of formation and activity of the scientific school of academician G. E. Rein is an actual scientific task.
Journal of obstetrics and women's diseases. 2015;64(4):103-110
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