Vol 64, No 3 (2015)

Articles
Perinatal loss: psychological aspects, the specificity of mourning, forms of psychological help
Dobryakov I.V., Blokh M.E., Faerberg L.M.
Abstract
The problem of perinatal losses in terms of features and dynamics of the stages of grief experiences, the main forms of psychological assistance in situations of perinatal loss.
Journal of obstetrics and women's diseases. 2015;64(3):4-10
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Оpioid analgesics effects mechanisms on the particular reaction of endogenous opioid system of the body and the regulation of uterine activity during the nociceptive response in the experiment on rats
Kiselev A.G., Zaitsev A.A.
Abstract
This article presents the results of experimental investigation of opioid (opiate analgesics) influence on the nociceptive response of rat’s circulatory dynamics, breath and skeletal muscles tonus. The article demonstrates influence of opiate analgesics on intact and pregnant rat’s amplitude and frequency of uterine activity. The results of investigation of drug-induced effect of opiate analgesics in case of pregnant and in case of act of delivery model pain reaction were also described in this article.
Journal of obstetrics and women's diseases. 2015;64(3):11-17
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Role of metformin pregravid preparation patients with prediabetes impaired glucose toletance
Komarov E.K., Pluzhnikova T.A.
Abstract
Tasks of investigation were concluded the characterization of insulin resistence (IR) and hormonal features in patients with prediabetes and influence of diet or metformin on the course of pregnancy and perinatal complications. There were examined 61 womans. The OGTT, definition of insulin levels in plasma and index IR were performed in all patiens. OGTT and index IR were normal in 14 womans (control group I). OGTT was normal but index IR was impared in 33 womans (group IR - II). From this group 22 womans were treated with diet (II A group) and 11 womans treated with metformin (IIB group). OGTT and index IR were abnormal in 14 womans (impared OGTT - III group), they were treated with metformin. Dose of metformin was 1500 mg/d, threatment was continueted for 3-4 manths. Conclusion: Used indexes IR basal and two hour after glucose load were significant in definition of normal and decreased insulin sensitivity (IR). Presence of IR is accompanied by high level of free testosterone in blood without impared secretion of ovarian and suprarenal androgens. There was impared sensitivity of endometrium of secretory stage. The frequency of obstetric and perinatal complications in patients receiving diet not differ from patients treated with metformin. There was only a tendercy to low frequency of threatening miscarriages befor 12 weeks of gestations in paitiens receiving metformin. Development of GDM was observed in 13,1 % of patiens only with presence of IR. The use of metformin in pregravidal stage preserved the development of macrosomia in offsprings of patients with prediabetes.
Journal of obstetrics and women's diseases. 2015;64(3):18-25
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Synthesis of the matrix metalloproteinases and its inhibitors by peripheral blood phagocytes of women with hypertansion disorders
Panova I.A., Malyshkina A.I., Kudryashova A.V., Khlipunova D.A., Rockatanskaya E.A., Sytova L.A.
Abstract
Development of the hypertension disorders in pregnant women is associated with the increase of the functional activity of innate immunity cells. RT-PCR assessment of the MMP-2 and TIMP-1 synthesis by peripheral blood phagocytes showed the significant elevation of the MMP-9 mRNA expression by neutrophils in women with chronic arterial hypertension (CAH) and TIMP-1 and TIMP-2 mRNA expression by monocytes in women with CAH and preeclampsia.
Journal of obstetrics and women's diseases. 2015;64(3):26-32
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Clinicoanamnestic risk factors of mixed urinary incontinence in women
Rusina E.I.
Abstract
Diagnosis of mixed urinary incontinence (UI) in women is a challenge for physicians in clini-cal practice. Objectives: The determination risk factors of mixed urinary incontinence in women Materials and Methods: The subjects were 633 women 22-88 years old with complaints of mixed (n = 356) and stress (n = 277) UI. Data of the history and clinical examination data were analyzed. For statistical data analysis t-test, chi-square (χ2) test was used. Results: Significant differences in the number of pregnancies and births, body mass index (BMI), the number of patients with concomitant pelvic organ prolapse (POP) between the groups of women with complaints of mixed stress and UI were not found. Clinicoanamnestic risk factors mixed UI in women compared with stress UI are older than 56 years (OR 1,67; 95 % CI1,2-2,36; p < 0,05), postmenopause ( OR 1,59; 95 % CI1,15-2,22; p < 0,05), medical comorbidity: hypertension (OR 1,99; 95 % CI1,43-2,76; p < 0,001), chronic cystitis (OR 1,85; 95 % CI1,1-3,1; p < 0,05), diabetes mellitus (OR 1,86; 95 % CI1,1-3,23; p < 0,05), ischemic heart disease (OR 2,13; 95 % CI1,5-3,0; p < 0,001), vascular lesions of the brain (OR 3,62; 95 % CI1,7-7,6; p < 0,001), neurological diseases (Parkinson’s, multiple sclerosis, myasthenia gravis) (OR 7,1; 95 % CI1,0-56,8; p < 0,05), surgery for pelvic organ prolapse (OR 3,12; 95 % CI1,25-7, 77; p < 0,05) and urinary incontinence history (OR 6,05; 95 % CI1,37-26,7; p < 0,01). Conclusions: Medical comorbidity, previous surgery on the POP and UI, age older than 56 years are clinicoanamnestic risk factors mixed UI.
Journal of obstetrics and women's diseases. 2015;64(3):33-39
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Comparative evaluation progestin preparations of the effect graviditas transformation of endometrial undeveloping pregnancy of the I trimester
Tolibova G.K., Tral T.G., Petrosyan M.A., Polyakova V.O., Kvetnoy I.M.
Abstract
The results of histological and immunohistochemical studies of the endometrium graviditas during non-developing pregnancy of the first trimester showed that the defective decidualization of the endometrium and poorly formed tangles of the spiral arteries are significantly more common in case of treatment with micronized progesterone than in case of treatment with dydrogesterone. The irregular distribution and increased expression of estrogen receptors in the glands and stroma of the endometrium are indicators of pathology of the first phase of the menstrual cycle.
Journal of obstetrics and women's diseases. 2015;64(3):40-46
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Diagnostic value of p16inkα/Ki-67 Dual-stained cytology in HPV-associated cervical diseases
Khachaturyan A.R., Orekhova E.K., Tolibova G.K., Tral T.G.
Abstract
Human papillomavirus (HPV) infection is currently considered the most common of sexually transmitted infections. However, only 8-20 % of cases of infection with human papillomavirus oncogenic risk has the potential to transform to a neoplastic process. Detection of productive forms of HPV infection is the basis of early diagnosis of precancerous lesions. In order to clarify the severity of neoplasia and choose a sufficient way of treatment we investigated the diagnostic value of p16inkα/Ki-67 Dual-stained cytology method for assessing the presence and degree of expression of p16inkα protein and Ki-67, biomarkers of virus-induced proliferation, the sensitivity and positive predictive value of co-expression degree of which can increase the diagnostic value of cervical cytology.
Journal of obstetrics and women's diseases. 2015;64(3):47-51
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Anti-D-immunoprophylaxis
Pavlova N.G.
Abstract
The working out and introducing of anti-D-immunoprofylaxis program in the time of pregnancy in foreign countries and Russia are discussed, effectiveness of its long-term using on the base of the federal programs in developed European countries and America is analyzed; necessity and economic advisability of its introducing on the base of the federal and municipal programs in Russia from the evidence-based medicine point of view are considered, indications and arguable points of the program are discussed.
Journal of obstetrics and women's diseases. 2015;64(3):52-57
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Identification of gestosis (preeclampsia) risk and evaluation of efficiency of its prevention by means of noninvasive measurement of endothelial function
Mozgovaya E.V., Postnikova T.B., Arzhanova O.N., Repinskaya E.A., Serdyukov S.V., Vinokurova N.V.
Abstract
Research included 64 pregnants in the I trimester with adverse anamnesis and/or clinical risk factors of preeclampsia and with revealed endothelial dysfunction by means of the device EndoPat-2000, on the basis of the reactive hyperemia index (RHI) less than 1.67, which is automatically measured by the device. Before detection of endothelial dysfunction all pregnants received basic prevention of preeclampsia with preparations of multivitamins, magnesium and progesterone. At identification of decrease in RHI to 1.3 preparation Norvesol containing omega-3 polyunsaturated fat acids (1 group, n = 32) was added. And at RHI value less than 1,3 a preparation of Angiofllux - capsular sulodexide, containing fraction of heparin 7000 Da was added. At pregnants accepting Norvesol, RHI grew in the II trimester to 1.85 ± 0.28 (р > 0.05), and in the III trimester to 1.95 ± 0.19 (р < 0,05 in comparison with the first research). At pregnants accepting Angioflux in the II trimester RHI increased to 1.77 ± 0.25 (р < 0.05) and in III to 1.88 ± 0.20 (р ˂ 0.01 in comparison with the first research). No significant changes of indicators of system of hemostasis in dynamics were revealed in both groups. At all examined patients the delivery occurred at the full-term pregnancy. Frequency of preeclampsia development was low (21.9 and 37.5 % respectively in 1 and 2 groups), and except 1 case of middle severity in 1 group, preeclampsia didn’t exceed mild degree and didn’t influence a way of delivery and perinatal indicators. Thus, the method of functional endothelial state assessment by means of the device EndoPat-2000, allowed to specify risk degree of preeclampsia and to control efficiency of preventive therapy. At moderate violations of endothelial functional state Norvesol’s application led to correction of endothelial dysfunction and achievement of favorable outcomes of pregnancy and delivery for mother and fetus. At the cases with expressed endothelial dysfunction addition of Angioflux (sulodexide) promoted considerable improvement of endothelial function that allowed to avoid development of middle and severe preeclampsia even at pregnants with the highest risk of its development.
Journal of obstetrics and women's diseases. 2015;64(3):58-68
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Early embryonic losses at HLA compatibility in married couples
Agnaeva A.O., Bespalova O.N.
Abstract
Despite achievements in area of reproductive medicine, recurrent pregnancy loss (RPL) remains the most frequent complication of pregnancy. While the majority of spontaneous abortions (50-75 %) are sporadic and don’t repeat, 2-5 % of couples face problem of repeated pregnancy losses. There is a set of various reasons of such situation. The immunological reasons occupy one of the leading places. Role of HLA system in reproductive failure and methods of their correction are studied since the beginning of the 1960th. A large number of works is devoted to this subject. However still there is a controversial issue: “does the immunization (active or passive) increase the frequency of pregnancy approach and childbirth in women with RPL and repeated implantation losses in ART cycles?”
Journal of obstetrics and women's diseases. 2015;64(3):69-80
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The role of regulatory molecules in the pathogenesis of disorders of reproductive function in patients with pelvic endometriosis
Yarmolinskaya M.I., Denisova V.M.
Abstract
There is a literature review about the influence of regulatory molecules on reproductive functions and also on duration and outcomes of pregnancies in patients with genital endometriosis in this article. Pathogenetic mechanisms which leads to complications during pregnancy are described in the article.
Journal of obstetrics and women's diseases. 2015;64(3):81-91
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