Vol 61, No 3 (2012)

Articles
Problems of high-tech health care in federal institutions of the North-West Federal District, and St. Petersburg
Aylamazyan E.K., Zainulina M.S., Eremeeva D.R.
Abstract
Currently available to the population of high-tech medical care is not provided in full, which is one of the reasons for high levels of preventable death and disability in the population, and causes the legitimate grievances of people. In this regard, the priority national project "Health" the development of high-tech medical aid was allocated in a separate direction. In just five years as part of the priority national project "Health" this kind of assistance could receive more than one million patients. The results achieved have had a positive impact on health and demographic indicators in the Russian Federation
Journal of obstetrics and women's diseases. 2012;61(3):3-6
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Catastrophic Antiphospholipid Syndrome in Obstetric Practice
Makatsariya A.D., Bitsadze V.O., Khizroeva D.K.
Abstract
Catastrophic antiphospholipid syndrome (CAPS) is an uncommon, often fatal, form of the antiphospholipid syndrome that results in a widespread coagulopathy and affects predominantly small vessels supplying organs with the development of multiorgan failure against a background of high level of antiphospholipid antibodies. Thrombotic microvasculopathy is the basis of multiorgan failure and clinically manifests with CNS disturbances, adrenal failure, and the development of acute respiratory distress syndrome. CAPS is a life-threatening condition and requires urgent measures. Optimal treatment for CAPS is not developed yet. CAPS present a multidisciplinary problem. Authors demonstrate 17 cases of CAPS in patients which were managed from 2001 to 2012 years. Molecular mechanisms of pathogenesis and different obstetric and non-obstetric manifestations of CAPS are discussed in the article. There is the description of first case of management of pregnancy and labor of patient with CAPS in her history. The methods of CAPS prevention are described
Journal of obstetrics and women's diseases. 2012;61(3):7-21
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The endometrial implant’s reaction after the experimental mechanical tissue damage
Aylamazyan E.K., Gzgzyan A.M., Savinov P.A., Niauri D.A., Dzhemlikhanova L.K., Usoltceva E.O., Rad’kova J.V., Savel’ev A.V.
Abstract
Number of experiments for creation of chronic inflammatory response in the implant of autologous endometrium was performing. It turns out, that results, which were morphologically closest to chronic endometritis were obtained after mechanical tissue damage. Endometrial implants with such morphological restructuring might be using for pathogenesis study and for searching of new ways for a treatment of chronic endometritis
Journal of obstetrics and women's diseases. 2012;61(3):22-30
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Optimization techniques of hysterectomy and hysterectomy cervical stump by laparoscopic access
Visotsky M.M., Sazonova E.O., Domokeeva U.U.
Abstract
The authors analyze the nature and frequency of complications of hysterectomy and extirpation of the cervical stump by laparoscopic access in order to optimize techniques for surgery and improve their security. Standardization of the basic steps of laparoscopic surgery reduces the incidence of complications and improve the effectiveness of surgical treatment
Journal of obstetrics and women's diseases. 2012;61(3):31-34
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Ovaries colony-stimulating factors secretionin patients with infertility in IVF cycles
Kogan I.Y., Motovilova N.O., Totolian A.A.
Abstract
This article arrange the data about G-CSF and GМ-CSF content in oocytes follicular liquid infertility patients in IVF and these factors influence for IVF performance
Journal of obstetrics and women's diseases. 2012;61(3):35-40
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The ways of prophylaxis complications of early after operating period during andoscopic operations in connectionwith women,s sterility
Neymark M.I., Haustova S.A., Marcova E.A., Kuzhnetsova T.A.
Abstract
The aim of the research is the reason of application of ketorol as an analgesic component of general anesthesia during endoscopic gynaecological surgery with regard to sterility. A retrospective analysis of medical history of 200 females at the age of 19–35 who underwent a surgery for sterility has been carried out. All the patients were divided into 4 groups (50 objects in each). In the first group ketamine anesthesia was applied, in the second group — dormicum-based ataralgesia, in the third group — neuroleptanalgesia, and in the fourth group – anesthesia by propofol together with preemptive analgesia by ketorol were applied. It was anesthesia risk of the first degree according to ASA classification. All the variants of anesthesia provided its adequacy. Among the patients from groups 1–3 28–40 % needed extra postsurgical analgesia, 8–12 % needed a postsurgical artificial lung ventilation period, 6–8 % had PONV. Аnalgesia by ketorol in complex with propofol provided adequate anesthesia during laparoscopic gynaecological operations with regard to sterility, it wasn’t followed by postoperative nausea or vomiting, it didn’t require extended postsurgical artificial lung ventilation or extra anesthetization
Journal of obstetrics and women's diseases. 2012;61(3):41-45
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Experience of application of fluorescence methods for diagnostics of cervical intraepithelial neoplasias of different degrees
Shuliko L.A., Dyachuk A.V., Drygin A.N.
Abstract
The study includes 132 patients with precancerous cervical disease. Along with a standard practice check-up, all the women have undergone photodynamic diagnostic procedure using photosensitizer Photoditazin. The method allows to increase the visibility of the transformation zone of cervical tissue. The results and advantages of the fluorescent cervicoscopy are compared to the traditional methods, with minimal complications and side effects. Diagnoctic effect of the Photoditazin does not depend on the route of administration
Journal of obstetrics and women's diseases. 2012;61(3):47-52
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Practical and fundamental results of prenatal diagnostics in North-West Russia
Baranov V.S., Aylamazyan E.K.
Abstract
Organized 25th years ago laboratory was of the first relevant prenatal center in Russia. Originally elaborated methods for chromosome preparations from different embryonic tissue samples (chorionic & placenta villi, umbilical cord blood) and for molecular genetic analysis of common and most sever inherited disorders such as cystic fibrosis, haemophilia A and B, Deuchenn myodistrophy, spinal muscular atrophy, phenylketonuria, adreno-genital syndrome, myotonic dystrophy, Huntington chorea, Martin-Bell syndrome etc. as well as automatic programs for biochemical screening of embryonic marker proteins substantiated efficient prenatal diagnosis service launched in Saint-Petersburg and in North-West region of Russia. Altogether 14 000 invasive prenatal diagnostics were carried out so far with total 1029 fetuses with chromosomal (734) or genetic (295) disorders identified. Implication of QF-PCR method for detection of common chromosomal disorders, one-stop clinic algorithm, preimplantation diagnosis as well as non-invasive diagnostics of fetal sex and Rh-factor are currently at use in our prenatal diagnostics service. Array — CGH for submicroscopic rearrangements, non-invasive diagnostics of chromosomal and genetic disorders as well as implication of Genetic Form of Female Reproductive Health, elaborated in our laboratory for prevention of fetal and pregnancy complications are our close future
Journal of obstetrics and women's diseases. 2012;61(3):54-60
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The renin-angiotensin system gene polymorphism and the vascular disease risk in pregnant women with pre-eclampsia
Glotov A.S., Vashukova E.S., Kanaeva M.D., Bicmullina D.R., Kurilov R.V., Zainulina M.S., Ivashchenko T.E., Baranov V.S.
Abstract
In the present work the renin-angiotensin system gene polymorphisms REN (I9–83G > A), AGT (M235T), AGTR1 (1166A > C), AGTR2 (3123C > A), BKR2 (–58T > C) in pregnant women with preeclampsia, women with physiological pregnancy, healthy donors have been studied using allele-specific hybridization on the biochip. There were no statistically significant differences in genotypes distribution and allele frequencies of any genes between pre-eclampsia patients and women with normal pregnancy or donors (p > 0.05). However, it was shown that C/C genotype for the AGTR2 gene is a risk factor for preeclampsia in women with chronic pyelonephritis. In addition, accuracy of predicting the risk of pre-eclampsia based on the pyelonephritis availability and genotypes for genes AGTR1, AGTR2, BKR2 was 69 % using a logistic regression method
Journal of obstetrics and women's diseases. 2012;61(3):61-68
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Early prenatal biochemical screening, present state, current problems and options
Kascheeva T.K., Nikolaeva Y.A., Baranov V.S., Karpov K.R., Vokhmyanina N.V., Romanenko O.P.
Abstract
In Saint-Petersburg total biochemical screening for Down’s syndrome in 2-d trimester have been established since 1997. Also all pregnant women underwent ultrasound examinations for screening for chromosomal abnormalities. Results of introduction of 1-st trimester combined screening since 2006, its influence for detection rate, achievements and problems were discussed in our paper
Journal of obstetrics and women's diseases. 2012;61(3):69-74
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Current state of preimplantation genetic diagnosis
Loginova J.A., Chiryaeva O.G.
Abstract
Preimplantation genetic diagnosis was first reported 20 years ago. During this time the range of possibilities of assisted reproductive technology has expanded and the possibility of molecular diagnosis of single cells greatly increased. Preimplantation diagnosis has evolved from an experimental procedure to an efficient form of Prenatal Diagnosis, which broadened the indications for Prenatal Diagnosis and can be applied at the earliest stage. This review shows the current state of preimplantation genetic diagnosis and describes its capabilities
Journal of obstetrics and women's diseases. 2012;61(3):75-82
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Noninvasive prenatal diagnostic. Problems, approaches and perspectives
Malysheva O.V., Baranov V.S.
Abstract
In the review possibilities of noninvasive prenatal diagnostics on DNA of a fetus circulating in peripheral blood of pregnant woman are discussed. Characteristics cell-free (cf) DNA of plasma and fetus cfDNA (cffNA), circulating in a parent blood-groove are resulted. Methodical approaches to extraction and analysis cffDNA are considered. Possibilities and restrictions of application of a method for fetal sexing and fetal Rhesus factor detection, and also prospect of noninvasive diagnostics of the most frequent aneuploidies are discussed
Journal of obstetrics and women's diseases. 2012;61(3):83-93
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THE ROLE OF BIOCHEMICAL MATERNAL SERUM MARKERS IN PROGNOSIS OF OBSTETRICAL COMPLICATIONS
Nikolaeva Y.A., Kascheeva T.K., Baranov V.S.
Abstract
The article represents the combined results of 1-st and 2-nd trimester maternal serum biochemical markers investigation. Associations of biochemical screening results and the main obstetric complications are studied. Authors critically analyzed the using of biochemical markers of the fetal chromosomal abnormalities as indicators for formation of high risk groups of obstetric complications
Journal of obstetrics and women's diseases. 2012;61(3):94-103
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CYP21A2 gene mutationsin the women with recurrent miscarriage
Osinovskaya N.S., Sultanov I.Y., Ivaschenko T.E., Baranov V.S.
Abstract
Miscarriage is one of the major problems of modern reproduction. Total frequency of micarrieges is estimated as 15–27 % of total pregnancies. Recurrent Miscarriage (RM) (three or more spontaneous abortions) is responsible for almost 20 % of total miscarrieges. The population frequency of RM fluctuates from 2 % to 5 %. One of the important causes of abortion in the first trimester are hormonal disturbances in the mother, including adrenal hyperandrogenism, which results in congenital adrenal hyperplasia (CAH). In 95 % of cases, this pathology is caused by mutations in the 21-hydroxylase gene (CYP21A2), encoding for 21-hydroxylase. A non-classical form of CAH is the leading factor in 30 % of RM in women with hyperandrogenia. The aim of this study was to investigate the role of the most common mutations in the CYP21A2 gene in women with RM for more accurate diagnosis of this pathology. The level of 17-OH-progesterone was measured in women with RM and with mutations in the gene CYP21A2. The frequency of mutations in the CYP21A2 gene in RM women was significantly higher than in the group of women who don’t have these mutations (14.4 ± 3.3 % and 2 ± 1.4 %, respectively, p <0,05 df = 1). According to the odds ratio the risk of RM in CYP21A2 mutations carriers is 8 times higher than in the women without these mutations (OR = 8.4 (1.9–37.6)). The level of 17-OH-progesterone is not associated with mutations in CYP21A2 gene in the women with RM
Journal of obstetrics and women's diseases. 2012;61(3):104-108
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Features of the gene polymorphism of estrogen and progesterone receptors in women with uterine leiomyoma
Osinovskaya N.S., Ivaschenko T.E., Dzhemlikhanova L.K., Baranov V.S., Tkachenko A.N., Sultanov I.Y.
Abstract
Uterine Leiomyoma (Leiomyoma) (LM) — benign and most common (incidence 20–45 %) hormone-dependent tumors of female genital organs. Comparative analysis of frequencies of polymorphic variants of genes of estrogen receptor (ERα) and progesterone receptor (PGR) in patients with LM and the population samples was conducted in this work. Also it was investigated their association with clinical manifestation of hyperplastic processes of the female reproductive system. It was founded that the development of LM are not associated with individual polymorphic variants of genes of estrogen receptor and progesterone receptor. This fact does not include their participation in the development of proliferative and hyperplastic processes of the myometrium
Journal of obstetrics and women's diseases. 2012;61(3):109-114
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Peculiarity of mitotic activity of chorionic villi cytotrofoblast on the first trimester of pregnancy
Trofimova I.L., Evdokimenko E.V., Kuznetzova T.V.
Abstract
Mitotic activity of chorionic villi cytotrophoblast of the 1st trimester at normal and missed pregnancy was studied. Proliferative activity of cytotrophoblast from missed abortions was somewhat increased in vitro. Application of a semidirect method of chromosomal preparation from chorionic villi is more efficient and provides better resolution for cytogenetic diagnostics of missed abortion. Unusual peculiarity in organization and replication of pericentric heterochromatin regions of chromosomes 1, 9 and 16 was detected
Journal of obstetrics and women's diseases. 2012;61(3):115-122
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Morphological, biochemical and physiological selection of spermatozoa for ICSI
Fedorova I.D., Shilnikova E.M., Gzgzyan A.M.
Abstract
Principles of individual sperm selection for fertilization were described, literary dates of correlation between morphological, functional and biochemical parameters of human spermatozoa and structural and functional peculiarities of its genome organization were presented
Journal of obstetrics and women's diseases. 2012;61(3):123-131
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A comparative cytogenetic analysis of miscarriages following natural conception and assisted reproductive technologies
Chiryaeva O.G., Pendina A.A., Tikhonov A.V., Efimova O.A., Petrova L.I., Dudkina V.S., Sadik N.A., Kuznetzova T.V., Baranov V.S., Galembo I.A.
Abstract
The present paper summarizes results of cytogenetic study of 679 chorionic samples from miscarriages following natural conception and assisted reproductive technologies. Frequency and spectrum of karyotype pathology and its correlation with maternal age and term of gestation are analyzed. The results are compared and discussed with relevant other studies
Journal of obstetrics and women's diseases. 2012;61(3):132-140
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Analysis of sperm DNA fragmentationin infertility patients
Shilnikova E.M., Fedorova I.D., Gzgzyan A.M.
Abstract
Using Terminal Deoxynucleotidyl Transferase dUTP Nick End Labelling (TUNEL) technique the assessment of the frequency of the spermatozoa with fragmented DNA in the ejaculate from sperm donors and men with infertility was analyzed. The DNA fragmentation rate was higher in spermatozoa of carriers of a chromosomal structural abnormality compared with the control group. There was no correlation between the sperm DNA fragmentation rate and the parameters of semen analysis. The direct linear correlation between the frequency of the spermatozoa with fragmented DNA and vacuole sperm head was found. The DNA fragmentation rate was not correlated to the frequency of the spermatozoa with bulb, amorphous heads or spermatozoa with abnormal acrosome
Journal of obstetrics and women's diseases. 2012;61(3):141-147
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Towards gene therapy of endometriosis
Shubina A.N., Kiselev A.V., Egorova A.A., Baranov V.S.
Abstract
Review of current state and future prospects of endometriosis gene therapy is presented. Main molecular pathogenetic mechanisms and possible ways of their correction by means of genetic constructs are described. Examples of anti-estrogenic, anti-angiogenic, suicidal gene therapy approaches are presented. Advantages of siRNA and microRNA mediated regulation of endometrial genes expression are discussed
Journal of obstetrics and women's diseases. 2012;61(3):148-158
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