Vol 64, No 6 (2015)

To date, pelvic endometriosis is one of the most widespread gynecological disorders in the women of reproductive age. It has been known that pelvic endometriosis is a progressive disease occuring on the background of chronic estrogen-dependent inflammatory response in the lesser pelvis. One of the key element of the pathogenesis of endometriosis is a disfunction of the immune system at both the local and systemic levels. In recent years an upward trend in the number of infiltrative forms has been noted. In relation to the pronounced adhesive process as well as presence of the endometrioid infiltration the risk of complications during surgery increases. Furthermore, aforementioned conditions can lead to subsequent longer period of rehabilitation and additional surgical interventions. Thereby, the markers for non-invasive diagnosis acquire the leading role in the diagnosis of pelvic endometriosis, analysis of the levels of which may yield a relatively complete picture of the extent of the lesions and adress the issue of the need for surgical treatment (especially repeated) timely. The most pertinent is the assessment of the levels of pro- and anti-inflammatory cytokines, the activity of natural killer cells as well as the factors of adhesion and proliferation. The article discusses the diagnostic value of interleukins IL6, IL2, IL33, IL22, transforming growth factor (TGF), vascular endothelial growth factor (VEGF), chemokine MCP1 as well as others for the non-invasive diagnosis of the disease. On the basis of the data presented it may be concluded that the comprehensive assessment of the several cytokines is required for more accurate and timely diagnosis and determining the severity of pelvic endometriosis.

Background. Actuality of the conducted research is concerned with the need of research of the development risk factors of placental insufficiency (PI), considering the regional specialties of Tajikistan for the development of preventive activities, aimed to decrease frequency of PI, which leads to negative perinatal outcomes. Methods. There was conducted a retrospective analysis of 2907 labor histories of pregnant women to assess the social and medical development risk are being labor migrants. The most efficient development risk factors of PI are the following social and medical factors - multireproduction in anamnesis, in the age of 18, labor migration of husbands during the current pregnancy, preeclampsiya, polyhydroamnios, iodine dericency disorders and anemia. Conclusion. Factors for PI. Risk assessment was carried out by calculating the relative risks (RR) and confidence intervals (CI), indicating contingency of the magnitude of the RR in the range calculated interval.

The contents of neuron-specific enolase (NSE) and brain-derived neurotrophic factor (BDNF) was studied in the umbilical blood serum of healthy full-term newborns elective planned caesarean section and spontaneous delivery. The study has established that their levels in umbilical blood serum after elective planned caesarean section surgery are lover, than after spontaneous delivery. The authors of the article discuss the causes and possible effects of low levels of BDNF of newborns extrected elective planned caesarean section surgery before 39 weeks.

Clinical and morphological analysis of 91 cases of adenomyosis was performed. In our study deep adenomyosis was found to be prevailing. The incidence of stages III and IV of the process was 49,5 % (45 cases) and 14,3 % (13 cases), respectively. Stages I and II were detected in 4,3 % and 31,9 % of cases, respectively. The most common morphofunctional type in adenomyosis stages I-II was stationary form (36,4 %). Expression of vimentin - a marker of mesenchymal differentiation, detected in the epithelial component of endometrioid heterotopias and eutopic endometrium in adenomyosis, suggests pathogenetic role of epithelial and mesenchymal transformation in the development and progression of this disease. Positive expression of vascular endothelial growth factor in the basal layer of the endometrium and endometrial heterotopias confirms the importance and unidirectionality of changes in the foci of adenomyosis and in the basal layer of the endometrium in patients with internal genital endometriosis. Expression of Ki-67, bcl-2, prevalence of proliferative changes in glands of the epithelium and cytogenic stroma cells in heterotopias, high frequency of endometrial hyperplasia demonstrate the importance of proliferation activity and low level of apoptosis in endometrial heterotopias and endometrium in adenomyosis.

Recent findings in stem cell biology and cell engineering cannot be left without physicians’ attention. Endometrium as actively regenerating tissue represents also a source of endometrial stem cells. Endometrial stem cells have specific properties that distinguish them from other somatic stem cells. Endometrial stem cells have already shown their therapeutic efficiency and safety in a number of experimental and clinical trials. The biological basis of endometrial stem cells therapeutic potential and recent data on their use in clinical practice are discussed in the article.

Urinary tract infections (UTIs) are among the most common infectious diseases in women, and are the most frequent cause of infectious complications of pregnancy. This paper reviews current scientific and methodical literature on UTIs in obstetrics and gynecology. Aspects of clinical importance of UTIs (epidemiology, clinical manifestations, complications), their etiology, antimicrobial resistance of UTIs agents were discussed, and current recommendations on diagnostics and treatment of UTIs were summarized. Special attention was paid to UTIs in pregnancy.

The article presents the substantiation of expediency of granting of paid services to the patients of maternity services in accordance with the applicable legal acts that are particularly relevant in the present time of reform of national health care. The necessity of expanding the range of medical and support services, enjoying considerable demand, the important role of the marketing Department in optimizing strategies for providing health and social care, the decision of problems of creation of market new services to better meet the needs of pregnant and parturient women. Special attention is paid to the analysis of the results of operations of the Department of paid medical services, studied the motivation of women using the services provided.