卷 69, 编号 4 (2020)

Hypothesis/aims of study. To date, intranatal injuries of the genital tract and their adverse effects on the woman’s body remain one of the most important issues in obstetrics and gynecology. Despite the improved management of childbirth, the frequency of the birth canal tissue injuries has no tendency to decrease and amounts to 10.2–39.0%. The aim of this study was to assess the possibility for predicting intranatal perineal injuries.

Study design, materials and methods. The study included a prospective analysis of 90 cases of labor through the natural birth canal based on data obtained from Ufa and Chita perinatal centers in the years 2017–2019. To determine the elasticity of perineal tissues, a perineoelastomer has been developed, which allows expressing the elasticity of the vulvar ring tissues by a special conditional coefficient. Data was processed using the IBM SPSS Statistics V25.0 software package.

Results. Based on the assessment of the obtained data, a probability coefficient of perineal injuries was developed. Its calculation is based on a nonlinear regression analysis and is expressed by the formula: T = (100 ∙ CFH) / (PAA ∙ FBD ∙ ε ∙ π), where CFH is the circumference of the fetal head at the level of visual tubercles (mm), PAA is the pubic arch angle (degrees), FBD is the distance from the front to the back of the adhesion of the vulvar ring (cm), ε is the coefficient of elastic deformation of the perineum. When the coefficient T is more than 1, perineal rupture in labor is predicted.

Conclusion. In the development of obstetric injuries of the perineum, a major role is played by the ratio of the circumference of the fetal head and the maximum perimeter of the extension of a vulvar ring, which, together with the value of the pubic arch angle and the coefficient of elastic deformation of the perineum, may be a criterion in favor of performing surgical protection of the perineum in case of a threatening rupture.

现实性。违反胎盘血管化过程会导致胎盘供血不足，继而减少孕产妇循环和胎儿循环之间营养物质和微量元素的交换。由于胎盘过多，胎盘功能失调。慢性胎儿缺氧导致胎儿发育迟缓。

目的是研究具有不同人体类型的女性胎盘功能不全的发生率，并开发出预测这种病理风险的模型。

研究材料和方法。对390名妇女进行了调查，其中110名为大型体，173名为中体，107名为微
型体。根据R.N. Dorokhov进行全身检查在怀孕初期的妇女中，怀孕期最长可达9-10天。在妊娠12-13和22-23周时的血清中。用ELISA法分光光度法测定胎盘功能不全标志物（VEGf，PlGf，IL-6和endocan-1）。

研究成果。胎盘功能不全在代表宏观和微观人体类型的女性中显着高于中，人体类型的女性（p < 0.05）。12-13周时患有胎盘功能不全的孕妇比尚无病理的女性水平(р < 0,05)血清VEGf和PlGf水平较低，血清endocan-1和IL-6的水平高于未发生病理的患者（p < 0.05）。多元回归分析过程中获得了回归方程（公式），就可以预测了不同人体类型女性的胎盘功能不全的发展。

结论。研究结果表明，可以很准确地预测胎盘衰竭的发展情况，并形成发病率高的高风险群体。
这将有助于有效实施预防和治疗措施，以防止这种疾病的发展。

Thrombotic microangiopathies during pregnancy and puerperium are rare and, if undiagnosed, can be life-threating conditions for both the mother and the baby. The aim of this review article is to briefly describe clinical profile and highlight the clues for a correct diagnosis of pregnancy-related thrombotic microangiopathies. Of particular interest and important practical significance are the presented data on changes in the hemostatic system in patients with a new coronavirus infection COVID-19 through the prism of thrombotic microangiopathies.

This article reviews the literature data on the mechanisms of the obesity effect on the in vitro fertilization (IVF) clinical efficacy and discusses the main directions of improving assisted reproductive technology data for overweight women. It was noted that the multi-level effect of obesity is manifested by a decrease in the frequency of clinical pregnancy with IVF, these women having a higher frequency of pregnancy complications, with, in particular, the risk of spontaneous miscarriages increased. It is believed that such disorders are associated with changes in the morphology of oocytes and embryos in this category of patients, as well as with impaired endometrial receptivity. A number of studies have shown that achieving normal body weight through lifestyle modifications that include healthy eating and exercise for several months before and during the IVF program and contribute to gradual and sustained weight loss can significantly improve the assisted reproductive technology outcomes.

腺瘤是一种普遍的良性疾病，经常被诊断为育龄妇女患有低血压、多月经、无怀孕和不育症。以前人们认为，病理过程与子宫内干扰、产科均等和/或子宫内膜异位症有关，“金标准”，其诊断为组织研究。目前，腺瘤被视为一种独立的疾病，其病因和病原体的产生是以复杂的分子-生物、基因组和免疫过程为基础的，包括无并发症的妇产科病史的妇女。现代非侵扰性诊断技术，如超声波检查和磁共振成像，在确定疾病特征方面具有高度的敏感性和特殊性。疾病的主要早期形态功能特征之一
是所谓的J区的变化（junctional zone-JZ）- 测量的过渡部分，次内分泌层的特点是独特的结构
组织，免疫化学结构和功能活动，尚未完全研究。关于腺瘤对怀孕期间和结果的影响数据不明确。
这篇文章介绍了关于伦理、病理学和腺瘤诊断及其对生育的影响的世界性研究结果。

Polycystic ovary syndrome (PCOS) is a common endocrine pathology that affects 8–14% of women of reproductive age. The leading signs of the disease are hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Over the past decades, a variety of animal models have been developed to study the etiology and pathogenesis of PCOS, including chemical, hormonal, and genetic interventions. However, a large number of experimental techniques differ even in the framework of a single model. In this review article, we summarized PCOS animal models using both direct hormonal effects and indirect methods.

A clinical observation of endometrioid infiltrate of a postoperative scar formed as a result of surgical delivery by cesarean section is presented in this article.