Vol 64, No 4 (2015)

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.

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.

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.

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.

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.

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.

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.

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.