Gynecology

 

About

Gynecology is the peer-review journal dedicated to providing the very latest information in clinical and research fields related to a wide range of topics in obstetrics, gynecology and women’s health. 

The journal publishes editorial conference updates, original research, reviews, clinical case reports, commentaries, clinical and laboratory observations by Russian and international authors, pertinent to readers in CIS countries and around the world.

The Journal emphasizes vigorous peer-reviewing and accepts papers in Russian and English with most rapid turnaround time possible from submission to publication. Abstracts for all papers are available in both languages.

It has served the interests of gynecologists, endocrinologists and all other professionals in gynecology and women's health by providing on bimonthly basis clinical information and practical recommendations to various aspects in the field of women's health. 

Special area focus/ journal sections:

  • Inflammatory diseases of the pelvic organs
  • Endometriosis
  • Contraception
  • Pregnancy failure
  • Hysteromyoma
  • Current methods of diagnosis and treatment

The journal welcomes papers both from researcher and clinical gynecologist, endocrinologist and pharmacologist from all around the globe to deliver up-to-date and authoritative coverage of leading research and clinical practice relevant to specialists in CIS and other countries. 

 

Publications

Bimonthly issues publish since 1999 in print and online in Open Access under the Creative Commons NC-SA 4.0 International Licensee.

 

Editor-in-Chief

Vera N.Prilepskaya
MD, PhD, Professor
ORCID: https://orcid.org/0000-0003-3993-7629

 

Indexation

  • SCOPUS
  • Russian Science Citation Index (RSCI) on Web of Science
  • Core Collection on e-library.ru
  • Directory of Open Access Journals (DOAJ)
  • Ulrich’s Periodicals Directory
  • Dimensions
  • WorldCat
  • EBSCO
  • VINITI Database RAS
  • ROAD

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Current Issue

Vol 25, No 4 (2023)

ORIGINAL ARTICLE

Outcomes of assisted reproductive technologies in discordant couples with HIV infection in a woman
Mituyrina H.V., Perminova S.G., Sannikova E.S.
Abstract

Aim. To evaluate the effectiveness of assisted reproductive technologies (art) in discordant couples with hiv-infected women.

Materials and methods.  The prospective clinical study included 432 women who received an in vitro fertilization (ivf) program. The main group included 214 subjects with hiv infection, and the control group included 218 subjects without hiv infection. In the main group, 182 "fresh" ivf/icsi (intracytoplasmic sperm injection) cycles and 162 cryocycles were performed; in the control group, 271 and 195 cycles, respectively.

Results. The median length of HIV infection was 9.8 (5.7; 12.4) years, subclinical stage 3 of the disease prevailed (59.8%), and the duration of antiretroviral therapy was 4.5 (2.4; 8) years. The CD4+lymphocyte count [630 (496; 791) cells/μL] indicated a relatively "good" state of the immune system due to the antiretroviral therapy. In the main group, a significantly lower number of oocyte-cumulus complexes [6.5 (3; 12) and 9 (6; 15); p<0.001], zygotes [4 (2; 8) and 6 (4; 10); p<0.001] and blastocysts [2 (0; 2) and 4 (1; 6); p<0.001] were obtained in comparison with the control group. The number of abnormally fertilized oocytes (3 or more PNs) was significantly higher in the group of HIV-infected women compared to HIV-negative ones — 0.21 (0.7) and 0.09 (0.2) (p=0.018), respectively. Evaluation of the effectiveness of "fresh" IVF/ICSI cycles showed that HIV-infected women had a significantly lower incidence of clinical pregnancy (16.5 and 32.8%; p=0.001), as well as live births (12.2 and 31.5%; p<0.001). Analysis of cryocycle outcomes showed that using their own oocytes in women with HIV infection, the frequency of clinical pregnancy (27.6 and 41%; p=0.014) and childbirth (16.7 and 27.7%; p=0.021) is significantly lower than in patients without HIV infection, and in cases of using donor oocytes, these indicators are comparable between the groups (40%; p=0.910 and 25.7%; p=0.809, respectively).

Conclusion. ART in HIV-infected women is associated with low pregnancy rates in both "fresh" and cryocycles using their own oocytes. The decrease in the oocytes/embryos obtained and the high proportion of abnormal fertilization in HIV-infected patients suggest the presence of oocyte factor as the main cause of the low effectiveness of ART programs in this group of patients.

Gynecology. 2023;25(4):378-382
pages 378-382 views
Role of growth differentiation factor-15 (GDF-15) in missed miscarriage and its relationship to oxidative stress markers
Tishkova O.G., Dikareva L.V., Romanenko K.M.
Abstract

Aim. The study aimed to investigate the level of growth differentiation factor-15 (GDF-15) and its relationship to markers of oxidative stress (OS) as predictors of missed miscarriage (MM).

Materials and methods. A prospective cohort study of 80 females was conducted. The main group included 40 patients with MM at 5–9 weeks of gestation; the control group included 40 females with elective termination at the same gestation period. OS markers, including malonic dialdehyde, carbonyl groups of proteins, and the superoxide dismutase antioxidant enzyme, as well as the GDF-15, were measured in serum, aspiration fluid, and chorionic tissues in women with normal pregnancy and MM at 5–9 weeks of gestation.

Results. The results showed that the complex balance maintained between the production of reactive oxygen species and antioxidant activity in MM is shifted towards oxidative reactions (p<0.05) and is associated with non-enzymatic lipid peroxidation, and OS can become a leading factor in the pathogenesis of MM. The GDF-15 levels were significantly higher in aspiration fluid and chorionic tissues in patients of the study groups; low concentrations of GDF-15 in MM patients in aspiration fluid and chorionic tissues highlight the role of this protein as an important regulator of proinflammatory molecules (p<0.05). In addition, a decrease in the GDF-15 level negatively correlates with OS markers, such as malonic dialdehyde and the superoxide dismutase antioxidant enzyme, suggesting the role of this cytokine in peroxidation and OS development.

Conclusion. The study of biomarkers of independent pathological pathways as predictors of miscarriage will allow clinicians to stratify and predict the risks of early reproductive loss more accurately.

Gynecology. 2023;25(4):383-388
pages 383-388 views
Factors influencing the sexual drive of Russian women of reproductive age in the digital age
Fedorova A.I., Kazakova A.V., Chechko S.M., Kozupitsa G.S., Dufinets I.E.
Abstract

Aim. To assess the impact of age, number of sexual partners, having children, family income, and time spent with a smartphone or computer on the sexual drive of women of reproductive age in the era of information technology.

Materials and methods. A study of the sexual drive of 79 women aged 18–35 in family (partner) relationships was conducted. The well-established international Female Sexual Function Index was used. Respondents also answered questions about some aspects of personality and social status. The results were evaluated using the methods of mathematical statistics: descriptive statistics, correlation, determination, and logit-regression analyses.

Results. The intensity of sexual drive correlates with a woman's age, the number of sexual partners, and the family income. There was no correlation between the level of a woman's sexual drive and having children and the time women and their partners spend with computers and smartphones.

Gynecology. 2023;25(4):389-396
pages 389-396 views
Surgical treatment of genital prolapse in combination with endometrial hyperplastic processes in postmenopausal women
Karanasheva A.K., Dobrokhotova Y.E., Khlynova S.A., Markova E.A., Fuzailova R.M.
Abstract

Aim. To study the long-term results of surgical treatment of postmenopausal patients with genital prolapse III and IV according to the POP-Q classification in combination with endometrial hyperplastic processes and to assess their quality of life.

Materials and methods. Fifty one elderly and senile patients with grade III–IV prolapse according to the POP-Q classification in combination with endometrial hyperplastic processes. 2 groups were formed: 1st – 21 patients after one-stage vaginal extirpation of the uterus with appendages and unilateral sacrospinous fixation of the vaginal stump with a synthetic endoprosthesis-tape in combination with reconstruction of II and III levels of pelvic floor support according to DeLancey; 2nd – 30 patients after one-stage vaginal extirpation of the uterus with appendages and median colporrhaphy using the Lefort and Neugebauer technique.

Results. The study was evaluated 1–7 years after surgical treatment. The average age of patients at the time of surgery in group 1 was 63.12±4.32 years, in group 2 – 74.2±3.28 years. The number of women with somatic pathology in the 1st group was 1.7 times less in percentage terms than in the 2nd. The disappearance of symptoms of an overactive bladder after surgery was noted by 4 (50.0%) of 8 patients of the 1st group and 4 (26.7%) of 15 women of the 2nd. Uroflowmetry after surgical treatment showed an increase in the maximum flow rate (Qmax) and a decrease in the volume of residual urine (Vom) in both groups (p<0.001). Recurrence of genital prolapse was detected in the apical region in 1 (4.8%) woman, prolapse of the anterior vaginal wall in 1 (4.8%). There were no recurrences of genital prolapse in the 2nd group. A significant improvement in the quality of life after surgery, according to the results of processing the PFDI-20 questionnaire, was noted by 19 (90.5%) women in the 1st group and 29 (96.7%) – in the 2nd.

Conclusion. The long-term results of the proposed operational benefits have shown satisfactory results and can be successfully used in the elderly and senile age. The choice of the volume of surgery taking into account age, sexual activity, concomitant gynecological and somatic pathology reduces the number of complications and improves the results of surgical treatment in this category of patients.

Gynecology. 2023;25(4):397-402
pages 397-402 views
Experience of inulin use for correcting intestinal microbiota in patients suffering from recurrent vulvovaginal candidiasis: A prospective cohort comparative study
Trupakova A.A., Kazakova A.V., Lyamin A.V., Kozupitsa G.S., Pechkurov D.V., Lineva O.I.
Abstract

Aim. To evaluate the effectiveness of inulin for the adjustment of intestinal microflora in patients with recurrent vulvovaginal candidiasis (VVC).

Materials and methods. A prospective cohort comparative study included 79 women aged 18 to 50 years. They were divided into three groups: the main group included 32 patients receiving complex treatment with a dietary supplement containing inulin derived from the "Extra" variety of Jerusalem artichoke root in combination with fluconazole; the comparison group included 27 patients receiving fluconazole only; and the control group included 20 healthy women. The patients were followed up for 12 months. Examination included stool culture for dysbiosis, complete blood count, urinalysis, blood chemistry (glucose, bilirubin, alanine aminotransferase, aspartate aminotransferase, total protein, urea, creatinine), examination of the vulva and vaginal mucosa, vaginal smear microscopy for microflora, Gram staining, real-time polymerase chain reaction for Mycoplasma hominis, Ureaplasma parvum, Trihomonas vaginalis, Chlamydia traсhomatis, Candida albicans. Subsequently, all subjects every three months underwent a bimanual examination, speculum examination of the cervical mucosa and vagina, Gram staining of vaginal mucosa and cervix swabs, a thorough interview, and history taking. At 12 months, stool was cultured for dysbiosis again, and the data were analyzed.

Results. The VVC therapy in the group of inulin-containing dietary supplement was more effective: the recurrence rate was 3 times lower than with the standard treatment regimen.

Conclusion. The use of dietary supplement containing inulin derived from the "Extra" variety of Jerusalem artichoke root in complex therapy for recurrent VVC can significantly improve the gut and vagina microflora condition and prevent the recurrence and normalization of stool in patients.

Gynecology. 2023;25(4):403-409
pages 403-409 views
Features of vaginal microbiota in women at different stages of postmenopause
Ziganshina L.Z., Muslimova S.Y., Sakhautdinova I.V.
Abstract

Aim. To study the dynamics of the vaginal microflora depending on the postmenopausal stage according to STRAW+10.

Materials and methods. After obtaining voluntary informed consent from each patient and determining eligibility criteria, we conducted a survey of 139 postmenopausal women. Participants were divided into 3 groups depending on the duration of postmenopause in accordance with the stages of aging of the reproductive system STRAW+10. Femoflor 16 real-time polymerase chain reaction was used to assess the state of the vaginal microbiome.

Results. After menopause in women in the group of obligate aerobes Lactobacillus spp. and Enterobacteriaceae were completely replaced by Streptococcus spp. and Staphylococcus spp., which increased in number. A significant depletion of the composition occurred in the group of obligate anaerobes. If at stages +1a and b this group is almost equally represented by 5 communities of microorganisms (Gardnerella vaginalis + Prevotella bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp. + Corynebacterium spp., Lachnobacterium spp. + Clostridium spp.), then only 3 groups prevailed in the total bacterial mass at the +1c stage (G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp., Megasphaera spp. + Veillonella spp. + Dialister spp., Mobiluncus spp + Corynebacterium spp.). At the postmenopausal stage +2, the total bacterial mass consisted of only 2 groups of microorganisms: G. vaginalis + P. bivia + Porphyromonas and Peptostreptococcus spp.

Conclusion. Thus, the main result of age-related changes in the vaginal microflora was the impoverishment of the composition of its microbiome.

Gynecology. 2023;25(4):447-451
pages 447-451 views

REVIEW

Chronic cervicitis in women of reproductive age: pathogenesis and treatment. A review
Prilepskaya V.N., Odyvanova A.A., Mezhevitinova E.A.
Abstract

The issue of cervicitis and vulvovaginitis is relevant worldwide due to the increasing incidence in women of reproductive age. To date, the significant role of chronic cervicitis in the development of cancer and other diseases of the reproductive system, including cervical cancer, has been proven. In recent years, a number of large studies have been conducted, covering a significant part of the clinical issues, pathogenesis, and epidemiology of cervicitis. However, there is a clear need for further studies of both the etiological factors and the pathogenetic mechanisms of inflammatory cervical disease to support the treatment choice.

Gynecology. 2023;25(4):411–415
pages 411–415 views
Metabesity: pathogenetic bases and predictive capabilities. A review
Orazov M.R., Radzinsky V.E., Khamoshina M.B., Dolgov E.D., Mullina I.A., Artemenko Y.S., Ryabova V.A.
Abstract

One of the most pressing problems of our time is obesity, recognized by the WHO as a pandemic of the XXI century. It is important to remember that obesity is a full-fledged nosological entity, but many women think that obesity is just a problem of beauty and aesthetics. It is important to note that this nosology has a number of serious consequences, starting with the development of cardiovascular disease and ending with cancer. However, the “problem in the problem” is the so-called “metabesity” – a new term that reflects a number of diseases, the pathogenesis of which is based on the metabolic syndrome. Obesity, metabolic syndrome and metabesity seem to be different concepts, but the absolute identity of the pathogenetic basis characterizes them as successive stages of one global process. In this regard, it is necessary to highlight the key mechanisms of the development of the described disorders and to consider the concept of clinical management of patients in this cohort.

 

Gynecology. 2023;25(4):416-423
pages 416-423 views

REVIEWS AND CASE REPORTS

Pyo-ovarium during pregnancy. Case report
Andreeva M.V., Shevtsova E.P., Gatsenko V.I., Dvuzhilov V.V.
Abstract

The issue of postpartum inflammatory diseases of the uterus and appendages remains relevant for modern obstetrics due to their high percentage (5–26%) in the structure of morbidity and mortality among postpartum women. A rare clinical case of purulent oophoritis that occurred in a woman at the end of pregnancy and was detected on day 22 after childbirth, which was due to diagnostic difficulties, is presented, and the management approach in this clinical situation is shown.

Gynecology. 2023;25(4):424-427
pages 424-427 views
Menopause and premature ovarian insufficiency in rheumatic diseases: A review
Panevin T.S., Ledina A.V., Zotkin E.G.
Abstract

Premature ovarian insufficiency (POI) is a clinical syndrome defined as loss of ovarian function before the age of 40 years. Among the causes of POI are genetic, metabolic disorders, as well as infectious or iatrogenic factors, but in some cases the exact cause cannot be established. Given the possible association of ovarian failure with autoimmune disorders, as well as the detection of antibodies to normal ovarian tissue in the serum of patients with POI, it is assumed that an autoimmune mechanism is a significant cause of the syndrome. Taking into account the relationship between POI and autoimmune diseases, it seems relevant to address the issues of mutual influence of the ovarian function of women with POI and rheumatic diseases (in particular, systemic lupus erythematosus, rheumatoid arthritis and systemic scleroderma), which is presented in this review. Hormone replacement therapy may be recommended for women with POI to improve their quality of life.

Keywords: premature ovarian insufficiency, menopause, anti-ovarian antibodies, systemic lupus erythematosus, rheumatoid arthritis, systemic scleroderma, rheumatic diseases, hormone replacement therapy.

Gynecology. 2023;25(4):428-434
pages 428-434 views
Non-surgical management of patients with ectopic pregnancy: A review
Dobrokhotova Y.E., Belousova T.N., Borovkova E.I., Sovaev N.I., Egorushkina V.D., Kladnitskaya A.D., Ermakova A.
Abstract

An ectopic pregnancy is a medical emergency. Currently, surgery is the main method of therapy, and non-surgical management with methotrexate is considered an acceptable alternative. Methotrexate is a folic acid antagonist and has an inhibitory effect on the proliferation of trophoblast cells. There are various methotrexate regimens; the choice is based on the level of β-subunit of human chorionic gonadotropin, the location of the ectopic pregnancy and the patient's adherence to treatment. Therapy of ectopic tubal pregnancy with methotrexate is an effective and safe alternative to surgical treatment, does not affect the ovarian reserve and preserves the woman's fertility.

Gynecology. 2023;25(4):435-441
pages 435-441 views
Uterine leiomyoma in the pediatric population: literature review
Kumykova Z.K., Batyrova Z.K., Dilanyan T.G., Turchinets A.I., Uvarova E.V.
Abstract

Uterine fibroids are the most common benign neoplastic tumor of the uterus, occurring in adolescents with a frequency of less than 1%. According to literature data, 87.5% of young patients, as a rule, have a variety of symptoms, the most frequent of which is abnormal uterine bleeding, anemizing the patient, abdominal pain, abdominal enlargement in volume. Diagnosis in adolescent girls may be difficult, due to the rarity, as well as the presence of some limitations in the echographic examination performed, as a rule, by transabdominal access. Methods of treating leiomyomas in women are well known and are widely described in clinical guidelines ranging from surgical to medicinal, however, they are not standardized for the pediatric population. Currently, no more than 25 clinical observations have been described in the literature, which indicates the importance of accumulating clinical data in order to develop an optimal clinical approach aimed at preserving reproductive function in such patients.

Gynecology. 2023;25(4):442-446
pages 442-446 views


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