Vol 15, No 6 (2013)

Quality of life is one of the criteria for therapy effectiveness assessment. The study’s aim was to assess the indicators of quality of life of patients with premenstrual syndrome (PMS) of moderate and severe gravity before and after combined therapy via micro dosed contraceptives containing 20 mcg of ethinyl estradiol and 3 mg drospirenone in a 24/4 regimen. 122 patients aged 16–45 years were observed. To assess the quality of life and the impact of PMS on different aspects of life, patients in the late luteal phase of the menstrual cycle have filled twice – before and after treatment, a Medical Outcomes Study – Short Form (MOS-SF-36) questionnaire. After treatment a statistically significant reduction in the deformation parameters, both physical and psyhological components of health were shown.

Hormonal contraception, because of the numerous beneficial effects is always used not only for protection against unwanted pregnancy, but also as means of treating a variety of gynecological diseases. Enthusiasm for curative aspects of hormonal contraceptives has led to a shift in emphasis on therapeutic practice and underuse of preventive potential of contraceptive hormones. This particularly refers to the management of women of seniorreproductive group repositories in premenopausal and perimenopausal age. In this group the leading role is left to the questions of treating disorders associated with the extinction of ovarian functions including abnormal uterine bleeding, and substitution of estrogen deficiency, while the problem of birth control tends to be overshadowed. Reduced fertility in this age period should not be an argument for abandoning contraception, especially taking into consideration the fact that timely administration of contraceptive will not heal, but prevent the development of similar violations, which subsequently become an indication for therapeutic purpose of contraceptive hormones. Dual prevention, including the prevention of unwanted pregnancies and prevention of gynecological diseases associated with aging of the reproductive system is the basis for the selection of effective, timely and safe contraception with additional healing properties for women entering into physiological premenopausal period.

Ulipristal acetate is a selective progesterone receptor modulator, characterized by partial tissue-specific antiprogesteron effect, which is used in order to prepare uterine cancer patients for surgery. In the uterus it exerts an antiproliferative, anti-fibrotic and pro-apoptotic effects in relation to the uterine cells, which leads to downsizing of the nodes. Interaction of ulipristal with endometrium causes amenorrhea or bleeding decrease by the 10th day and reduces pain, which is important in symptomatic myoma. Its prescription at a dosage of 5 mg/day for 3 months reduces the volume of large fibroids, in average, by 45–50%. These results are comparable with the effect of agonists of gonadotropin-releasing hormone, but unlike them it’s more easily transferred due to the lower likelihood of developing hypoestrogenism symptoms

Research objective. Development of a program of correction of neurovegetative symptoms of climacteric syndrome in patients with estrogen deficiency, to prove the effectiveness of b-alanine in acute attacks of hot flashes and heat in patients of reproductive age, who use therapy agonist of gonadotropin-releasing hormone and the low level of estrogen.The study involved women 2 groups: group 1 – patients with adenomyosis and external genital endometriosis 3 – grade 4, a total of 78 patients; 2nd group – control (30 people with the same diagnosis).Patients in groups 1 and 2 were treated for 6 months triptorelininjection of 3,75 mg (1 injection per month), for 2–3 months of treatment were seen estrogen deficiency symptoms: hot flashes, sweating, tachycardia. At 3 months, all patients of group 1 was assigned to b-alanine at a dose 800 mg/day, the duration of receiving b-alanine 3 months. The control group is the patients refused the correction of b-alanine symptoms of menopausal syndrome. To assess the severity of symptoms of menopausal syndrome was used modified menopausal index (MMI).Control estrogen deficiency implemented by measuring the serum estradiol level (pg/L).Results. After 6 months of treatment was obtained by statistically significant (p<0,05) decrease with MMI 45,78±0,99 (before treatment) to 24,23±0,6 points (after treatment).When comparing the research and control groups (after treatment), there was a significant (p<0,05) difference in rates of two groups: lower scores MMI, which indicates a positive trend climacteric symptoms in patients treated with b-alanine. Changes in serum estradiol were statistically nonsignificant difference.Conclusion. b-Alaninbe called the drug of choice in the treatment of neurovegetative symptoms of menopausal syndrome, caused by the use of triptorelininjection of 3,75 mg, while it does not affect the blood levels of estrogen.

The analysis of the frequency of detection of polymorphisms of genes associated with the risk of multifactorial disease in patients with infertility who applied to the clinic for the implementation of pregravid preparation before assisted reproductive technologies. We studied gene polymorphisms of platelet fibrinogen receptor, collagen, coagulation factors, F2, 5, 7, 13. The study of the individual parameters of hemostasis deviations from normal variants have been identified. Significantly were significant indicators that reflect gene polymorphism inherited thrombophilia factors 2,7 and platelet fibrinogen receptor. The definition of these parameters would eliminate the risk of thrombosis during hormonal stimulation in patients with infertility.

The article presents data on the safety, tolerability and therapeutic efficacy of Panavir in cases of CMV infection exacerbation in pregnant women, collected in an open randomized comparative multicenter controlled clinical trial. Recommendations on its use can also be found there.

This article describes the features of the various forms of intravaginal treatment of vulvovaginal candidiasis (VVC). Effectiveness of topical treatment of acute VVC is about 90% and is not significantly different from the effectiveness of systemic antifungal agents. Use of a single dose of fungicidal imidazoles, such as 2 % butoconazole nitrate cream ensures maximum adherence and high efficiency of treatment as well as relief of acute exacerbation of recurrent VVC. Weekly use of 5 g of 2% butoconazole nitrate cream for preventing recurrent VVC can be an alternative to the use of systemic antifungal drugs.

Проблема ранних потерь беременности в течение мноих лет остается актуальной, это наиболее частое гестационное осложнение, причем согласно современным представлениям до 80% всех потерь беременности приходится на первые 12 нед.В рамках XI Всемирного Конгресса по Перинатальной медицине, проходившего под лозунгом: «Глобальные изменения в заботе о здоровье матери и ребенка: применение на практике достижений доказательной медицины для улучшения качества оказываемой помощи», состоялся симпозиум «Ранние осложнения беременности» с участием ведущих международных и российских ученых.

To determine the effect of dydrogesterone on the course and outcome of pregnancy in patients with recurrent pregnancy loss a prospective cohort study was conducted. It involved 702 women, divided into three groups according to their anamneses and I trimester therapy. The research showed that dydogesterone use in the first pregnancy trimester in habitual miscarriage patients minimizes the risk of miscarriage to 51,9% (RR 0,48; 95% CR 0,18–0,47; p=0,002), preeclampsia development risk 36,7% (RR 0,63; 95% CR 0,25–0,35; p=0,048).

76 women suffering from postpartum depression were included in the survey. In 36 cases the concomitant endocrine pathology (hypothyroidism and Hashimoto's thyroiditis, hyperthyroidism and hyperprolactinemia) was found. Used for the diagnosis were the scales specifically designed to detect depressive symptoms in the postpartum period (BPDS, EPDS, PDSS). These scales are estimated as the most sensitive and specific.It was estimated that endocrine diseases, hypothyroidism and more AIT, are risk factors for anxiety and depression in postpartum women, hyperprolactinemia seldom being the cause of postpartum depression. Monitoring of hormonal parameters in the period of pregnancy and the identification of other known risk factors (transferred affective disorders in the past, in the previous depression postpartum period, negative socioeconomic factors) would allow to determine women tending to developing postpartum depression which in its turn would let to run timely prophylaxis. During pregravidal training Hypothyroidism and AIT should be corrected by thyroid hormones, in hyperprolactinemic states in the event of severe anxiety – depression in postpartum period lactation suppression by dopamine receptor agonists and cabergoline is recommended.