Gynecology

Modern views on the issue of menopausal hormone therapy based on updated recommendations of the International Menopause Society 2013 are reviewed in the following article as well as the basic principles of hormone therapy in peri - and postmenopausal women, its benefits and possible risks. An important emphasis is made on unequal undesirable consequences from the use of combined hormonal preparations, depending on their composition and, above all, progestin component.

In this paper we investigate the effect of dienogest on endometrial morphology and function in patients with external genital endometriosis. It is shown that dienogest is effective in reducing pain in patients with external genital endometriosis and endometrial morphology and function improves, suppresses manifestations of inflammation in the lining of the uterus.

Female sexual health is the guarantee of the gynecological illnesses prophylaxis and a key component defining quality of life. Choice of contraception method providing the absence of any unexpected pregnancy risks and fears, as well as high level of freedom in sex and intimate comfort formation holds an important place in harmonization of sexual relations.

PMS may have a negative impact on the daily lives of women, leading to various disorders. Objective: based on the survey results with general international questionnaire MOSSF-36 in order to examine the quality of life (QOL) of patients with PMS ranging from average to severe, before and after treatment with herbal remedies, on the basis of dry extract of Vitex agnus castus and oral hormonal contraceptives (COC) containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone in a 24+4 regimen.We observed 243 patients aged 16 to 45 years, of mean age of 29,7±5,8 years, and an average degree of heavy PMS has been identified and confirmed by ICP-diaries. To assess the quality of life and ICP influence on the physical and psychological aspects of life in patients the late luteal phase of the menstrual cycle twice, before and after treatment, filled the general quality of life questionnaires Medical Outcomes Study - Short Form (MOSSF-36). After treatment the statistically significant decrease in deformation parameters, both physical and psychological components of health was shown.Conclusion. Treatment of women with PMS and the average degree of severe type with herbal remedies, on the basis of dry extract of prostrata ordinaryextract and COC containing 20 mcg of ethinyl estradiol and 3 mg of drospirenone in 24+4 regimen has led to the improvement of the patients, as well as their quality of life, which resulted in a statistically significant decrease in strain indicators of physical and psychological components of health.

The article presents the results of simultaneous clinical multicenter controlled study of comparative assessment of therapeutic efficacy, safety and tolerability Panavir, solution for intravenous injection of 0,04 mg/ml with the Standardl human immunoglobulin, intravenous solution in the complex treatment of cytomegalovirus infection in pregnant women in the II and III trimester. It was found that introduction of Panavir complex therapy effectively reduces acute cytomegalovirus infection titer immunoglobulin G and prevents infection of newborns, making it safe for both mother and fetus, and is not accompanied by side effects and adverse reactions.

The aim of the presented research was investigation of induced by 5-ALA PPIX accumulation kinetics in mucosa, vagina and vulva chronic in women with vulvovaginal candidiasis after treatment of 5-ALA and the choice of optimal time mode of fluorescence diagnosis and photodynamic therapy (PDT) in chronic vulvovaginal candidiasis. The investigation was held in group of 60 women: 20 with vulvovaginal candidiasis, 25 - bacterial vaginosis, 15 - non - specific vaginitis. Each woman had 4 sessions of PDT. Before and after each of the sessions fluorescence diagnosis (FD) of photosensitizer accumulated in mucosa, vagina and vulva was performed. By means of local fluorescent spectroscopy difference of accumulated PPIX was estimated with statistical methods. It was obtained, that difference between accumulation of PPIX after 1, 2, 3 and 4th session is statistically significant. After the 4th session it was estimated that there is no significant statistical difference between PPIX accumulated in healthy tissue and mucosa of vagina. According to this we concluded, that PDT in this case showed high efficiency.

Normal microflora of the genital tract of healthy women of reproductive age has a different species composition represented by a wide range of microaerophiles, facultative and obligate anaerobes. Lactobacilli play an important role in maintaining the normal vaginal biocenosis. In patients with chronic inflammatory diseases of the urinary tract above the risk of nonspecific vulvovaginitis. Inclusion of oral probiotics in the treatment regimen of inflammatory diseases of the urinary tract can significantly improve outcomes and reduce the number of relapses.

On the basis of immunohistochemical studies the role of chronic endometritis in the potentiation of the proliferative activity of the endometrium was demonstrated; defined and denoted were the values of the chronic inflammatory process in the endometrium, as an independent factor determining the prognosis of the disease.

Ovarian hyperstimulation syndrome (OHSS) is a relatively common complication of ovarian stimulation. The pathophysiology of OHSS is characterised by increased capillary permeability. As a consequence of this, there is a fluid shift into third-space causing hemoconcentration, it may contribute to hypercoagulable state, with increased risk of venous thromboembolism. The article presents modern data on prevention of thromboembolic complication in OHSS patients with special focus on an approach to determining the antithrombitic therapy effectiveness.

During pregnancy the effects of a number of predisposing factors (influence of progesterone, a violation of the passage of urine, the occurrence of vesicoureteral reflux) often lead to exacerbation of chronic diseases of the urinary tract, the development of eye and preeclampsia. This has an adverse impact on the course of pregnancy and perinatal outcomes. The Multicenter study «Evaluation of efficacy, safety and tolerability of cranberry extract in soft capsules Iuravit (biologically active additive to food) for prophylaxis and complex therapy of urinary tract infections in women during pregnancy» in cases of 195 women showed high efficacy, tolerability, a small number of side effects (5,6% of women), and worsening of urinary tract infections in 4,6% (mostly due to a violation of the outflow of urine and indications for stenting ureters). It allows to recommend the use of cranberry extract Juravit as prophylaxis in pregnant women with diseases of the urinary tract.