Vol 16, No 5 (2014)

A comparative analysis of 123 pregnant women who underwent laparotomy or laparoscopy surgery for adnexal masses was performed. Laparoscopy has obvious benefits in pregnancy because of decreased postoperative pain, less narcotic use, shorter hospital stays and faster postoperative return to regular activity. First and mid-second trimester of pregnancy seems to be the most appropriate period for laparoscopic surgery because of minimal risk of preterm labour.

This article summarizes the practical experience of operations for the correction of prolapse by setting synthetic materials. Presented based technique extraperitoneal colpopexy, highlighted the advantages and disadvantages of the method.

Early diagnosis, early detection and treatment of diseases associated with HPV, helps in prevention of precancerous diseases and cancer of the cervix. When surveying women of reproductive age it is appropriate to include testing for HPV viral load. Possibility of using a non-specific antiviral drug with immune modulating effect in patients with ASCUS (atypical squamous cells of undetermined significance) and LSIL (low-grade squamous intraepithelial lesions) associated with HPV reduces the risk of viral persistence and increases the chance to avoid exacerbating the severity of the pathological process.

The article presents the terminology and modern views on the microbiota of the vagina. The characteristic of endogenous and exogenous trigger factors leading to the violation of vaginal microbiocenosis are also being discussed. Special attention is paid to the endocrine and immune regulation of endogenous microbiota of the vagina and affectation by its mechanisms, as well as the connection between endogenous microorganisms and pathogens of exogenous genital infections. The characteristic of varieties of dysbiosis of vagina, stages of development of endogenous infection and its clinical manifestations are mentioned below as well, as are various diagnostic approaches and principles of endogenous infection treatment.

Lower genital tract infections are one of the most frequent reasons for consulting the gynecologist (bacterial vaginosis - 30-35%, vulvovaginal candidiasis - 20-25%, mixed infections - 15-20%, trichomoniasis - 10%, other infections - 10%). Vulvovaginitis tends to grow regardless of the circumstances, is frequently recurrent, and difficult to treat. In the management of patients with different etiologies of vulvovaginitis it is crucial to choose the therapy method wisely. According to the requirements of the International Expert Council of the Centers for Disease Control and Prevention USA (CDC) when choosing the appropriate drug for treatment, it is recommended to take into account the need for drug effects on microbial associations, preferring the means of the elimination of a wide spectrum of possible pathogens that has both trichomonacistic, bactericidal, fungicidal and inflammatory effects. One of the preparations that meets such requirements, is a combined preparation of local action Neo-Penotran Forte L.

In this paper, a comparative assessment of the endometrium in patients using levonorgestrel induced intrauterine system (IUS) Mirena and copper IUDs is presented, on the basis of cytology smears performed after removal of the IUD.The study included women who have already given birth, and those who never have, and that makes it more meaningful in terms of assessing the various conditions of endometrium as a factor in reproductive health.The return of fertility (for a year's period) in women who choose to perform the reproductive function has been analyzed as well.

Different pathological conditions (endocrinopathies, infectious agents prior to repeated intrauterine manipulations, the presence of functionally defective receptors endometrial tissue to the corresponding steroid hormones, progesterone autosensibilization) can lead to the further development of endometrial insolvency. Hypoplasia of the endometrium may be a consequence of both systemic problems (hormone deficiency, decreased blood flow in the branches of the uterine arteries, hypercoagulability) and local disturbances in the endometrium (the receptor, immunological changes, with a predominance of the increased activity of natural killer cells, suppression of immunosuppressive mechanisms, and decreased activity of macrophages). The article describes the methods of diagnosis and treatment of the basic principles of hypoplasia of the endometrium.

Ovarian stimulation protocol and other potential risk factors of poor ovarian response (POR) were analyzed in retrospective case-control study. Due to ESHRE criteria (2011) 150 infertile women of IVF department were divided into the group of cases with POR and the control group with the normal ovarian response. The elder age of the women and the earlier age of menopause in their mothers seemed to be the significant risk factors of POR. Also POR was associated with the history of abortions, ovarian stimulation, and hormonal contraception. Ovarian stimulation protocol did not influence the number of follicles and oocytes in both case and control groups. The pregnancy rate was higher in patients with GnRH antagonists protocol.

The article highlights the current issues of the use of anticoagulants (unfractionated and low molecular weight heparin) for the prevention of venous thromboembolic complications in obstetric practice. The assessment of risk factors, depending on the stage of pregnancy and delivery, comorbidities and indications for pharmacologic thromboprophylaxis; preventive and therapeutic doses of unfractionated and low molecular weight heparin. The use of anticoagulants on delivery stage requires special attention, due to the risk of hemorrhagic complications during surgery and neuraxial analgesia/anesthesia. The use of pharmacological thromboprophylaxis should be in accordance with current protocols.

This article presents current information on existing methods hormonal contraception, covered medical and clinical aspects acceptability of hormonal contraceptives.An important emphasis is made on the benefits of Laktinet® in women of postpartum period, and breastfeeding women older than 40 years.

Psychosomatic and behavioral changes before menstruation, perceived by the majority of women violate daily activities, relationships with the environment and quality of life, becoming a disease by the name of premenstrual syndrome (PMS). The etiology of PMS remains unclear and concise, universal diagnostic criteria are missing, which leads to the lack of effective diagnosis and therapy. Hormone therapy of the PMS is one of the leading methods to eliminate the symptoms that occur in the luteal phase, but it has some limitations, and sometimes causes side effects that negate the benefits of its application. Psychotropic drugs are the drugs of choice for premenstrual dysphoric disorder, but their long-term use is generally not recommended because of the possibility of addiction and the occurrence of adverse reactions. The research for relevant means of reducing the severity or eliminating the symptoms of PMS, not only among drugs, but also among the means of herbal medicine and non-drug methods of exposure remains important.