Vol 17, No 1 (2015)

The article is devoted to an actual problem of modern health care is the treatment and prevention of cervical dysplasia. In recent years, despite the development of science and medicine has continued to increase the incidence of precancer and cancer of the cervix, which necessitated the creation of newand improvement of existing methods of diagnosis and treatment of precancerous diseases of the cervical epithelium. According to many researchers in a large percentage of cases of this pathology has a viral etiology and due carriage of HPV (human papilloma virus) high-risk types. The currently existing immunomodulators suppress the activity of HPV, thereby reducing the risk of pathological changes in the cervical epithelium. One of these drugs with proven efficacy is Isoprinosine. Given the urgency of this problem, it is necessary to further study and selection of schemes of immunomodulators, evaluation of their effectiveness in terms of clinical outcomes with the aim of reducing the risk of developing dysplasia moderate and severe and cervical cancer, on the background of carrying HPV.

The study of the sensitivity to antibiotics of microbial flora of the cervix in patients with chronic cervicitis, and HPV infection. Patients were divided into 2 groups. The study group included patients with chronic cervicitis, against papillomavirus infection. The comparison group consisted of women with chronic cervicitis without the presence of human papillomavirus infection. Microbial landscape of the cervical canal of patients in both groups was represented by the following microorganisms: Gram-positive cocci (Staphylococcus aureus, S. epidermidis, S. saprophyticus, Enterococcus faecium), Gram - negative bacteria (Escherichia coli, Proteus mirabilis, Klebsiella), class Mollicutes (Ureaplasma urealyticum, Mycoplasma hominis). We have identified the impact of human papillomavirus infection susceptibility to antibiotics of the microbial flora of the cervical canal.

The use of combined hormonal contraceptives is a pathogenetically sound method of treating pathological conditions associated with the menstrual cycle. The study, the purpose of which was to study the effectiveness and acceptability of hormonal microdosed combined oral contraceptive containing 20 mcg ethinylestradiol and 3 mg drospirenone (Yaz®, Bayer HealthCare Pharmaceuticals, Germany), in the treatment of women who suffer from premenstrual syndrome manifestations and of moderate to severe dysmenorrhea. As a result of treatment revealed a statistically significant reduction of the symptoms of premenstrual syndrome, in the absence of serious adverse effects.The study showed high efficacy and acceptability of a microdosed drospirenone-containing combined oral contraceptive in 24/4 mode for the treatmentof women with premenstrual syndrome secondary to severe.

Vasomotor symptoms, including hot flushes (HF), are the most common symptoms of menopause, requiring treatment with estrogen and/or progestogen. Recent international guidelines recognize the need to use the lowest effective dose of hormone replacement therapy. Drospirenone (DR) in combination with 17-estradiol (E) is used as hormone therapy (HT) for relief the symptoms and prevention of postmenopausal osteoporosis.The aim of this review is a meta-analysis of studies examining the efficacy and safety of low-dose DR and E for the treatment of vasomotor symptoms inpostmenopausal women.The review presents data of 2 large randomized controlled studies that evaluated the lowest effective dose combination DR/E, the safety of this dose for endometrium, identified features of its pharmacodynamics and pharmacokinetics, depending on various factors.In the first, a study of the lowest effective doses of DR/E for the treatment of HF in postmenopausal women was made. It led to the conclusion that the com-bination of DR 0,25 mg/E of 0,5 mg is the minimum effective dose. Efficacy of low doses of DR/E correlated with exposure DR and E in serum, while smoking had a negative impact on the Efficacy of treatment.Another study assessed the risk of endometrial hyperplasia and bleeding pattern in patients receiving 0,25 mg DR/E of 0,5 mg for 12 months. At the end of the study no evaluable women in the DR/E2 group had an endometrial biopsy result of hyperplasia or worse, which endometrial confirmed the safety of receiving DR 0,25 mg/E of 0,5 mg.Thus, the minimum effective dose for the relief of HF without causing any significant impact on the endometrium is DR of 0,25 mg/E of 0,5 mg. According to the results of the pharmacokinetic study a correlation between effectiveness of low dose DR/E with DR and E exposure levels was showed, and smoking reduces the effectiveness of hormonal therapy. This drug not only copes with moderate to severe hot flashes, but also reduces the incidence of symptoms of vulvovaginal atrophy, improving quality of life.

The definition of ovulation moment, during which the probability of conception is maximal, can be considered as the basis for planning pregnancy. The following article deals with the accessibility and effectiveness of methods for determining ovulation tests; the evaluation of their benefits is based on immuno-chromatographic determination of the peak concentrations of luteinizing hormone.

The article reflects the modern views on the problem of the use of vitamin and mineral supplements for pregnant women and nursing mothers. Given are the norms of physiological needs for energy and nutrients for women during pregnancy and nursing, as well as qualitative and quantitative composition of essential vitamins and mineral complexes used in our country.

Vitamins and minerals are essential for normal conception, pregnancy, fetal and child's development. Widespread micronutrient deficiency in the modern population adversely affects the health of both mothers and children. The use of vitamins and minerals in step pregravidal preparation and during pregnancy is an important factor in the prevention of miscarriage, premature delivery, impaired function of the fetoplacental complex, fetal malformations and weight lacking infants or immature ones, and, the best way to introduce the necessary micronutrients is the use of vitamin-mineral complexes .Vitamin and mineral complexes have obvious advantages in comparison with a subsidy of some micronutrients in pregnant women. The review highlights the role of vitamins and minerals in a successful pregnancy and justified their prophylactic use.

In recent years a large amount of data on a varied effect of the adipose tissue on a female reproductive system was accumulated. Molecular mechanisms of regulation reproductive function by hormones of the adipose tissue are discussed in the article. It describes the mechanisms of development different variants of reproductive function abnormalities with the obesity.

Over the past years, new conservative methods of treatment of uterine fibroids and minimally invasive techniques that allow more frequent organ preserving interventions to take place. Accumulated experience allows us to compare the reproductive outcomes, quality of life in the postoperative period and other long-term results. Based on these data a gynecologist can make an informative decision about the optimal algorithm of patients with different clinical manifestations of myomas. This review presents recent data on the use of uterine artery embolization, the use of intrauterine shaver and possible ways of optimizing the laparoscopic myomectomy in order to improve the safety and efficacy of treatment.