Vol 17, No 2 (2015)

Articles
Vaginal microbiocenosis and citocine genes polymorphism as the female health marker (literature review)
Prilepskaya V.N., Letunovskaya A.B., Donnykov A.E.
Abstract
The review is devoted to modern notions of vaginal microbiocenosis and the use of hormonal contraception as well as modern methods of researching and assessing vaginal microbiocenosis.
Gynecology. 2015;17(2):4-13
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Therapeutic possibilities in treatment of cervical pathology in patients with HPV-infection
Chulkova E.A., Chulkova O.V.
Abstract
The article provides an overview of the scientific data on the effectiveness of Polyoxidonium® in gynecological practice with the influence of the drug on the local and systemic immunity and effectiveness in the treatment of inflammatory diseases of the female genital organs being the focus. A comparative analysis of the results of complex therapy in 15 patients with cervical neoplasia (CIN I-II), associated with human papilloma virus was made. It was found that the use of immunomodulatory therapy in the complex anti-inflammatory therapy improves the parameters of local immunity, increases the effectiveness of the therapy, and helps to reduce the recurrence of the process.
Gynecology. 2015;17(2):14-16
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Personalized approach to the correction of vaginal biocenosis
Kononova I.N., Oboskalova T.A.
Abstract
On the basis of molecular biological studies of 80 patients with cervical intraepithelial neoplasia II-III an algorithm was developed, using a personalized approach to the correction of vaginal microbiocenosis based on molecular biological studies of vaginal microbiocenosis and restore the pH, followed by degradation via radiowave surgery. The selected tactics allowed to reduce the frequency of recurrence of violations of the vagina dysbiotic for 9 times, complications after inflammatory destruction for 4 times.
Gynecology. 2015;17(2):17-20
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The place and role of mycoplasma infection in the structure of inflammatory diseases of the pelvic organs
Kuzmin V.N.
Abstract
The new methods of diagnosis, treatment, and different variants of approaches mycoplasma infection in gynecology. The concepts forms of mycoplasma infection with the pathogenic and opportunistic form. The features of resistance to antibiotics in the treatment of mikst-infektsii.Provedeny parallels in violation of the microflora of the vagina and dysbiosis.
Gynecology. 2015;17(2):21-26
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Current approaches to the treatment of viral infections in gynecology
Posiseeva L.V.
Abstract
The deterioration of women's reproductive health in recent years all over the world is due to the steady growth of the virus of genital infections and above all - herpes and human papillomavirus, leading to severe genital lesions, complications of pregnancy and perinatal pathology. The treatment of viral infection is a challenge, due to the damage to the immune system in patients. Review of the literature demonstrates the feasibility of using antiviral drugs, interferons and immune modulators to reduce or prevent the likelihood of emergence of resistant mutants of herpes viruses and human papillomavirus and increase the effectiveness of therapy.
Gynecology. 2015;17(2):27-31
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The role of vitamins, minerals and antioxidants in the pathogenesis, complex therapy and prevention of endometriosis
Unanyan A.L., Arakelov S.E., Polonskaya L.S., Guriyev T.D., Alimov V.A., Baburin D.V., Kadyrova A.E., Kossovich Y.M.
Abstract
Violated antioxidant defenses in the pathogenesis of endometriosis are an important factor in the progression of the pathological process. Stimulation of natural antioxidant systems, the introduction of exogenous antioxidants, a number of vitamins and minerals is one of the key moments in the complex of conservative therapy and prevention of endometrioid process. The absence of significant side effects when using the majority of antioxidants, vitamins and minerals further argues the feasibility of their application.
Gynecology. 2015;17(2):32-35
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Catamenial (menstrual) pneumothorax is a complication of extragenital endometriosis
Voskresensky O.V., Damirov M.M., Tarabrin E.A., Galankina I.E., Sharifullin F.A.
Abstract
In Sklifosovsky RIEM for 10 years 27 women were operated on with spontaneous pneumothorax. Thoracic endometriosis was in 4 females, pneumothorax evolved during menstruation, but without the macroscopic features and morphological verification of thoracic endometriosis - in one woman. Overall endometriosis related complications amount to 5 patients (18,5%). This article describes two clinical observation of patients with catamenial spontaneous pneumothorax caused by thoracic endometriosis. This article shows the complexity of the diagnosis and treatment of this pathologic condition. Use of simultaneus approach of gynecologist, thoraxic surgeons, and radiologist - a way to successful treatment of such complications.
Gynecology. 2015;17(2):36-40
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Rational contraception: minimizing the risks
Kiryushchenkov P.A., Tambovtseva M.A.
Abstract
The use of COCs, even low - and microdosed should be based on an individual assessment of the risk of thrombotic complications. It is advisable to combine the COC together with multivitamin complexes that affect the hemostatic system in the first place, vascular endothelial component (Duovit® for women). The therapeutic use of COCs in women high risk of VTE may together with antithrombotic drugs (heparin and LMWH).
Gynecology. 2015;17(2):41-44
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Features of the psychosexual development of children born to women who received hormonal treatment during pregnancy
Kuznetsova I.V., Grigoryan A.N., Geppe N.A., Koval-Zaytsev A.A.
Abstract
Hormone therapy is widely used in obstetric practice for the treatment of miscarriage, but, despite the known facts about the decisive influence of hormones on the sexual differentiation of the brain, long-term effects of intrauterine exposure to steroid drugs (drugs) on the formation of sexual behavior insufficiently studied. Therefore, the purpose of the study was to assess the performance of psychosexual development of children whose mothers received hormonal drugs during pregnancy. The cross-sectional study included 148 children whose mothers took estrogens and/or progestogens, and/or glucocorticoids, or did not take steroids (control group). The evaluation of indicators of mental development of children using the methods of «Age and gender identification», «Figure-posture-clothing», «Picture yourself», «Drawing the human behind the front» has been held.Results. Most of the children's sexual development was in line with the norm, gender and age identification formed by age and without features, elements of sexual dysontogenesis observed in isolated cases. Deviations were more common in girls whose mothers took estrogens and progestogens, and boys whose mothers received corticosteroids, but the proportion of these children were not significantly different from the proportion of children in the group of women who did not receive hormone therapy.Conclusion. The data obtained refute assumptions about the relationship of hormonal drugs during pregnancy with the development of disorders of puberty and sexual behavior anomalies in the offspring.
Gynecology. 2015;17(2):45-49
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Pregnancy tests history and modern methods of determining early pregnancy
Terebneva L.A.
Abstract
The article gives a review of historical information relating to the possibilities of determining pregnancy; the characteristics that exist today and methods of determining early pregnancy are also discussed. Particular attention is given to the test systems, which are widely used in women for determining pregnancy at home, and a comparison of their effectiveness.
Gynecology. 2015;17(2):50-54
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Effectiveness of micronized progesterone for the prevention of miscarriage
Maltseva L.I., Nikogosyan D.M.
Abstract
The data on the efficacy of micronized progesterone (Prajisun) for the prevention of miscarriage in women with a obstetric and gynecological history. Materials and methods. The study involved 56 women aged 19-38 years at 4-14 weeks of pregnancy, of which the main group of 30 were: infertility in anamnesis - 17 thrombophilic states against the background of the centers of urogenital infection - 7, uterine malformations - 6 pregnant. A control group comprised 26 healthy women without a history of complications during current pregnancy. All patients have gone through the physical examination, including the definition of the parameters of hemostasis D-dimer, AIII, protein C and S. In the study, blood levels of progesterone, interleukin-1b, interferon-y before and after treatment with micronized progesterone. Changes in the hemostatic system is also evaluated in the dynamics of observation and treatment.The results of the study. Among women, in the main group lower levels of progesterone in the blood were found, with the most pronounced case being retrochorial hematoma. The threat of abortion directly correlated with the level of progesterone and content of proinflammatory cytokines in the blood, the values of which are several times higher than health indicators: , interleukin-1b - 5, interferon-y - 3,7 times. Against the background of treatment with 400 mg Prajisun vaginally within two weeks there was a significant decline in pro-inflammatory cytokines, increased progesterone levels, normal levels of fibrinogen, D-dimer and spontaneous rate of platelet aggregation. Pregnancy progressed successfully in all women.Conclusion. The use of micronized progesterone Prajisun in early pregnancy in women with obstetric and gynecological history pathogenetically substantiated and effective in reducing high risk of miscarriage.
Gynecology. 2015;17(2):56-59
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The efficacy of assisted reproductive technologies in patients with uterine fibroids (review)
Podzolkova N.M., Koloda Y.A., Korennaya V.V., Kayibkhanova K.N.
Abstract
Despite the urgency of the problem, the impact of uterine fibroids on the effectiveness of programs assisted reproductive technology (ART) remains open. The data indicate that the induction of superovulation in vitro fertilization (IVF) increases the production of factors that contribute to the proliferation of fibroids. These data may explain the link between uterine myoma and effectiveness of ART programs, as expression of the same genes associated with implantation and post-implantation embryo development. Surgical removal of large knots prior to the IVF program in most cases, is regarded as a positive prognostic factor. However, surgical treatment, in turn, has a negative impact on the fallopian tubes and peritoneal and also leads to the appearance of the scar on the uterus. This review gives an idea of the current state of the problem and can help in the development of individual approaches in patients with infertility and uterine myoma.
Gynecology. 2015;17(2):60-64
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Modern approaches to uterine artery embolization in the treatment of uterine leiomyoma (review)
Damirov M.M., Belozerov G.E., Oleynikova O.N.
Abstract
The article presents the issues of application of endovascular mini-invasive method - uterine artery embolization (UAE) in the treatment of patients with uterine leiomyoma (UL). Reflected controversial aspects of the use of UAE depending on the location and size of fibroids. Presented testimony and contraindications for UAE in patients with UL, technical difficulties and complications that arise in its implementation.
Gynecology. 2015;17(2):65-69
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Different approach to conserving therapy of uterine fibroids in women of reproductive age
Plekhanov A.N., Tatarova N.A., Shishkina Y.S.
Abstract
The aim of the study was to evaluate the effectiveness of integrated treatment of uterine fibroids in women of reproductive age; 103 women of reproductive age of minimally invasive myomectomy performed accesses. To prevent a recurrence of fibroids patients in Group 1 as adjuvant therapy was administered agonist of gonadotropin-releasing hormone (buserelin) prolonged action for 4-6 months, patients in group 2 did not receive anti-relapse therapy, patients of group 3 as neoadjuvant ulipristal acetate therapy received. An assessment of long-term effects in all groups of patients. The criteria for the effectiveness of treatment were: frequency of recurrence of fibroids, reproductive and normalization of menstrual function. The result is a significant increase in the recurrence of uterine fibroids in the group receiving no adjuvant therapy (5,2% vs 25%).
Gynecology. 2015;17(2):70-73
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The circadian rhythm of urine formation in incontinent women
Osipova N.A., Niaury D.A., Ziyatdinova G.M.
Abstract
The objective of this study was to estimate the circadian rhythm of urine formation and its association with the quality of life in incontinent women. 277 patients with complaints of urinary incontinence were analysed according to a specific protocol: urodynamic testing, transperineal ureterovesical segment ultrasonography, a 3-day frequency-volume (FV) chart. Subjects had to fill in a standardised quality of life questionnaire as well. Nocturia was defined as two or more micturitions per night calculated from the FV chart. The overall prevalence of nocturia was 39,7%. The nocturics were classified into one of the responsible pathophysiologic categories: nocturnal polyuria in 30%, a low functional bladder capacity in 23,6%, a combination of both in 24,5%, polyuria in 21,8% of the cases. In 54,5% of nocturics nocturia is due to change of physiological urine formation rhythm-nocturnal polyuria. So nocturnal polyuria is a frequent symptom among urinaryincontinent patients, with a negative impact on several aspects of the quality of life.
Gynecology. 2015;17(2):74-76
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Ultrasound markers of adolescent polycystic ovary syndrome according to a complex three-dimensional transrectal ultrasound
Grigorenko Y.P., Uvarova E.V., Ogryzkova V.L., Ashrafyan L.A.
Abstract
The results of a complex three-dimensional transrectal ultrasound of internal genitals of 83 virgins aged from 14 to 16 years with clinical and the hormonal confirmed polycystic ovary syndrome (PCOS) are hereby discussed. The control group consisted of 20 healthy contemporaries having regular menstruations and normal values of hormones. As a result of complex inspection it was established that in an adolescent with PCOS the volume of ovaries is 3 times higher , than in control group; also, there were 3 times more varicosities of internal vessels of pelvis minor, and 2,1 times more often - a hypervascularization of a stroma of ovaries occurred. Taking into account the sizes and an arrangement of follicles at PCOS we have allocated an equal type (57%) and mixed type (43%) of ovarian structure, contributing to the difference in hormonal status and organ sizes.
Gynecology. 2015;17(2):77-80
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Present-day physiotherapy in the prevention and treatment of complications after abortion in the I trimester
Ipatova M.V., Malanova T.B., Kubitskaya Y.V.
Abstract
The article presents the indications, contraindications, specific techniques for using various physical factors in various, individually controlled and differentiated ways, in patients after abortion up to 12 weeks by different methods. Physical factors are used at all in order to prevent possible complications, as well as for the treatment of already established complications in women with a history of somatic and gynecological diseases in combination with drug therapy. Displaying differential use of medical factors, depending on the age of patients, parity, type of abortion, individual response to physiotherapy.
Gynecology. 2015;17(2):81-84
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Meta-analysis of the effectiveness and safety of drugs line Magne B6 in gynecology
Gromova O.A., Torshin I.Y., Grishina T.R., Sardaryan I.S., Kalacheva A.G., Nikolaeva L.B., Kerimkulova N.V.
Abstract
Magnesium deficiency is an important factor in the etiopathogenesis of premenstrual syndrome (PMS) and the cause of complications in patients receiving menopausal hormone therapy (MHT).Materials and methods. The results of a meta-analysis of 8 clinical studies on the use of magnesium preparations in the form of organic salts for oral administration.Conclusions. PMS therapy includes the use of drugs, e.g. magnesium which is associated with a reduction in PMS symptoms: irritability, and emotional lability (5 studies, n=775, OR 0,24, 95% CI 0,20-0,29, p<10-33), depression (5 studies, n=537, OR=0,53, 95% CI 0,44-0,63, p<10-20), headache (5 studies, n=219,OR 0,48, 95% CI 0,37-0,61, p<10-15), and mastalgia mammalgia (5 studies, n=717, OR 0,23, 95% CI 0,19-0,27, p<10-38), bloating, flatulence (5 studies,n=489, OR 0,53, 95% CI 0,44-0,63, p<10-12), swelling, a feeling of "fullness" (5 studies, n=262, OR 0,36, 95% CI 0,28-0,46, p<10-25), tearfulness (3 studies, n=432, OR 0,51, 95% CI 0,42-0,61, p<10-35), sweating (3 studies, n=190, OR 0,20, 95% CI 0,14-0,28, p<10-27). Side effects associated with taking drugs were noted. In general, the meta substantiates of widespread use of preparations based on organic magnesium salts (citrate, lactate and pidolate) in the treatment of PMS and accompanied MGT.
Gynecology. 2015;17(2):85-92
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The use of lactic acid in combination with glycogen in the treatment of bacterial vaginosis
Kira E.F., Artymuk N.V., Savicheva A.M., Rogovskaya S.I., Goushchin A.E., Rumyantseva T.A., Ivanova O.V.
Abstract
The efficacy and safety of laktagel in the treatment of bacterial vaginosis was studied. Two components proved more effective in treatments based on the use of metronidazole and ornidazole with lactic acid, compared with the monotherapy group of 5-nitroimidazole. The combined use of local ornidazole and lactic acid is a safe method to achieve high efficiency and reduce the frequency of relapses in the separated BV period. BV complex therapy and examination algorithm in patients of various age is presented.
Gynecology. 2015;17(2):93-96
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Myths and realities of inflammatory diseases of the pelvic organs
- -.
Abstract
3 марта 2015 г. начал свою работу XXI Всероссийский конгресс с международным участием «Амбулаторно-поликлиническая помощь в эпицентре женского здоровья». Основной целью конгресса его организаторы считают необходимость улучшения качества амбулаторно-поликлинической помощи, внедрение новых медицинских технологий, совершенствование знаний практикующих врачей.В рамках конгресса состоялся научный симпозиум с участием ведущих российских экспертов в области акушерства и гинекологии, микробиологии и лабораторной диагностики, антимикробной химиотерапии, посвященный проблеме диагностики и рациональной терапии воспалительных заболеваний органов малого таза (ВЗОМТ).
Gynecology. 2015;17(2):101-106
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XXI All-Russian scientific congress with international participation «Outpatient care from menarche to menopause» Resolution
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Abstract
Очередной XXI Всероссийский научный конгресс с международным участием «Амбулаторно-поликлиническая помощь: от менархе до менопаузы» состоялся в Москве в период с 3 по 6 марта 2015 г. Конгресс был организован Министерством здравоохранения Российской Федерации, ФГБУ «Научный центр акушерства, гинекологии и перинатологии им. акад. В.И.Кулакова» Минздрава России, Российским обществом акушеров-гинекологов, Российской ассоциацией по кольпоскопии и патологии шейки матки, Российским обществом по контрацепции. Он собрал 898 участников из 67 субъектов РФ и 150 городов, а также специалистов из 8 стран мира (Россия, Австрия, Беларусь, Казахстан, Молдавия, Украина, Франция, Швейцария).В рамках Конгресса было проведено более 35 научно-практических мероприятий: пленарные, секционные заседания, семинары, круглые столы, школы и мастер-классы и т.п., на которых было сделано свыше 200 докладов. Ведущими зарубежными экспертами в области акушерства, гинекологии и перинатологии были прочитаны лекции для практикующих врачей.
Gynecology. 2015;17(2):107-111
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