Vol 17, No 3 (2015)

Articles
Algoritm of therapeutic and prophylactic tactics of conducting patients with uterine myoma
Sinchikhin S.P., Mamiev O.B., Magakan S.G.
Abstract
Presented their own data on the prevalence of uterine fibroids in women in different age groups, as well as infertility, miscarriage, and with other diseases of internal genital organs. Shows the main clinical manifestations of uterine fibroids. Proposed algorithm for the management of patients with uterine fibroids, which takes into account the size and localization of nodes, concomitant somatic disorders and gynecological and reproductive plans woman. Pathogenesis noted the desirability and efficacy of clinical mefipristone in conservative therapy of uterine fibroids. Shown the importance of modern organ treatments.
Gynecology. 2015;17(3):4-8
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Features of the hemostatic system in patients with endometrioid ovarian cysts
Lapina I.A., Ozolinya L.A., Patrushev L.I., Nasyrova N.I., Avakian S.V.
Abstract
Objective: evaluation of the hemostatic system in patients with endometrioid ovarian cysts before and after treatment of various types of surgical exposures.Materials and methods. 90 patients with with endometrioid ovarian cysts were operated, depending on the method of surgical treatment and therefore divided into two groups. The study was prospective in nature. The patients then underwent a complete clinical and laboratory examination, genotyping of the most significant thrombophilic polymorphisms.Conclusions. The analysis showed a reduction in performance of hemostasiogram compensatory mechanisms even in the absence of pronounced changes of hemostasis. In such a situation it is very important to choose the least traumatic method of surgical treatment, which allows not only to preserve ovarian reserve, but also reduce the level of response to the hemostatic system of interventions.
Gynecology. 2015;17(3):9-12
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New ways in therapy of abnormal uterine bleedings related to adenomyosis
Rukhliada N.N., Biriukova E.I., Melnikova M.A., Gasimova D.M.
Abstract
The purpose of research was a comparison of the effect of a three-phase combined oral contraceptive (COC) containing estradiol valerate and dienogest in dynamic mode and single agent containing dienogest, to reduce menstrual blood loss on the background of adenomyosis.Materials and methods. Women aged 18-50 years, with a diagnosis of adenomyosis and pain hospitalized for abnormal uterine bleeding. Hysteroscopy and curettage of the uterus were performed on all the patientsw. After discharge, and the results of histological examination, patients of group 1 (no need of hormonal contraception), dienogest monotherapy was administered at a dose of 2 mg per day continuously for 6 months. Group 2 patients (who needed effective contraception) were administered three-phase COCs containing estradiol valerate and dienogest (2 days 3 mg estradiol valerate, 5 days estradiol valerate 2 mg/2 mg dienogest, 17 days estradiol valerate 2 mg/3 mg dienogest, 2 day 1 mg estradiol valerate and 2 days of placebo); 3 groip patients (not need for contraception) were treated with antifibrinolytic drug tranexamic acid at a dose of 1000 mg per day orally. Evaluates the performance of blood coagulation.Conclusions. Against the background of monotherapy a significant and reliable reduction of menstrual blood loss and the severity of pain was shown that demonstrates its effectiveness in the treatment of abnormal uterine bleeding associated with adenomyosis.
Gynecology. 2015;17(3):13-16
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Nomegestrol acetate - a new progestogen for oral contraception (a review)
Prilepskaya V.N., Mgeryan A.N., Mezhevitinova E.A.
Abstract
This review of literature is devoted to the study of highly selective progestogen of the last generation - nomegestrol acetate. Showing its high antigonadotropic effect, as well as selective effect on the progesterone receptors, and low binding to other receptors, which results in a low incidence of side effects. No less significant are the high contraceptive efficacy, acceptability and lack of influence on the parameters of hemostasis, blood lipid profile, mammary glands.
Gynecology. 2015;17(3):17-22
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Prolonged schemes of combined hormonal contraceptives assignment
Korennaya V.V., Kayibkhanova K.N., Liubimova E.A., Agisheva V.V.
Abstract
This article is a review of continuous use of oral contraception.
Gynecology. 2015;17(3):23-25
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An integrated approach to the diagnosis and correction of osteoporotic changes in postmenopausal women
Zakharov I.S., Kolpinskiy G.I., Ushakova G.A., Wavin G.V.
Abstract
In the present study the possible comprehensive diagnosis and correction processes of bone resorption associated with postmenopausal osteoporosis are identified, given the markers of oxidative stress. The predictive role of MDA, SOD and catalase in the development of osteoporotic changes was evaluated. A single-blind, randomized, placebo-controlled study evaluating the efficacy of antioxidant complex SeltsinkR plus was held. Antioxidant course correction for 6 months significantly reduced the concentration of MDA (p=0.002) and increased the activity of SOD (p=0.001) compared to placebo. At the same time significantly reduced urine deoxypyridinoline indicators (p=0.03) is a marker of bone resorption process.
Gynecology. 2015;17(3):26-29
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Cholelithiasis ascomorbidity polycystic ovary syndrome disease
Uspenskaya Y.B., Kuznetsova I.V.
Abstract
Polycystic ovary syndrome (PCOS) is a complex interdisciplinary problem in connection with the involvement in the pathogenesis not only of reproductive system, but also multifaceted metabolic disorders, many of which are pathognomonic for cholelithiasis. Presented in the article the literature and their own clinical observation suggest predisposing role in the development of PCOS cholelithiasis. Hormonal contraceptives greatly increase the risk of gallstone disease, and may be the trigger of stone formation. The individualized approach to the appointment of COC patients with PCOS with the additional risk of cholelithiasis, and dynamic monitoring would prevent the onset and progression of cholelithiasis.
Gynecology. 2015;17(3):30-33
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Menopausal hormonal therapy or non-hormonal treatment: rational choice
Pestrikova T.Y., Yurasova E.A., Yachinskaya T.V., Kovalyova T.D.
Abstract
Patients with the "climacteric syndrome" diagnosis make only 1,0% in structure of the general incidence of the women who visit the female consultation, and 1.6% - total of the patients consisting on the dispensary account. The patients who are health workers ask for medical care less than managers, teachers. Patients with the diagnosis of a climacteric syndrome had a certain relation to reception of the menopausal hormonal therapy (MHT). So, 22.69% of patients initially feel fear of reception of hormonal preparations; 16.81% - pass to reception of MHT after absence of effect from reception of non-hormonal therapy. Only 16.81% of patients have contraindications to reception of MHT.Purpose of MHT (a combination of estradiol to 1 mg / drospirenone 2 mg) renders high medical effect at patients with a climacteric syndrome (p<0.001) during the first (1-2 days) days. MHT doesn't cause increase of parameters of body weight, deterioration of biochemical indicators of blood, indicators of system of a hemostasis.Maintenance of parameters of arterial pressure within gradation "optimum" and "normal" belongs to important positive influence of MGT (a combination of estradiol 1 mg / drospirenone 2 mg) (р<0.001).
Gynecology. 2015;17(3):34-39
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Fast track: surgical protocols of accelerated rehabilitation in gynecology
Puchkov K.V., Korennaya V.V., Podzolkova N.M.
Abstract
Fast track (FT) surgery - a comprehensive treatment program, including training in the preoperative phase, the use of minimally invasive techniques of surgical intervention and active management of the postoperative period, in order to reduce the timing of hospital treatment, the time rehabilitation and patients as quickly as possible to return to normal life.For the first time the principles of FT programs were formulated in the late twentieth century. Henrik Kehlet and initially introduced in cardiac surgery, coloproctology and oncology, but gradually began to gain recognition in other surgical areas.Own experience of FT-protocols in gynecologic patients has shown that they can improve during the early postoperative period, no adverse effects on long - term outcomes and readmission rates, can significantly reduce the time of recovery after the operation and increase the satisfaction of patients of the treatment.
Gynecology. 2015;17(3):40-45
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The prevention of postoperative complications in gynecological patients
Levakov S.A., Sheshukova N.A., Borovkova E.I., Bolshakova O.V.
Abstract
The study allowed to compare the clinical efficacy of the drug and antibiotic Terzhinan gynecological patients operated on for tubal peritoneal factor infertility. In women receiving traditional intraoperative antibiotic prophylaxis, the antimycotic treatment followed 2 weeks; after surgery the violation of the qualitative and quantitative composition of the microflora of the vagina was observed, which further required additional therapy. In patients who used Terzhinan, dysbiotic violations in the vagina were observed only in 2 women was a decrease in the number of representatives of the indigenous microflora. Thus, the local use of antibacterial drugs in the perioperative period can be considered as an alternative to the system or the single use of antibiotics, which allows to recommend their use in order to reduce the incidence of inflammatory and infectious diseases of the vagina in gynecological patients before and after surgery.
Gynecology. 2015;17(3):46-48
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The use of bemiparin in obstetric antiphospholipid syndrome
Tetruashvili N.K., Ionanidze T.B., Agadzhanova A.A., Menzhinskaya I.V.
Abstract
A study on the treatment of obstetric antiphospholipid syndrome in women with recurrent miscarriage by assigning low molecular weight heparin - bemiparin. The results show that the therapeutic effects of the drug as a preventive and therapeutic doses side effects are not registered. It was possible to achieve a full-term pregnancy to prolong life in 93.5% of cases, premature birth due to placental insufficiency observed in 6.5% of cases. None of the observation is marked by thrombocytopenia, bleeding in the second and third trimesters of pregnancy. At delivery blood loss did not exceed the standard indicators. Anticoagulation bemiparin based therapy was continued for 6 weeks of the postpartum period for the prevention of thrombotic complications.
Gynecology. 2015;17(3):49-51
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The possibility of reducing the risk of developing preeclampsia (review of foreign literature)
Levakov S.A., Borovkova E.I., Sheshukova N.A.
Abstract
The article presents a review of international literature on the possibilities of prevention of pre-eclampsia in women at high risk. Given data from recent randomized trials and meta-analyses, have confirmed whether the use of low-dose antiplatelet therapy with 12 weeks of pregnancy to prevent the development of pre-eclampsia.
Gynecology. 2015;17(3):52-53
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The role of bacterial agents in the structure of deterioration of uteroplacental perfusion
Kaptilnyy V.A., Yekimova E.V., Kuznetsova I.V., Uspenskaya Y.B.
Abstract
Objective: to make analysis of isolated deterioration of blood flow in the pool of uterine arteries in low-risk pregnancy after 18-week gestation, to detect connection of blood flow deterioration with infection processes of different location in the organism of pregnant women.Methods. Doppler screening research was made as well as analysis of spectrograms of uteroplacental and fetal blood flow of 357 pregnant women. Results. Low-risk pregnancy was accompanied by high frequency of hyperdynamic deterioration in the system of "mother-placenta-fetus" (14%), most frequently was detected the reduction of perfusion data of uteroplacental blood flow (67.9%) with almost absolute dominance (prevalence) of one-sided deterioration; high correlation dependence was revealed between reduction of uteroplacental blood flow and existence of extragenital chronic infection foci (71.4%); asymptomatic bacteriuria and infection-and-inflammatory disease of laryngological organs; causal treatment improved hemodynamic rates, with idiopathic forms of uteroplacental perfusion deterioration, pathogenic treatment is recommended, dipiridamol - 75 mg daily (1/3 three times a day) is a chosen medicine.Conclusion. Isolated one-sided deterioration of uteroplacental blood flow during low-risk pregnancy may be considered as the mark of chronic infection foci in the body of a pregnant woman; well-timed diagnostics and causal treatment allow to avoid progressive deterioration of hemodynamic rates.
Gynecology. 2015;17(3):54-59
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Comparison of low urinary tract symptoms during pregnancy between primiparous and multiparous women after vaginal delivery versus caesarean section
Osipova N.A., Niaury D.A., Gzgzyan A.M., Ziyatdinova G.M.
Abstract
Low urinary tract symptoms (LUTS) are a common problem during pregnancy. This study aimed to compare changes in the prevalence of LUTS during pregnancy between primiparous and multiparous women after vaginal delivery versus caesarean section.In total 270 women with the physiological pregnancy (83 - in the I trimester, 78 - in the II trimester and 109 - in the III trimester) aged from 18 till 44 years with no LUTS before the current pregnancy were examined. LUTS are revealed at 81.9±2.3% of pregnant women. The most common LUTS during pregnancy were: urine incontience, urgency, frequency and nocturia. There was a significantly higher prevalence of storage, voiding and post micturition symptoms with gestational age. Stress urinary incontinence is more often in the multiparous women; nocturia, urgency and frequency are identical in nulliparous and multiparous women. Stress urinary incontinence is more common after vaginal delivery but prevalence rates of nocturia, urgency and frequency do not depend on delivery method.
Gynecology. 2015;17(3):60-63
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Caesarean section: past and future
Dobrokhotova Y.E., Kuznetsov P.A., Kopylova Y.V., Dzhokhadze L.S.
Abstract
In today's world cesarean section performance frequency surpasses all other abdominal surgery operations. This article describes the historical aspects of the cesarean section and its role in modern obstetrics; it also raises urgent issues to be addressed in order to optimize the frequency of abdominal delivery
Gynecology. 2015;17(3):64-67
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Breast cancer and pregnancy: risks and opportunities for prevention
Novikova V.A., Penzhoyan G.A.
Abstract
Breast cancer (BC) in 12% diagnosed in women aged 20-34 years. Fertility problems and associated risk of BC is still valid for obstetricians and gynecologists, oncologists, reproductologists. The need for a decision on prolongation of the pregnancy in BC, the choice of modern methods of treatment, improve delivery outcomes for the mother and the fetus requires knowledge of current trends in the study of this problem. In the review the modern Russian and foreign literature data on the risks and opportunities of BC prevention.
Gynecology. 2015;17(3):68-75
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Pharmacoeconomic particulars of ovaries cancer’s treatment
Zhurman V.N., Eliseeva E.V., Gurina L.I., Volkov M.V.
Abstract
The appearance of cytostatics made a revolution in the treatment of malignant neoplasm’s, allowing to make curable previously fatal diseases and prolong life for many patients with incurable tumors. Taking into account the steady growth of malignant neoplasms of the female reproductive system, including ovarian tumors, high rates of mortality in patients of reproductive age, and also the emergence of costly new anticancer drugs, allow to make a pharmacoeconomic analysis of ovaries cancer’s treatment ways, to select the most effective and safe means in conditions limited health care resources.
Gynecology. 2015;17(3):76-78
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The modern approach to the etiology, pathogenesis, treatment and prevention of bacterial vaginosis and vaginal candidiasis
Pustotina O.A.
Abstract
The article outlines modern points of etiology, pathogenesis, diagnosis, treatment and prevention of bacterial vaginosis and vaginal candidiasis - the most common causes of vaginal discharge. Place of the combined drugs and the importance of an integrated campaign in the treatment and prevention of vaginal disorders microbiocenosis are also discussed.
Gynecology. 2015;17(3):79-82
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Antiviral drugs with immunomodulatory effects role in treatment of anogenital diseases associated with HPV infection
Osipova N.A., Kustarov V.N., Khadzhieva E.D.
Abstract
In the review the role of HPV infection in development of diseases of anogenital area and methods of diagnostics and treatment of HPV infection of anogenital area is considered. Pathogenetic justification of application of preparations with immunomodulatory action is given in complex treatment of the diseases associated with HPV infection.
Gynecology. 2015;17(3):83-87
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Evaluation of therapeutic effects and impact on the sexual activity of Belara
Pestrikova T.Y., Yurasova E.A., Nikonorkina I.Y.
Abstract
The paper presents the evaluation of therapeutic effects of Belara contraceptive (ethinyl estradiol + chlormadinone) and its impact on the sexual activity of women. The majority of patients (47.83%) when choosing a hormonal method of contraception considered a priority the improvement of the appearance (skin and hair), and the contraceptive effect was on second place. Use of the drug had a statistically significant treatment effect in patients with hyperandrogenism; the effect of the drug on sexual activity resulted in an increase in the number of patients with increased sexual sensation and lubrication; In addition, 3.2-times decrease in the number of patients with dyspareunia was noted.
Gynecology. 2015;17(3):88-92
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Complex diagnostics of the endometrium in women with infertility and intrauterine pathology with the use immunohistochemical markers
Arutyunyan N.A., Dzhibladze T.A., Zuev V.M., Ishchenko A.I., Bryunin D.V., Hohlova I.D., Gadaeva I.V., Siordiya A.A.
Abstract
In the article information is resulted about the complex inspection of women with fruitlessness and different endometrial pathology, including the immunogistokhimicheskie methods of diagnostics. 100 patients are inspected in age from 27 to 42 years, from them at 59 immunogistokhimicheskie markers were determined (Ki-67, Cd34, Cd56, Cd68, CD 138, VEGF).
Gynecology. 2015;17(3):93-96
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