Vol 17, No 5 (2015)

Pregnancy is the special female condition. During this period, you are obliged to take care of yourself, your health, your food and drink and medications you use. It is during this period when major changes occur as well as the needs of women themselves - in fact they should supply the body with nutrients, vitamins and minerals not only themselves, but also the unborn child. Recently, of particular importance in the physiological support of pregnancy are micronutrients such as chromium, selenium and molybdenum. Chromium normalizes metabolism of sugars, prevents formation of insulin resistance, has immunomodulatory and anti-hyperlipidemic action. Molybdenum is needed for the prevention of anemia in pregnant women and the formation of congenital malformations in the fetus. Selenium is essential for nutritional periconceptual support, prevention of disorders of lipid metabolism and cholestasis, and is essential for the functioning of the thyroid gland.

The review examines the problem of increase of liver transaminases in the second half of pregnancy. ALT and AST reflect processes of hepatocyte injury, but are not specific for the diagnosis of a particular disease of the liver. However, determining the cause of changes of liver samples in a short time in pregnant women is extremely important because of the significant differences in prognosis for the mother and the fetus, and the tactics of treatment and management of patients. Authorspresent algorithm of differential diagnosis of obstetric and non-obstetric causes of enlarged alanine aminotransferase and aspartate aminotransferase in the later stages of gestation.

Iron fumarate, especially in combination with vitamins is an important form of iron for use in the therapy and prophylaxis of iron deficiency anemia (IDA) in women of reproductive age. The results of a meta-analysis of 11 clinical trials of drugs iron fumarate, have incorporated in a total of 473 patients in the "Case" (receiving iron fumarate) and 470 in the group "Control". The average age of study participants was 30±5 years; patients took drugs based on iron fumarate at a dose of 20 to 150 mg/day, based on elemental iron: an average of 58±21 mg/day, where 58 mg/day - average value (M), and 21 mg/day - the standard deviation (m). Preparations were made for 41±25 days. In 10 of the 11 studies used the drug on the basis of iron fumarate - Ferretab. Meta-analysis of the association between the drug intake and the risk of Ferretab various pathological states allowed to establish a significant decrease in the risk of iron deficiency anemia by 71% (RR 0.29, 95% CI 0.21-0.42, p=6.9¥10-11), the risk microcytosis - by 68% (RR 0.32, 95% CI 0.20-0.50, p=1.2¥10-5), the risk of reduced (less than 110 g/L) hemoglobin levels - by 62% (RR 0.38, 95% CI 0.20-0.50; p=1.1¥10-3) reduced the risk (less than 20 g/L) ferritin levels - by 63% (RR 0.37, 95% CI 0.24-0.56; p=7.1¥10-5) and reduced the risk (less than 20 mmol/liter) levels of serum iron - by 71% (RR 0.29, 95% CI 0.19-0.45; p=5.3¥10-7). Levels of serum iron and ferritin - the generally accepted criteria for evaluating the effectiveness of treatment of IDA. The side effects associated with Ferretab intake were not ascertained, including those of the gastrointestinal tract. Thus, this meta-analysis suggests that the drug Ferretab is effective and safe for the treatment of iron deficiency states.

The high incidence of unintended pregnancy remains a significant problem in many countries, including Russia. This figure can be significantly reduced when using reversible contraceptive methods for a long-acting, which include intrauterine levonorgestrel - therapeutic hormonal system and copper-containing intrauterine contraceptive means. Intrauterine remedies are highly assessed and effective, being characterized by a small number of contraindications and side effects with long-term economic viability application and can be a good choise for most women. The article presents the results of a multicenter non-interventional prospective comparative observational program, the main aim of which was to examine the tolerability of intrauterine and patient satisfaction results of their application.

The aim of the present work is to optimize the system prediction of osteoporosis in postmenopausal women. In the present study included 224 postmenopausal women aged up to 65 years, which examined the role of a low intake of calcium and vitamin D deficiency in the prediction of postmenopausal osteoporosis. When assessing the prognostic role of these factors method was used binary logistic regression. The area under the ROC-curve (AUC) was for the level of calcium intake - 0.781 (0.648; 0.913) for the concentration of vitamin D in serum - 0.730 (0.618; 0.843). Comprehensive assessment of studied predictors will increase the predictive value of existing models that determine the probability of occurrence of postmenopausal osteoporosis and optimize the prevention of bone loss in women.

This paper presents a review of publications devoted to the conditions associated with magnesium deficiency in women. Considers the pathological processes occurring in different age and biological periods. Known role of the cation in the prevention of a number of obstetric complications such as premature labor, eclampsia, ischemic disorders of the central nervous system of the fetus. Well-grounded is the appointment of drugs of magnesium combined with vitamin B6 in the premenstrual tension syndrome, post-menopausal disorders. The complex of magnesium and pyridoxine has a protective effect by using combined hormonal contraception and menopausal hormone therapy, reducing the side effects of these drugs. The combination of magnesium drugs increases the efficiency of correction of osteoporosis. Thus, the use of magnesium-containing drugs in combination therapy to reduce the risk of some serious obstetric complications and help to cope with a number of states, reducing the quality of life of women.