Vol 18, No 2 (2016)

Objective. The objective of this research was to estimate influence of vitamin D saturation on calcium metabolism in pregnancy. Materials and methods. Cohort retrospective and prospective study. 110 pregnant women (mean age 29,64±2,3 years) at 30-38 weeks of pregnancy were examined. Investigation time lasted from September 2013 to June 2014. All patients had blood sampling done with the following determination of the levels of 25-hydroxycalciferol, calcium, parathyroid hormone. All patients lived in Saint Petersburg and Leningrad region. From 12 gestational week all patients were using a multivitamin complex, which contained 400 IU of vitamin D. Results. 110 pregnant were analyzed. Among all examined pregnant women the normal blood serum level of 25-OH-D was in 49 (44,5%) pregnant, 25-OH-D insufficiency - in 22 (20%) patients, 25-OH-D deficiency - in 39 (35,5%) pregnant. Calcium level in blood serum in pregnant with normal vitamin D saturation was 2,32±0,06 mmol/L, with insufficiency - 2,17±0,03 mmol/L, with vitamin D deficiency - 2,08±0,02 mmol/L Parathyroid hormone levels in blood serum in pregnant with normal vitamin D saturation was 23,63±1,9 pg/ml, with vitamin D deficiency - 31,±2,3 pg/ml. Conclusion. The increase of parathyroid hormone in blood serum occurs during the insufficient saturation of vitamin D in pregnant women. In pregnant with vitamin D deficiency and insufficiency relative hypocalcemia occurs. Received data confirm correlation between body saturation of vitamin D and calcium metabolism during pregnancy.

The objective of the study was to evaluate the efficacy of detoxification therapy omega-3-polyunsaturated fatty acids and flower pollen (apifitohol) in fetal growth restriction prevention (FGR). In the 1st trimester of pregnancy 140 pregnant women were randomized to receive omega-3-PUFA (group 1), apifitohol (group 2) or no treatment group (group 3). In the beginning of the pregnancy and 1st day after labor all patients passed daily urine Pb/Cd test, and benz(a)pyrene/styrene/formaldehyde blood serum test. The patients of the 1st and 2nd group had much lower level of heavy metals in daily urine and organic pollutants in blood serum after labor compared with the onset of pregnancy. FGR was twice more often, and newborn weight was significantly lower in women of no treatment group ( p=0,0022). Detoxification therapy during the pregnancy can prevent FGR and can be recommended in the condition of environmental pollution.

To date, the problem of genital prolapse remains relevant in connection with a high frequency of occurrence. The article provides a brief obzorprichin, leading to the development of genital prolapse, in particular, describes the different types of connective tissue dysplasia. The most common genital prolapse combined with various types of urinary incontinence, which greatly impairs the quality of life of patients. Considering the pathogenesis of connective tissue dysplasia and disorders from urinating, the article shows the need for this category of patients comprehensive treatment, including hormone treatment, aimed at addressing estrogen deficiency, metabolic therapy, improves collagen synthesis and treatment aimed at removing overactive bladder symptoms.

The efficacy of measures that improved postoperative rehabilitation of natural fertility in women after conservative surgical treatment of progressive tubal pregnancy (TP) was assessed. A randomized, controlled, open examination of 102 those who planned pregnancy, have undergone treatment endovideosurgical progressive TP was held. The improved complex of rehabilitation: 1) used anti-adhesive barrier; 2) bacteriological and virological examination of discharge from the fallopian tubes, followed by determination of sensitivity to antibiotics; 3) for the rehabilitation of the reproductive system, improve the regenerative processes in the fallopian tubes, and effective contraception for women of the main group in the postoperative period were appointed individually combined oral contraceptives (drospirenone 3 mg/ethinylestradiol 30 mcg) the duration of 9-12 months; 4) anti-inflammatory therapy (nonsteroidal anti-inflammatory drugs in the form of rectal suppositories, enzyme) was determined. The effectiveness of the improved complex to recovery of fertility in women after conservative surgical treatment of progressive TP was 80%.

In a following review evidence on the role of genital viral infections in the development of reproductive system of women and men, their influence on fertility and reproductive losses is presented. It reflects the role of immunomodulatory therapy in the treatment of viral infections of the genital, in particular, inosine pranobex. The conclusion about the need for timely diagnosis, prevention and effective treatment of viral genital infections in both women and men during the clinical examination of the general public and especially at the stage of preparation pregravid couples is also made clear.

In the literary review presents recent data on different forms of magnesium deficiency and how best to correct it. Presented is the biological role of magnesium in the body of women. We describe the clinical and laboratory signs of magnesium deficiency in gynecological (premenstrual syndrome, menopausal syndrome) and obstetrics (miscarriage, pre-eclampsia) practice. Magnesium drugs reduces the risk of magnesium deficiency in pregnant women and the possibility of threatened abortion and pre-eclampsia. For the correction of magnesium deficiency necessary preparations that have proven high clinical efficacy and good tolerability.

The aim: to identify the relationship between the severity of psychovegetative and pain in women with dysmenorrhea. Patients and methods: 46 women (mean age 22.3±6.2 years old) with dysmenorrhea. 3 groups: mild, moderate and severe dysmenorrhea were distinguished as symptoms severity. Results. The correlations between the pain severity according to numerical pain intensity scale (NPIS) and the values of other parameters: with the anxiety severity Sheehan scores (r=0.644, p <0.01), depression on the Hamilton scale (r=0.824, p <0.01), disorders the autonomic nervous system by questionnaire Wayne (r=0,442, p <0.05), reproductive system functioning satisfaction numerical scale (r=0.702, p <0.01), and the overall life quality on the SF-36 questionnaire (r=0.615, p <0.01) were identified. Patients with severe dysmenorrhea score on the Hamilton scale and severity of psycho-vegetative syndrome was significantly higher it was found when variance analysis depending on the Hamilton scale score and score on the questionnaire Wayne from a group at the prevailing sex hormones concentration changes, clustering parameter for the severe dysmenorrhea presence. Conclusion. Severe dysmenorrhea is probably a "yellow flag" patient psychosocial distress and requires the development of specific therapeutic strategies. The article also shows the relationship between the pathophysiological mechanisms of psycho-vegetative syndrome, pain and disorders of regulate the menstrual cycle hormones.

Malignant tumors are encountered in pregnancy in cases of 0.07-0.1% of all pregnancies. Endometriod adenokratsinoma is an extremely rare disease in pregnancy. However there is the urgency of oncological vigilance against endometrial adenocarcinoma in women of reproductive age, including the background of pregnancy.

This article presents a new model of gynecological and obstetrical pessary for treatment of pelvic organ prolapse, elimination of symptoms of stress urinary incontinence, preventive care and treatment of cervical insufficiency and habitual abortion.

The article deals with the problems associated with the role and significance of estrogen in the preservation and maintenance of women's reproductive health. Presents the causes and potential effects of endometrial hypoplasia. It presents the possibility of transdermal estrogen (Divigel) described their clinical and pharmacological charac- teristics, their own experience and training schemes for pregnant women of reproductive age with endometrial hypoplasia.