Vol 18, No 2 (2016)


The role of micronutrient preparations of periconceptive prevention of obstetric complications and congenital malformations

Korennaya V.V., Agisheva V.V., Lyubimova E.A.


The period of pregnancy is associated with increased need for vitamins and mineral elements. It is known that various micronutrient deficiencies lead to congenital malformations in the fetus and increase the frequency of pregnancy complications. Whatever was not balanced nutrition of pregnant and lactating women, to fully meet its needs for vitamins and minerals due to the correction of the diet is extremely difficult, so in most cases recommended to carry out prevention nutrient deficit. Much attention is paid to the composition of preparations because multicomponent additives may provide additional prophylactic effects.
Gynecology. 2016;18(2):4-7
pages 4-7 views

Features of calcium metabolism during pregnancy depending on body saturation of vitamin D

Shelepova E.S., Zazerskaya I.E., Chazova E.L., Kuznetsova L.V., Yakovleva N.Y., Vasileva E.Y.


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.
Gynecology. 2016;18(2):8-10
pages 8-10 views

Pathology of the cervix during pregnancy: screening and treatment strategy (the review)

Pikuza T.V., Chilova R.A., Kaptil'nyy V.A., Chushkov J.V., Tkacheva M.V.


The review presents the current state of pathological conditions of the cervix. The changes of the cervix during pregnancy, the risk of cervical pathology with pregnant women are described here. The modern classification of pathological conditions of the cervix, including inflammatory diseases, background and precancerous state are described here. Peculiarities of the pathology of the cervix with pregnant women are shown here, modern methods of diagnosis and treatment are given here.
Gynecology. 2016;18(2):11-18
pages 11-18 views

The role of detoxification therapy in fetal growth restriction prevention

Dolgushina N.V., Kazantseva E.V., Tereshkov P.P., Pivovarova L.V.


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.
Gynecology. 2016;18(2):19-23
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Non-invasive fetal RHD determination in out-patient practice

Makhmudova S.M., Pavlovich S.V., Trofimov D.I., Donnikov A.E., Faizulin L.Z., D'iakonova A.A., Karnaukhov V.N.


The aim of the study was to improve approaches to the use of Rh0(D) immune globulin in pregnant women with Rh-negative blood by introducing noninvasive method of determination of fetal rhesus blood factor by mother’s blood into curation program of pregnancy at risk of RBC sensitization. The accuracy of noninvasive method of rhesus genotyping in 204 pregnant women with Rh negative blood in 14-27 weeks of pregnancy was 99.0%. The determination of fetal rhesus allows personify implementation of immunological prophylaxis in Rh negative pregnant women.
Gynecology. 2016;18(2):25-26
pages 25-26 views

Non-surgical methods of correction of genital prolapse and urinary disorders

Il'ina I.I., Dobrokhotova I.E.


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.
Gynecology. 2016;18(2):28-31
pages 28-31 views

Papillomavirus infection of the urogenital tract: epidemiological aspects (review)

Abramovskih O.S., Dolgyshina V.F., Telesheva L.F., Letyaeva O.I., Antimirova E.A.


This review shows the influence of regional peculiarities in the distribution and frequency range of the human papillomavirus (HPV), which is necessary to predict the formation of malignant transformation of cervical epithelium, allocation risk of developing a malignant process, as well as for monitoring of HPV infection. Epidemiological studies on the prevalence of HPV allow to allocate the prevailing types of the virus and can serve as a basis for the creation of economically appropriate programs for the prevention and treatment of cervical cancer in different regions.
Gynecology. 2016;18(2):34-39
pages 34-39 views

Possibility to save and recovery of fertility after surgical treatment of tubal pregnancy

Matveev A.M., Novikova V.A., Fedorovich O.K.


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%.
Gynecology. 2016;18(2):40-43
pages 40-43 views

Chronic endometritis as a result of infectious inflammatory diseases of the uterus

Kuznetsova I.V., Zemlina N.S., Rashidov T.N.


Chronic endometritis is one of the most urgent problems of modern gynecology. The difficulties of verification, the lack of unity in the understanding of the nature of the inflammatory lesions of the endometrium, a symptomically uneven picture with multiple negative outcomes for reproduction - all this determines the interest in the pathogenesis, diagnosis and treatment of chronic endometritis. The treatment of endometritis, as a form of inflammatory diseases of the pelvic organs, lies in the use of antibiotic therapy. However, the formation of chronic inflammation is associated not so much with the virulence of the organism, but with the features of the immune response of host and the local immunity of the endometrium. This justifies the use in the treatment of immunomodulatory drugs and drugs with proteolytic action, aimed at preventing fibrosis and sclerosis of tissues. One of these drugs is bovhyaluronidase azoximer (Longidaze).
Gynecology. 2016;18(2):44-50
pages 44-50 views

The virus infections and reproductive health

Posiseeva L.V.


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.
Gynecology. 2016;18(2):51-55
pages 51-55 views

A comprehensive approach to the treatment of infertility caused by inflammatory diseases of the pelvic organs

Lapina I.A., Ozolinia L.A., Nasyrova N.I., Patrushev L.I., Dobrokhotova Y.E., Bondarenko K.R.


Objective. To develop the tactics of complex treatment of patients with infertility caused by chronic inflammatory diseases of the pelvic organs to improve the quality pregravid stage and reduce the risk of reproductive losses. Materials and methods. 70 patients were operated with chronic inflammation of the pelvic organs, primary or secondary infertility. The study was prospective in nature. All patients were performed complete clinical and laboratory tests, genotyping of the most significant thrombophilic polymorphisms, as well as assessed the vaginal microflora. Conclusions. The tactics of treating the patients with infertility caused by inflammatory diseases of the pelvic organs, should include an individual holistic approach aimed at improving pregravid stage of treatment. In it, in addition to surgical approach, normalization of hemostasis system, preparation of the endometrium, the prevention of exacerbations of bacterial and viral infections should be included.
Gynecology. 2016;18(2):56-62
pages 56-62 views

The biological role of magnesium deficiency in violation of homeostasis in women: a literature review

Pestrikova T.Y., Yurasova E.A., Yurasov I.V.


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.
Gynecology. 2016;18(2):63-66
pages 63-66 views

Confounding factors of primary venous thromboses and embolisms associated with reproductive behavior of women

Belokrinitskaya T.E., Frolova N.I., Galygin E.V., Nardin D.B., Morozov E.Y.


Objective. To identify the major confounding factors of primary venous thromboses and embolisms associated with reproductive behavior of women. Subjects and methods. Retrospective analysis of risk factors for venous thromboembolic events (VTEEs) was made in 53 reproductive-aged (18-45-year-old) women with no history of severe somatic diseases and thromboses. Results. In 67.9% of the patients, the major triggers of primary VTEEs were the use of combined oral contraceptive (COC) pills (43.4%) and pregnancy/postpartum (24.5%). The most common cofactors were lower extremity varices (79.2%), over 35 years of age (62.4%), a sedentary lifestyle (60.4%), smoking (33.9%), obesity (33.9%), and positive family history of thromboses/genetically verified thrombophilia (20.8%). The mean number of background risk factors was 3.4±0.1 in COC users, 3.7±0.2 in pregnant women, and 5.0±0.1 in puerperas. Conclusion. When prescribing COC pills, planning, and managing pregnancy/postpartum, it is necessary to keep in mind that the risk of VTEEs is increased, to thoroughly assess the already existing risk factors, and to take every measure for their prevention.
Gynecology. 2016;18(2):67-70
pages 67-70 views

Psychovegetative disorders and pain at women with dysmenorrhea

Sergeeva S.P., Aleksandrov L.S.


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.
Gynecology. 2016;18(2):71-74
pages 71-74 views

The triad of symptoms in the diagnostic algorithm of pelvic endometriosis

Sinchikhin S.P., Magakyan O.G., Magakyan S.G., Mamiev O.B.


This article presents the invention "Method for early diagnosis of endometriosis of the pelvic organs" - priority reference from 24.11.2015, request №2015150378(077570). Installed the triad of clinical and instrumental signs in patients with endometriosis: the complaint of dyspareunia, polymorphically the presence of skin lesions on the face and detection of an ultrasound fluid in excavatio rectouterina any day of the menstrual cycle. Presents clinical examples which are showing the informative of this method and ease of application in practical work.
Gynecology. 2016;18(2):76-80
pages 76-80 views

Endometrioid adenocarcinoma in pregnancy: case report

Musina E.V., Tral T.G., Tarasova M.A.


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.
Gynecology. 2016;18(2):81-83
pages 81-83 views

Clinical case of ovarian cancer during pregnancy

Dobrokhotova Y.E., Ter-Ovanesov M.D., Danielian S.Z., Venediktova M.G., Sarantsev A.N., Zykov A.E., Hasan A.S., Panova N.P., Morozova K.V., Savina Y.A.


Ovarian cancer is one of the most common locations of cancer of female genitalia. Association of ovarian cancer with pregnancy is rare and extremely difficult problem. The absence of pathognomonic symptoms until the advanced stage of the process makes it difficult diagnosis of ovarian cancer. The presence of a malignant tumor may adversely affect the course of pregnancy, while the presence of the pregnancy can provoke active progression of cancer. The difficulty in diagnosing early stages of ovarian cancer because of the lack of pathognomonic clinical manifestations leads to the identification of the primary process in the advanced stage, which significantly worsens the prognosis of the disease. Modern medicine offers a variety of methods of diagnosis of ovarian cancer, but their use during pregnancy has its limitations and differences. It is necessary to optimize approaches to managing this group of patients, primarily aimed at early detection of malignant ovarian tumors.
Gynecology. 2016;18(2):84-86
pages 84-86 views

A new model of gynecological and obstetrical pessary

Schneiderman M.G., Gorshkov A.V.


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.
Gynecology. 2016;18(2):92-95
pages 92-95 views

Presentation of the application of tissue engineering in gynecology (review)

Sulina Y.Y., Ishchenko A.I., Lyundup A.V., Alexandrov L.S., Ischenko A.A.


The review deals with the development stages of the application of cell engineering technologies in Gynecology, Gynaecologic Oncology, Urogynecology. The basic principles, opportunities, advantages and disadvantages of development for the treatment of pelvic prolapse, urinary incontinence syndrome and partial organo with cell structures. The results of works published in the last 15 years. This review reflects the significance of the achievements of tissue-engineering technology for the regeneration of complex tissues and organs, as well as the importance of these innovations for the clinic.
Gynecology. 2016;18(2):96-102
pages 96-102 views

Transdermal estrogen in women of reproductive age (for the practitioner's aid)

Mezhevitinova E.A.


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.
Gynecology. 2016;18(2):103-106
pages 103-106 views

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