Vol 18, No 5 (2016)


Association of polymorphism of aromatase (CYP19A1) with the risk of complications in the application of hormonal contraception in women of reproductive age

Ivanova E.V., Prilepskaya V.N., Mezhevitinova E.A., Donnikov A.E., Trofimov D.Y., Nikitin I.G.


An increasing number of hormonal contraceptives and their varying system effects on the body of a woman makes it necessary to personify their prescription and search for means of predicting their safety and tolerability. The article presents the research data and shows the various informative clinical predictors in the development of adverse reactions in the background. It was found that the most significant clinical predictors of occurrence of side effects and complications on the background of the use of the HC are the existence of gynecological diseases associated with menstrual cycles and poor portability of HC in history; an independent predictor of adverse effects on the background of the COC are chronic cholecystitis and dysfunction of the sphincter of Oddi; dynamics of lipid parameters, biochemical blood spectrum, as well as some parameters of hemostasis with the use of different variants of HC; genotype women polymorphic locus rs2414096 aromatase gene (CYP19A1) is a significant predictor of complications and side effects when using HC.
Gynecology. 2016;18(5):4-9
pages 4-9 views

Emergency contraception among young people

Aganezov S.S., Morotskaya A.V., Aganezova N.V.


Purpose of the study is to determine the frequency of the use of emergency contraception among young people and awareness of the emergency contraception in the youth environment. Material and methods. Analysis of data from anonymous questionnaires was received from 952 people from various educational institutions and by the young doctors of various specialties. The gender composition of participants was: girls - 802 (84.2%), boys -150 (15.8%) aged 15 to 24 years (mean age 20.7±1.6 years). Results. Pregnancy rates among young people is 9.9% and increases with age. Two-thirds of pregnancies were medically aborted. Every third woman (32.9%) has an experience in using emergency contraception. For the levonorgestrel, emergency contraception is used. Awareness about emergency contraception is low.
Gynecology. 2016;18(5):10-13
pages 10-13 views

Polycystic ovarian syndrome: a modern overview

Dubrovina S.O.


Polycystic ovarian syndrome (PCOS) is one of the most common metabolic and reproductive disorders among women of reproductive age. Women suffering from PCOS have a whole complex of symptoms associated with menstrual dysfunction and androgen excess, which significantly impacts their quality of life. They may be at increased risk of multiple morbidities, including obesity, insulin resistance, type II diabetes mellitus, endometrial cancer, and psychological disorders. This review summarizes guidelines to diagnosis of PCOS, stress on the various aspects of treatment and screening recommendations currently used in the management of this condition.
Gynecology. 2016;18(5):14-19
pages 14-19 views

The experience of using the placenta hydrolyzate in women with climacteric syndrome in perimenopausal period

Kovalenko I.I., Atalyan A.V.


This article presents the results of randomized, blind, placebo-controlled prospective study in parallel groups. 40 premenopausal women with symptoms of climacteric syndrome, menstrual disordersand FSH level more than 20 mIu/ml, were recruited and randomized into 2 groups: 20 women (group 1) used placenta extract Melsmon (Japan), 2 ml (100 mg), subcutaneously, every 2nd day for 2 weeks, then 2 time a week (30 injections for 4 months in total). 20 patients (group 2) were included in the placebo group (2 ml subcutaneously, in similar regimen). After 4 months of treatment the significant decrease of modified Kupperman menopausal index, decrease of time required tofall asleep and night time awakenings number, as far as increasing of sleep duration and significant improvement of general health self-assessment were registered in both groups. The improvement of psycho-emotional symptomsand skin condition after intervention was reported only in the 1st group. 32% of women used placental extract and 5% patients from placebo group reported about menstrual episodes after period of amenorrhea, without any significant changes in endometrial thickness. Study limitations: because of the small sample size and limited observation period, more long-term trials are needed.
Gynecology. 2016;18(5):20-25
pages 20-25 views

Place of immunomodulators in the treatment of pelvic inflammatory diseases

Kuznetsova I.V., Rashidov T.N.


Pelvic inflammatory diseases (PID) are widespread in the population of women of reproductive age. The special properties of pathogens of urogenital infections, immune dysfunction of host systems often lead to the formation of chronic inflammation, especially in women with asymptomatic infection infections, sexually transmitted infections, and patients with subclinical PID. Chronic pelvic inflammatory disease, in turn, are associated with numerous disorders reproductive system, including infertility, miscarriage, chronic pelvic pain. Prevention of chronic inflammation and its negative consequences is early detection and adequate treatment as STDs and PID, especially their subclinical variants. Unfortunately, antibiotics do not always justify the hopes placed in it, partly because of rising resistance of pathogens, in part due to their own side effects, including an immunosuppressive action. To optimize antibiotic therapy and prevention of pelvic inflammatory disease and relapse in the treatment regimen immunomodulators may be used. Since a key role in the immune response to infectious implementation is played by phagocytic link, inclusion in therapy azoximer bromide, providing a full function of phagocytes, seems reasonable and appropriate.
Gynecology. 2016;18(5):26-31
pages 26-31 views

Modern methods of prevention and treatment of intrauterine adhesions (literature review)

Khirieva P.M., Adamyan L.V., Martynov S.A.


Intrauterine adhesions (IUA) or Asherman's syndrome - multifaceted condition, which is being diagnosed with increasing frequency in recent years and a major cause of secondary infertility. Despite the widespread adoption of hysteroscopic adhesiolysis, the management of IUAs still presents a big challenge: the recurrence rate could be up to 62.5% in severe IUAs. The literature review highlights the current capabilities of surgical treatment, methods and means of prevention of recurrence, as well as the most promising research into the pathogenesis and treatment of Asherman's syndrome.
Gynecology. 2016;18(5):32-36
pages 32-36 views

Early predictive markers of preeclampsia

Dubrovina S.O., Mutsalkhanova Y.S.


Despite of preeclampsia is a leading cause of perinatal morbidity and mortality, the pathophysiology of preeclampsia remains unknown. Early prediction of preeclampsia would allow for timely initiation of preventive therapy. A combination of anamnesis, biophysical and biochemical markers are superior to other tests for early prediction of the development of preeclampsia. This article reviews the current research of the most important strategies for prediction of preeclampsia, including the use of maternal risk factors and biomarkers.
Gynecology. 2016;18(5):38-43
pages 38-43 views

Late-induced abortion in cases of congenital fetal malformation incompatible with life

Kravchenko E.N., Kolombet E.V.


Objective: To evaluate the efficacy and safety methods for termination of pregnancy in the late period of congenital fetal malformation incompatible with life. Materials and methods. A randomized comparative study in 2 stages (retrospective and prospective). On stage, I conducted a retrospective analysis of the termination of pregnancy in 150 women who were divided into 2 groups: Group A - 75 women who underwent transvaginal method of transcervical amniocentesis. Under the prospective study (II stage) was 195 pregnant women were divided into 2 groups. The main group - 98 women with the combined method (medical combined with kelp); comparison group - 97 women (WHO scheme). Results. The efficiency of abortion (I stage) by amniocentesis was 93.3%, with prostaglandins - 92%. The effectiveness of the methods used abortion at stage II was 99.0% in the intervention group and 96.9% - in the comparison group. With a decrease in the length of time from the beginning of the method to the induction of late induced abortion in both groups there was a decrease in complications. The greatest number of complications observed in women with a duration of late induced abortion 24 hours or more. Conclusion. The advantages of the combined method has a shorter duration of time from the start of the method prior to uterine activity, due to the mechanical action of kelp on the cervix. A smaller dose of mifepristone (3 times) and a lower dose of misoprostol (2-fold) in the combined process has reduced adverse events (4.2 times).
Gynecology. 2016;18(5):44-49
pages 44-49 views

Features of the art programs funded by the CHI in women over 40 years of age

Kuleshova D.A., Melehova N.Y., Gustovarova T.A., Ivanyan A.N., Chernyakova A.L., Krukovsky C.B.


Purpose of the study is assessment of the effectiveness of the ART programs funded by the Compulsory Health Insurance Fund among patients older than 40 years of age. 80 ART programs at the expense of the mandatory health insurance funds (40 patients at the age of 40 and older, 40 patients younger than 40 years) have been analyzed. We have analyzed the data of the anamnesis, clinical and gynecological examinations, hormonal status, ultrasound scans, parameters of folliculogenesis in stimulation protocol, number and quality of the oocytes and embryos. There’s a tendency of age-related decrease in number and quality of the embryos. The effectiveness of the ART programs in women of this age group is not high (20%), which requires an expansion of using the donor oocytes’cycles.
Gynecology. 2016;18(5):50-52
pages 50-52 views

Interdisciplinary aspects of breast pathology: literature review

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


In the given review of the article, the data on the frequency, pathogenesis of breast disease, including cancer is presented. The general aspects of risk factors such as benign breast disease, and for breast cancer are also given. The modern types of classifications and survey methods in patients with breast disease, as well as the role of multi-disciplinary approach, namely continuity between the doctors of various specialties: obstetricians, mammalogy, surgeons, oncologists, and morphology are listed as well. The advantages of efficacy and safety of non-hormonal drug Mamoclam in the pathology of the mammary glands are many. As a result of the action of iodine, polyunsaturated fatty acids and omega-3 chlorophyll included in the preparation of laminaria (Mamoclam), normalization occurs and the balance of thyroid hormones, cells, cell proliferation in breast tissue, which has a therapeutic effect in patients with fibrocystic disease. The clinical efficacy of Mamoclam from the kelp reaches 90%. The modern approach of rational strategies for any disease, including breast pathology, carried out on two principles: the existence of evidence and regulatory documents is described in detail.
Gynecology. 2016;18(5):53-59
pages 53-59 views

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