Vol 18, No 6 (2016)

Articles
Personification of hormonal contraception
Karakhalis L.Y., Penzhoyan G.A., Mogilina M.N.
Abstract
The article deals with the problems related to women's reproductive health, issues of birth control and rational contraception using modern means of hormonal contraception, and in particular, MODELL drug line.
Gynecology. 2016;18(6):4-7
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Pharmacoeconomic advantages of using intrauterine levonorgestrel containing Mirena system in conjunction with the transdermal estrogen containing drugs for the treatment of menopausal syndrome and contraception during the menopausal transition
Baeva N.G., Filyaeva Y.A.
Abstract
The current article provides the pharmacoeconomical comparison of cost-effectiveness between combined preparations for treatment of climacteric syndrome and IUD Mirena combined with trans-dermal estrogen formulations.
Gynecology. 2016;18(6):8-13
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A comprehensive approach to the treatment of septic pelvic inflammatory disease using immunomodulatory therapy
Lapina I.A., Dobrokhotova Y.E., Bondarenko K.R., Gavrilov M.V., Ermolenko N.S.
Abstract
Objective - to develop the tactics of complex treatment of patients with purulent inflammatory diseases of the pelvic organs in order to reduce the time to achieve a stable remission. Materials and methods. A randomized, controlled clinical prospective study, the object of which were 62 women of reproductive age with acute exacerbation of chronic bilateral salpingoophoritis with disease duration of more than 3 years, complicated by the formation of one or two-sided suppurative tubo-ovarian structures (abscesses, piosalpings and others). All patients had surgical treatment in conjunction with antibiotic therapy simple women were randomly were divided into two groups: Group 1 (core) consisted of 32 women who are additionally appointed immunomodulatory therapy (drug Polyoxidonium®), Group 2 (control) included 30 patients who received standard therapy (surgery, and antibacterial). The control group consisted of 40 healthy women of childbearing age without any acute and chronic infectious inflammatory diseases of any localization at the time of the survey. Everyone involved in the study was conducted complex clinical, laboratory and instrumental examination. Evaluation indicators in patients 1 and 2 groups was performed twice in dynamics - before the start of therapeutic measures and 1 month after treatment. Results and conclusions. The findings suggest that for reducing the time of normalization of clinical and laboratory parameters and to achieve long-term remission in purulent inflammatory diseases of the pelvic organs pathogenetic sound may be considered included in the standard treatment regimen of funds aimed at correcting violations of the local immune system, and the system hemostasis.
Gynecology. 2016;18(6):14-19
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Corifollitropin alfa application in art programs in women over 40 years
Kuleshova D.A., Melekhova N.Y., Gustovarova T.A., Ivanyan A.N., Chernyakova A.L., Kryukovskiy S.B.
Abstract
Purpose of the study is evaluation of clinical outcomes, embryological characteristics, pharmacoeconomic aspects of corifollitropina alpha application in the ART programs, conducted in patients older than 40 years at the expense of mandatory health insurance funds (compulsory medical insurance).40 ART programs at the expense of the compulsary medical insurance (OMS) were analyzed (20 patients whose controlled ovarian stimulation - COS was carried out using follitropinalfa, 20 patients, whose COS was conducted using corifollitropina alpha). We analyzed the data of the anamnesis, clinical and gynecological examinations, hormonal status, ultrasound scans, folliculogenesis parameters in stimulation protocol, number and quality of the oocytes, embryos. The effectiveness of corifollitropina alfa and follitropinalfa in patients older than 40 years is the same. Implementation of the ART programs using corifollitropina alpha is more pharmaeconomicly reasonable and saves budget money.
Gynecology. 2016;18(6):20-23
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The role of immunohistochemical research at the diagnosis of neoplastic lesions of the cervix
Shchegolev A.I., Mishnev O.D.
Abstract
The analysis of literature data about the use of immunohistochemical markers for the diagnosis and differential diagnosis of cervical lesions. The most significant assistance in identifying and determining the degree of cervical intraepithelial neoplasia has immunohistochemical detection of Ki-67 and p16. Shows the changes of p63, topoisomerase, C-erbB-2, cyclin D1 at the cervical intraepithelial neoplasia of different degrees of severity and cervical cancer. It is concluded that the immunohistochemical research is legitimate considered as an effective method for histopathological studies. It allows to carry out an objective diagnosis of neoplastic lesions of the cervix, to carry out their differential diagnosis with reactive and tumor-like changes, as well as to determine the prognosis of the disease.
Gynecology. 2016;18(6):24-27
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Efficacy of Mastodinone® for mastalgia correction in preand perimenopausal women
Rozhkova N.I., Burdina I.I., Zapirova S.B., Mazo M.L., Prokopenko S.P., Yakobs O.E.
Abstract
The purpose of the study wasto examine the effectiveness of the drug Mastodynon® for the treatment of mastopathy in pre - and perimenopausal women. Materials and methods. The research was carried out within 12 months. Patient presenting complaints of pain in the breast, passed a comprehensive examination (clinical and Х-ray and/or sonographic) and questionnaires at the first visit and every 6 months. The plant-based drug Mastodynon®. Results. We examined 38 patients aged 45-56 years. Most women in this group for many years were observed due to mastopathy of different forms and degrees of severity. After 6 months after start of treatment with Mastodynon® the majority of patients reported decrease or absence of pain in the breasts, improvement of psycho-emotional condition. The positive effect of various degree was observed in 71.05% of the patients. After 1 year revealed a stabilization of the therapeutic effect of the drug Mastodynon® in 83.3% of cases. Mastodynon® has shown high effectiveness, good tolerability in the treatment of mastopathy in women of pre - and perimenopausal age, it has improved thepatients quality of life.
Gynecology. 2016;18(6):28-31
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Evaluation of cervical screening at treatment of a vulvovaginal atrophy in periand postmenopausal women
Klinyshkova T.V., Samosudova I.B., Mironova O.N.
Abstract
Objective. Determination of effective application of vaginal complex estriol 0,2 mg/progesteron 2 mg/Lactobacillus casei rhamnosus 2¥109 at women with a vulvovaginal atrophy in peri-and postmenopausal women with a evaluation of cervical screening. Materials and methods. 109 patients with a vulvovaginal atrophy (VVA) were examined: the 1st group - 53 patients in a perimenopauza (middle age - 50.11±3.89 years), the 2nd group - 56 women in a postmenopause at the age of 65.8±4.13 years. The complex of researches included an assessment of complaints, the anamnestic and clinical data, bakterioskopic, cytologic and kolposkopic researches with interpretation of results according to the International standards and use of the modern equipment. The medical stage included vaginal application of a complex estriol, progesterone, L. casei rhamnosus on the 2nd capsules once a day during 14 (in the 1st group) and 21 day (in the 2nd group). Control of cervical cytologic inspection was carried out twice (in 4 and 6 weeks) after treatment. Conclusions. After the carried-out local therapy at patients of two groups clinical improvement of a current of VVA, normalization of a biocenosis of a vagina in comparison with basic data is established (p<0.001). At patients of the 1st group normalization of cytologic dabs (NILM in 83% of cases) against a reduction of ASC-US, regression of an inflammation (is 5.6 times more often in comparison with basic data) and an atrophy was noted (3.7 times more often) (p<0.001); in the 2nd group - decrease in rates of normalization of cytologic dabs (NILM in 48% of cases), a full reduction of ASC-US (p<0.05) with a tendency to regression of an inflammation (by 1.9 times) and atrophies (1.3 times more often) than rather basic data.
Gynecology. 2016;18(6):32-35
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Features of bioregulatory therapy in gynecological practice (review)
Lineva O.I.
Abstract
Bioregulatory approach and by its principles bioregulatory complex preparations such as Traumeel® S have the ability to influence midget doses, activation of detoxification and recovery of self-regulation processes. This review presents the current published data on the effectiveness of medication Traumeel® S in treatment of certain gynecological diseases in accordance with the principles of bioregulatory medicine.
Gynecology. 2016;18(6):36-42
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Pregnancy and eye diseases (literature review)
Sinchikhin S.P., Ramazanova L.S., Mamiev O.B., Stepanyan L.V., Napylova O.A.
Abstract
It presents historical data on the management of pregnancy in women with diseases of the eye, showing ophthalmic manifestations in various pathological conditions by the organs of sight and order management of pregnancy and childbirth in women with ophthalmic pathology, including in ophthalmic morphological and functional changes associated with the development of gestational complications. Noting also the permissibility of performing laser-surgical procedures in pathological changes in the organs of a pregnant woman and ophthalmic changes are taken into account when choosing a mode of delivery.
Gynecology. 2016;18(6):43-50
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Obstetric and perinatal aspects of choosing folate containing medications for miscarriage treatment
Kurmacheva N.A., Kharitonova O.M., Verizhnikova E.V.
Abstract
Objective - to compare the pregnancy and the condition of full-term newborns of women with gene polymorphisms of folate cycle and a history of miscarriage, receiving metafolin containing complex and mega-doses of folic acid (FA). Materials and methods. A retrospective study of medical records of 114 patients (form number 025/a, 111/a, 113/y). Compare homocysteine levels, coagulation screening indicators, peculiarities of pregnancy, childbirth, newborn status, depending on the version of folate deficiency correction. Results. In the group of patients treated with metafoline containing vitamin and mineral complex (n=60) had significantly lower levels of homocysteine, fibrinogen, thrombinemia markers, the frequency of some obstetric and perinatal complications (in 1.5-3.9 times; p<0.05) compared to women receiving mega-doses of synthetic drugs FC (n=54). Conclusion. Routine administration of excessive doses of synthetic FC in the treatment of miscarriage in women with folate polymorphisms cycle genes is impractical, preference should be given drugs containing the active form of folate - metafolin.
Gynecology. 2016;18(6):51-55
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Experience of using the local combination product containing miconazole and metronidazole for the treatment of bacterial vaginosis and vulvovaginal candidiasis in pregnant women
Bitsadze V.O., Radetskaya L.S.
Abstract
The problem of vaginal infections, such as bacterial vaginosis and vulvovaginal candidiasis during pregnancy is extremely relevant in connection with adverse perinatal outcomes, and an increased risk of preterm birth. Treatment of vaginal infections is a serious problem in connection with the formation of bacterial resistance, frequent recurrence, late onset of therapy due to the prolonged diagnosis and drug selection. We conducted a prospective study to evaluate the efficacy and safety of topical formulation containing 750 mg of metronidazole and 200 mg of miconazole nitrate (Neo-Penotran Forte) for the treatment of bacterial vaginosis and vulvovaginal candidiasis in pregnant women in II trimester. Methods. The study included 122 pregnant women aged 18 to 40 years (mean age 29.6±2.5 years) without concomitant extragenital pathology in 18-22 weeks gestation with a confirmed diagnosis of bacterial vaginosis (n=51) and candidiasis vulvovaginitis (n=71). The clinical and therapeutic efficacy of the drug was evaluated, as well as the speed of the onset of clinical efficacy (the day of the start of treatment), perinatal outcomes, the incidence of preterm delivery in both groups, the incidence of side effects during treatment with the drug. Results. The therapeutic efficiency of the preparation (no normalization of subjective symptoms and laboratory values) in a group of pregnant women with bacterial vaginosis at 14 and 28 days from the start of the study was 96% (n=48) and 94% (n=47), respectively. In the group with candidal vulvovaginitis - 94.2% (n=65) and 91.3% (n=63). Clinical efficacy (lack of subjective symptoms) by the end of the course of treatment achieved completely in all patients in both groups, and in many patients before the end of the full course of treatment. Conclusion. Neo-Penotran Forte is a highly effective and safe and can be recommended for the treatment of bacterial vaginosis and vulvovaginal candidiasis in pregnant women, starting with the II trimester. Effective treatment of pregnant women with bacterial vaginosis and vulvovaginal candidiasis drug Neo- Penotran Forte prevent adverse pregnancy outcomes and reduces the risk of preterm birth associated with vaginal infection, but due to the small sample size, this problem requires further investigation.
Gynecology. 2016;18(6):56-60
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A case of successful thrombolysis in massive pulmonary embolism in pregnancy
Shakurova E.Y., Yastrebov M.A.
Abstract
We present a case of successful thrombolysis in massive pulmonary embolism in pregnancy. No severe haemorrhagic complications were observed. Thrombolysis was effective and did not affect the pregnancy and the fetus.
Gynecology. 2016;18(6):61-62
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Effect of increased body weight and obesity on the incidence of gynecological pathology, during childbirth, postnatal period and the state of newborns
Karakhalis L.Y., Mogilina M.N.
Abstract
Increased body weight and obesity affect the incidence of gynecological diseases, the development of children, the growth of estrogen-dependent diseases. The issues of prevention of obstetric complications in women with overweight and obesity through the use of modern desogestrel-containing contraceptives.
Gynecology. 2016;18(6):67-70
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