Vol 19, No 1 (2017)

Articles
Emergency hormonal contraception (literature review)
Prilepskaya V.N., Mgeryan A.N.
Abstract
The article presents modern literature data on emergency contraceptive methods and the principles of the action of drugs used for this purpose, their characteristics, effects on the reproductive system, efficacy, acceptability, their effect on ovulation and the state of the endometrium.
Gynecology. 2017;19(1):10-14
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Prolonged treatment of combined oral contraceptive: a focus on the prevention of inflammatory diseases of the pelvic organs
Tapilskaya N.I., Glushakov R.I.
Abstract
The article presents data on preventive effects of combined oral contraceptives (COCs) with respect to the risks of inflammatory diseases of the pelvic organs (pelvic inflammatory disease - PID), complemented by modern ideas about the influence of COCs on the state of cervicovaginal lavage, depending on the secretion of antimicrobial peptides from the phase of the menstrual cycle and the use of COCs. The data meta-analysis to reduce the recurrence of bacterial vaginosis in patients receiving COCs, the justification of the preventive effect of the prolonged mode of Yaz® intake in a flex cartridge for PID in women in need of contraception is given.
Gynecology. 2017;19(1):15-20
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Evaluating the effectiveness of alternative treatments for menopausal symptoms in postmenopausal women
Yureneva S.V., Ermakova E.I.
Abstract
Purpose of the study - to evaluate the effectiveness of black cohosh extract (Chi-Klim drug) and its combination with beta-alanine (Chi-Klim Alanine) for the treatment of menopausal symptoms in women in the early and late postmenopausal women. Materials and methods. A pilot randomized clinical trial included 60 patients aged 40 to 65 years with a duration of menopause not less than 12 months and with a frequency of vasomotor manifestations (tidal) not less than 10 per day. The study did not include women who received menopausal hormone therapy or alternative methods of therapy for the past 3 months. Results. The therapy there was a significant reduction in the severity of menopausal manifestations in both treatment groups, however, in the group 2 the decline was more effective. Acceptance of the drug based on the extract of black cohosh in combination with a dietary supplement on the basis of beta-alanine was 2 times more effective than monotherapy with black cohosh reduced hot flushes per day and had a more pronounced adjoint positive effect on the psycho-emotional symptoms.
Gynecology. 2017;19(1):21-26
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The possibility of human placenta extract in the treatment of symptoms genitourinary syndrome in postmenopausal women
Orazov M.R., Khamoshina M.B., Bebneva T.N., Policarpova S.R.
Abstract
Article is devoted an actual problem of modern gynecology - correction of the symptoms genitourinary syndrome (GUS), which has important medical and social importance. In addition to traditional hormone therapy, modern medicine has a broad range of metabolic substances, antioxidants and reparants to treat women with clinical manifestations of GUS. In this prospective study were 62 women aged up to 60 years in postmenopausal women with clinical symptoms of GUS, for the comprehensive treatment which the metabolic therapy was used the Melsmon (human placenta extract for subcutaneous injection).The results of the study demonstrated high clinical efficiency of the use of this therapy for relief of symptoms of GUS that improve the quality of life for women of postmenopausal age.
Gynecology. 2017;19(1):27-30
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Prolonged regimens for combined oral contraceptives
Kuznetsova I.V.
Abstract
One way to improve combined oral contraception is to optimize the regimens for its reception. The standard mode of use of combined oral contraceptyves (COCs) does not always justify the expectations of women, especially in situations where additional therapeutic indications exist for their use. The extended regimens for use of COCs are more appropriate for both contraceptive tasks and the therapeutic uses of progestagen-estrogen preparations. The spread of prolonged regimes is hampered by a number of prejudices associated with insufficient awareness of doctors and patients, as well as a small number of drugs annotated for use without inter-hormonal intervals. Recently registered in Russia low-dose COC containing levonorgestrel and ethinyl estradiol, provides the option of prolonged contraception in the 84+7 mode. On the example of this drug, the review addresses the issues of contraceptive and therapeutic effectiveness, acceptability and prospects for using fixed, prolonged contraceptive regimens.
Gynecology. 2017;19(1):31-36
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Screening and treatment of patients with breast diseases in practice of obstetrician-gynecologist
Ovsyannikova T.V.
Abstract
The article presents the program and stages of breast examination in patients seeking an obstetrician-gynecologist. The classification of benign breast diseases (BBD), the possibility of treatment of gynecological diseases with dyshormonal pathology and the effectiveness of this therapy in mastitis and mastodynia. Submitted by the products developed and registered for the treatment of BBD. Attention is paid to drug Mastodynon possessing a multifaceted effect on various parts of the endocrine system in the treatment of premenstrual syndrome, defective lutein phase, mastitis and mastodynia.
Gynecology. 2017;19(1):37-41
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Modern possibilities of ovarian endometrioid cyst treatment
Lapina I.A., Dobrokhotova Y.E., Gavrilov M.V., Sdvigov A.S., Ermolenko N.S.
Abstract
The aim of the study was to evaluate the effectiveness of the procedure of removing endometrioid cysts using the PerClot local haemostatic system for the maintenance of healthy ovarian tissue, as well as revealing the possible systemic effect of this drug on hemostasis. Materials and methods. A controlled clinical randomized prospective study was conducted, targeting 82 women of reproductive age with endometrioid ovarian cysts. All patients underwent surgical treatment. The method of simple randomization of women was divided into two groups: 1 group (main) consisted of 32 women who were removed the capsule of the cyst, followed by treatment of the bed with the haemostatic system Perclot. The second group consisted of 50 patients who had been removed from the endometrioid cyst according to the traditional method, including a complete excision of the capsule, and as a hemostasis bipolar electrosurgery was used. The control group consisted of 40 healthy women of reproductive age. All participants in the study conducted a comprehensive clinical laboratory and instrumental examination. Results and conclusions. The data obtained suggest that the local method of using the new generation of hemostatic, PerClot, allows quickly and effectively to stop bleeding in combination with a low traumatic effect on healthy ovarian tissue, thereby allowing the preservation of its follicular reserve, which is especially effective in patients with endometriomas 5 cm.
Gynecology. 2017;19(1):42-45
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Prevention high blood loss and coagulopathic bleeding at abdominal delivery
Sinchikhin S.P., Sarbasova A.E., Stepanyan L.V., Mamiev O.B.
Abstract
The purpose of the study - to assess the effectiveness of intraoperative application of complex drugs calcium gluconate (10 ml of 10% solution) and tranexamic acid (1.0 g) for abdominal delivery of patients with disorders in the fibrinolytic links of blood coagulation. Material and methods. We observed 160 patients, delivery by caesarean section, which carried out by one and the same surgical team. All pregnant women are at risk for the development of coagulopathic bleeding. The average age of patients was 28.3±1.7 years. Observed were divided into equal groups and the number of subgroups (40 persons in each). According to the developed method, a specified author invention priority reference from 18.07.2016, Application №2016129336(045647), one group of patients at the time of abdominal wall incision sequentially intravenously injected into a peripheral vein with 10 ml of 10% solution of calcium gluconate and tranexamic acid. The patients in the other groups these drugs are either not used or used individually. The results. A decrease in the 2.5-1.5 times the total blood loss in patients who have a caesarean section at the complex were used calcium preparations and tranexamic acid, compared with women who did not receive these drugs, or treated them separately. In addition to clinical observation and gravimetric method of counting blood loss, a positive impact has a tranexam on perioperative volume so reduction and it has been proven by laboratory tests. Conclusion. To prevent the coagulopathic bleeding and reduce the total perioperative blood loss, highly effective and safe is the combined use of drugs calcium gluconate and tranexamic acid for the above scheme with operative delivery of patients with disorders of fibrinolytic level in the blood coagulation system.
Gynecology. 2017;19(1):46-50
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Immunotherapy for recurrent miscarriage due to alloimmune reasons
Saribegova V.A., Tetruashvili N.K., Krechetova L.V., Agadzhanova A.A.
Abstract
The article presents the current understanding of the pathogenetic mechanisms of habitual abortion realization of alloimmune genesis and proposed methods of immunotherapy. The mechanisms of the impact and effectiveness of various drugs and cell therapies.
Gynecology. 2017;19(1):51-55
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Results of human papillomavirus testing on self-collected versus clinician-collected samples
Belokrinitskaya T.E., Frolova N.I., Turanova O.V., Pletneva V.A., Shemyakina K.N., Sambueva N.B., Maltseva E.E.
Abstract
Objective - to evaluate the prevalence of high-risk human papillomavirus infection (HR HPV), the efficiency and acceptability on self-collected using the Qvintip device versus clinician-collected samples in vaginal discharge. Subjects and methods. A cross-sectional study involving 200 women attituded to an employer’s outpatient clinic for periodic/annual medical examination. The mean age of the patients was 32.7±6.9 (range: 18-45 years). Vaginal discharge was collected using a Qvintip device and vaginal smear from the cervical canal was taken by a physician for a further HR HPV PCR test. A face-to-face interviews using to assess acceptability of the compared methods. Patients evaluated comfort, pain, privacy and embarrassment using the rating «yes» or «no». Results. 42% of all patients were HR HPV positive. The efficiency of the survey using the self-collected Qvintip device was higher than the clinician-taken samples: 38% vs 27.5% (OR=1.6; pχ2=0.025). The use of the Qvintip device only increased a chance to detect HR-HPV by 5 times: 36.3% vs 9.5% (OR=5.0; pχ2=0.0001). HPV-16 was the most frequently encountered HPV type (17.7%), followed by HPV-56 (16.3%), HPV-39 (13.6%), HPV-31 (10.9%), HPV-33 and HPV-51 (8.2%), HPV-58 (7.5%), HPV-52 (6.1%); HPV-45 (5.4%), HPV-18 (4.1%); HPV-35 (1.4%), HPV-59 (0.7%). 51.2% of HPV-positive women were infected with several types of HR HPV. Two types of HR HPV were detected in 34.5%, three - in 9.5%, four - in 6%, five - in 1.2 % patients. Self-sampling using the Qvintip device was a well-accepted method. Compared to physician-sampling, women reported a preference for self-sampling (64%), as it was more comfortable (75% vs 22.2%, p<0.001) and caused less pain (70.3% vs 22.2%, p<0.001) and less embarrassment (25.8% vs 1.4%, p<0.001). Most preferred to take the self-sample at home in the future (96%) because it was simple and did not require a doctor’s appointment. Conclusion. Reproductive age women show a high rate of HR HPV infection (42%). Vaginal self-sampling using the Qvintip device was more easy and comfortable, and shown higher diagnostic efficiency than the clinician-taken samples. Offering self-sampling for HPV testing may improve screening participation rates and overcome women’s embarrassment regarding clinician examination.
Gynecology. 2017;19(1):56-62
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The case of ineffective conservative treatment of endometriosis of anterior abdominal wall from the point of view of the possible role of stem cells
Dubrovina S.O., Berlim Y.D., Gimbut V.S., Krasilnikova L.V., Areshyan K.A., Lukash A.I.
Abstract
The article highlights the pathogenetic mechanisms of endometriosis outside the peritoneal cavity from the point of view of the role of bone marrow stem cells, given a possible explanation for the low efficiency of drug therapy of endometriosis outside the peritoneal cavity. The paper presents our own experience of using agonist of gonadotropin-releasing hormone intrauterine device with levonorgestrel at the same time.
Gynecology. 2017;19(1):63-65
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Clinical pregnancies in interstitial region of the fallopian tubes
Zakharov I.S., Fetishcheva L.E., Ushakova G.A., Demyanova T.N., Kofanova E.S., Vasyutinskaya Y.V., Petrich L.N.
Abstract
The case of a rare gestational pathology is described in the report below. The pathology is that of an ectopic pregnancy,localized in the interstitial region of the fallopian tubes. The difficulty of diagnosing the condition is also referred to.
Gynecology. 2017;19(1):66-67
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Correction of iron deficiency anemia in patients with gynecological diseases using liposomal iron
Fedorova T.A., Borzykina O.M., Bakuridze E.M., Ivanets T.Y., Strelnikova E.V., Tsakhilova S.G.
Abstract
Iron deficiency anemia (IDA) - one of the most common conditions in patients with gynecological diseases. Purpose - to evaluate the clinical efficacy and tolerability iron supplements Sideral forte in the treatment of IDA in patients with gynecological. Materials and methods. The study group consisted of 30 women aged 28 to 50 years with uterine myoma, adenomyosis and menorrhagia with iron deficiency anemia. Diagnosis is based on the results of clinical, laboratory and special methods of investigation. All patients revealed a moderate degree of IDA (WHO classification for non-pregnant women). IDA treatment was carried out drug Sideral forte 1 capsule per day for 6 weeks. Dynamic analysis of hematological and ferrokinetic indicators showed increase in the number of red blood cells, hematocrit, hemoglobin level of 104.5±8.5 to 118.2±8.6 g/l in 75% of patients. The level of serum iron in the dynamics of treatment increased from 5.45±2,3 to 11.63±5.82 mmol/l, to the sixth week of treatment and observation. In the dynamics of therapy showed an increase in the levels of ferritin in the group average from 8.0±4.3 to 12.13±4.7 g/l. The increase in Sideral forte dose to 2 capsules per day was needed in 25% of women due to continuing chronic blood loss. Adverse eventswere in 6.7% of patients in the third week of treatment. Allergic reactions were none of the patients. Conclusion. The liposomal iron can be used as antianemic drug in the complex treatment of mild iron deficiency anemia in patients with uterine myoma, adenomyosis and menorrhagia. The frequency of adverse eventswas 6.7%. Allergic reactions were not. Sideral forte was effective in 75% of patients; 25% of patients were needed to solve the issue about the surgical management of the underlying disease, that resulted in chronic blood loss.
Gynecology. 2017;19(1):68-73
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