Vol 20, No 5 (2018)
Articles



Climacteric syndrome and magnesium (literature review)
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Classical Article Evaluation of health-related quality of life the women with human papillomavirus-associated lesions of the cervical epithelium
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To the question about diagnostics, prevention and therapy of pathology of the cervix
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Rehabilitation therapy as a component of the complex approach to the treatment of chronic forms the pelvic inflammatory disease in women
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Features of pregravid preparation in women with connective tissue dysplasia
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Comparative assessment of effectiveness of new drugs for targeted therapy of endometriosis by experimental model
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Transvaginal echography in the diagnosis of localization foci of deep infiltrative endometriosis
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Possibilities of preservation and realization of reproductive function in girls with Turner syndrome (analytical review)
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Efficiency of cryoperenosis depending on various factors
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Materials and methods. The article presents an assessment of the influence of factors on the effectiveness of cryoprenoses. Scientists conducted a retrospective analysis of 149 cryogenic transfer on the basis of the department of Auxiliary reproductive technologies of the Irkutsk Regional Perinatal Center for 2017. Patients signed voluntary consent to participate, the patients were divided into 4 groups, depending on the duration of storage of embryos: group 1 - 57 people, with a shelf life of 1-3 months, group 2 - 29 people, storage period 4-6 months, group 3 - 25 people, the shelf life is 7-11 months, group 4 - 38 people, the shelf life is 12 months or more. The average age of women is 30.69±2.9 years. Selection criteria for research: tubal factor of infertility, frozen embryos. Results. The analysis of cryopreference showed that the age of patients, the quality of transferred devitrified embryos and the duration of storage of cryopreserved embryos have a more important influence.



Modern approaches to endovascular treatment of uterine leiomyoma
Abstract
Individual features of the blood supply to the uterus and ovaries in 20-25% of cases cause failures in endovascular treatment of patients with uterine leiomyoma (ULM) and are forced to return to traditional surgical methods. The purpose of the study is to assess the possibilities of preventing iatrogenic complications of endovascular treatment of ULM through the use of separating occlusion of the uterine arteries, taking into account the characteristics of the blood supply to the uterus and ovaries. Materials and methods. The work is based on the analysis of the results. X-ray endovascular occlusion of the uterine arteries for ULM performed in 88 women aged 34-46 years (mean age 38.8 ± 2.5 years). The patients were divided into 2 groups: the 1st group comprised 65 patients without visible uterine-ovarian interarterial anastomoses. They performed standard embolization of the uterine arteries (EUA) using spherical PVA microemboli (COOK, USA), Embosphere (Merit Medical, USA) with a diameter of 500-700 microns. The second group consisted of 23 patients in whom utero-ovarian inter-arterial anastomoses were detected. In patients of this group, EUAs were produced with Embox cylindrical emboli (Plastis-M, Russia) with a length of 10 mm and a diameter of 500-700 μm, which occlude only the bed of the uterine arteries and are not capable of to overcome utero-ovarian inter-arterial anastomoses. In the 2nd group of EUA patients wore the character of occlusion, separating the uterine and ovarian arteries. The original EUA protocol was applied, which includes, in addition to the standard stages of selective arteriography of the uterine arteries, performing preliminary abdominal aortography to visualize the ovarian arteries and pelvic arteriography to assess pelvic vascular anatomy and identify utero-ovarian interarterial anastomoses. The results of the study. A total angiographic examination of the ovarian and uterine arteries, including a review angiography of the infrarenal section and bifurcation of the aorta, ileal vessels. In 23 (26.1%) patients with angiographic examination, uterine-ovarian arterio-arterial anastomoses. In 13 patients (56.5% of the detected anastomoses), these were type 1 anastomoses. In 10 patients (43.5% of the detected anastomoses), type 3 anastomoses were detected. Endovascular occlusion of the uterine arteries was performed in all patients. In 5 (7.69%) patients from the 1st group after EUA, amenorrhea occurred. In contrast, in all 23 patients from the 2nd group in the postembolization period, no observation of ovarian function was observed in any of the observations. Conclusion. For endovascular treatment of ULM in the presence of pronounced utero-ovarian interarterial anastomoses, the method of separating uterine artery occlusion is a safe and effective way to prevent ischemic damage to the ovaries.



Vitamin D deficiency: a modern approach to pathogenesis and therapy
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