Vol 17, No 3 (2015)

Presented their own data on the prevalence of uterine fibroids in women in different age groups, as well as infertility, miscarriage, and with other diseases of internal genital organs. Shows the main clinical manifestations of uterine fibroids. Proposed algorithm for the management of patients with uterine fibroids, which takes into account the size and localization of nodes, concomitant somatic disorders and gynecological and reproductive plans woman. Pathogenesis noted the desirability and efficacy of clinical mefipristone in conservative therapy of uterine fibroids. Shown the importance of modern organ treatments.

The purpose of research was a comparison of the effect of a three-phase combined oral contraceptive (COC) containing estradiol valerate and dienogest in dynamic mode and single agent containing dienogest, to reduce menstrual blood loss on the background of adenomyosis.Materials and methods. Women aged 18-50 years, with a diagnosis of adenomyosis and pain hospitalized for abnormal uterine bleeding. Hysteroscopy and curettage of the uterus were performed on all the patientsw. After discharge, and the results of histological examination, patients of group 1 (no need of hormonal contraception), dienogest monotherapy was administered at a dose of 2 mg per day continuously for 6 months. Group 2 patients (who needed effective contraception) were administered three-phase COCs containing estradiol valerate and dienogest (2 days 3 mg estradiol valerate, 5 days estradiol valerate 2 mg/2 mg dienogest, 17 days estradiol valerate 2 mg/3 mg dienogest, 2 day 1 mg estradiol valerate and 2 days of placebo); 3 groip patients (not need for contraception) were treated with antifibrinolytic drug tranexamic acid at a dose of 1000 mg per day orally. Evaluates the performance of blood coagulation.Conclusions. Against the background of monotherapy a significant and reliable reduction of menstrual blood loss and the severity of pain was shown that demonstrates its effectiveness in the treatment of abnormal uterine bleeding associated with adenomyosis.

This article is a review of continuous use of oral contraception.

Polycystic ovary syndrome (PCOS) is a complex interdisciplinary problem in connection with the involvement in the pathogenesis not only of reproductive system, but also multifaceted metabolic disorders, many of which are pathognomonic for cholelithiasis. Presented in the article the literature and their own clinical observation suggest predisposing role in the development of PCOS cholelithiasis. Hormonal contraceptives greatly increase the risk of gallstone disease, and may be the trigger of stone formation. The individualized approach to the appointment of COC patients with PCOS with the additional risk of cholelithiasis, and dynamic monitoring would prevent the onset and progression of cholelithiasis.

Fast track (FT) surgery - a comprehensive treatment program, including training in the preoperative phase, the use of minimally invasive techniques of surgical intervention and active management of the postoperative period, in order to reduce the timing of hospital treatment, the time rehabilitation and patients as quickly as possible to return to normal life.For the first time the principles of FT programs were formulated in the late twentieth century. Henrik Kehlet and initially introduced in cardiac surgery, coloproctology and oncology, but gradually began to gain recognition in other surgical areas.Own experience of FT-protocols in gynecologic patients has shown that they can improve during the early postoperative period, no adverse effects on long - term outcomes and readmission rates, can significantly reduce the time of recovery after the operation and increase the satisfaction of patients of the treatment.

A study on the treatment of obstetric antiphospholipid syndrome in women with recurrent miscarriage by assigning low molecular weight heparin - bemiparin. The results show that the therapeutic effects of the drug as a preventive and therapeutic doses side effects are not registered. It was possible to achieve a full-term pregnancy to prolong life in 93.5% of cases, premature birth due to placental insufficiency observed in 6.5% of cases. None of the observation is marked by thrombocytopenia, bleeding in the second and third trimesters of pregnancy. At delivery blood loss did not exceed the standard indicators. Anticoagulation bemiparin based therapy was continued for 6 weeks of the postpartum period for the prevention of thrombotic complications.

Objective: to make analysis of isolated deterioration of blood flow in the pool of uterine arteries in low-risk pregnancy after 18-week gestation, to detect connection of blood flow deterioration with infection processes of different location in the organism of pregnant women.Methods. Doppler screening research was made as well as analysis of spectrograms of uteroplacental and fetal blood flow of 357 pregnant women. Results. Low-risk pregnancy was accompanied by high frequency of hyperdynamic deterioration in the system of "mother-placenta-fetus" (14%), most frequently was detected the reduction of perfusion data of uteroplacental blood flow (67.9%) with almost absolute dominance (prevalence) of one-sided deterioration; high correlation dependence was revealed between reduction of uteroplacental blood flow and existence of extragenital chronic infection foci (71.4%); asymptomatic bacteriuria and infection-and-inflammatory disease of laryngological organs; causal treatment improved hemodynamic rates, with idiopathic forms of uteroplacental perfusion deterioration, pathogenic treatment is recommended, dipiridamol - 75 mg daily (1/3 three times a day) is a chosen medicine.Conclusion. Isolated one-sided deterioration of uteroplacental blood flow during low-risk pregnancy may be considered as the mark of chronic infection foci in the body of a pregnant woman; well-timed diagnostics and causal treatment allow to avoid progressive deterioration of hemodynamic rates.

In today's world cesarean section performance frequency surpasses all other abdominal surgery operations. This article describes the historical aspects of the cesarean section and its role in modern obstetrics; it also raises urgent issues to be addressed in order to optimize the frequency of abdominal delivery

The appearance of cytostatics made a revolution in the treatment of malignant neoplasm’s, allowing to make curable previously fatal diseases and prolong life for many patients with incurable tumors. Taking into account the steady growth of malignant neoplasms of the female reproductive system, including ovarian tumors, high rates of mortality in patients of reproductive age, and also the emergence of costly new anticancer drugs, allow to make a pharmacoeconomic analysis of ovaries cancer’s treatment ways, to select the most effective and safe means in conditions limited health care resources.

In the review the role of HPV infection in development of diseases of anogenital area and methods of diagnostics and treatment of HPV infection of anogenital area is considered. Pathogenetic justification of application of preparations with immunomodulatory action is given in complex treatment of the diseases associated with HPV infection.

In the article information is resulted about the complex inspection of women with fruitlessness and different endometrial pathology, including the immunogistokhimicheskie methods of diagnostics. 100 patients are inspected in age from 27 to 42 years, from them at 59 immunogistokhimicheskie markers were determined (Ki-67, Cd34, Cd56, Cd68, CD 138, VEGF).