Vol 18, No 6 (2016)

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.

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.

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.

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.

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.

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.

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.