Vol 19, No 1 (2017)

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.

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.

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.

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.

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.

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.