The journal brings together original research and analytical reviews devoted to the latest advances in obstetrics, gynecology, and reproductive medicine. The materials presented consider key issues of fertility preservation in cancer patients and the pathogenetic mechanisms of obstetric complications. They also cover innovative methods of diagnosing and treating gynecological diseases. Particular attention is paid to interdisciplinary aspects and personalized patient care, making use of the advances in molecular medicine and artificial intelligence. Articles combine fundamental research with clinical trials, offering new opportunities to enhance diagnostic and therapeutic strategies and contribute to the advancement of reproductive medicine as a multidisciplinary field.

Aim: identification of the features specific to course of pregnancy, childbirth and reproductive behavior of women in the Arctic zone of the Russian Federation.

Materials and Methods. A retrospective content analysis was conducted to assess information from individual medical records (2019) of pregnant and postpartum women (n = 91) retrieved from the archive of the Hospital of the Kola Science Center of RAS and statistical data provided by the medical information and analytical center as well as Bayandin Murmansk Regional Clinical Hospital (1998–2018). Three study groups were stratified: women aged under 30 years, 30–35 years, and above 35 years old. An assessment of the primary risks of pregnancy and childbirth in different age groups was carried out. An analysis of childbirth outcome was performed. Differences were considered significant at p ≤ 0.05 level (assessed by Mann–Whitney U-test).

Results. The article presents significant differences while assessing perinatal and biological risk factors in women above 35 years of age compared to those under 30 years old and subjects ranged from 30 to 35 years of age (p < 0.019). The ratios of the identified factors that can affect course of pregnancy and childbirth are revealed. The most common pregnancy complications were found to be a threat of early-stage miscarriage (30.0 %) and anemia of pregnant women (25.0 %), diseases of the urinary tract (18.7 %). Pregnancy ended by cesarean section in 30.7 % of women, whereas primiparous women older 35 years it reached 57.1 %.

Conclusion. The course of pregnancy and childbirth in women living in the Arctic zone of the Russian Federation is affected by complementary effects of widespread, negative risk factors (in-pregnancy diseases, burdened obstetric history, social factors), as well as specific climatic and geographical conditions of the living environment (cold exposure, unique circadian rhythm, heliogeomagnetic features). In addition to the above-mentioned causes affecting the course of pregnancy and fetal development, the most significant are also presented by infectious diseases of the urinary tract. Among the endogenous risk factors during pregnancy and childbirth, the predominant risk factors are pregnancy complications such as a threat of early pregnancy termination and anemia. The negative trend of increase in the number of primiparous women older 30 years of age is confirmed.

Aim: to study ophthalmic artery blood flow parameters for predicting preeclampsia (РЕ) development, as well as compare prognostic value of their changes with calculated PE risk during prenatal screening.

Materials and Methods. A prospective cohort comparative study was conducted by enrolling 80 pregnant women divided into two groups: per 40 subjects at high or low РЕ risk based on first-trimester prenatal screening assigned to main group and control group, respectively. Ophthalmic artery blood flow parameters (assessing the average magnitude from right and left examined vessels) was conducted from 11 to 13⁺⁶ weeks of pregnancy using Doppler ultrasound. Peak systolic velocity 1 (PSV1), peak systolic velocity 2 (PSV2), pulsatility index, and resistance index were assessed. Analysis of pregnancy course and outcomes was carried out.

Results. In main group (high РЕ risk), 27 (67.5 %) patients had a normal course of pregnancy and term delivery (38–40 weeks). The remaining patients experienced hypertensive disorders and РЕ. Of the 40 women in main group, 25 (62.5 %) had vaginal deliveries, while 15 (37.5 %) underwent cesarean section (СS), 13 (86.7 %) subjects of those had indications related to РЕ and fetal growth restriction (FGR). In control group (low РЕ risk), 38 (95.0 %) women also had term delivery, with 31 (77.5 %) subjects having vaginal delivery and 9 (22.5 %) undergoing СS for indications unrelated to РЕ and FGR. Of the 80 patients from both study groups, РЕ developed in 10 (12.5 %) subjects: 2 cases (5.0 %) in low-risk PE group and 8 (20.0 %) in high-risk PE group. Early-onset РЕ (before 34 weeks of gestational age) was diagnosed in 2 patients (20.0 %) out of 10, whereas late-onset РE (after 34 weeks of gestational age) was diagnosed in 8 (80.0 %) subjects suggesting late PE predominance (ratio 1:4). PSV1 magnitude tended to insignificantly increase in control group. Pulsatility and resistance indices also did not reveal significant differences. In patients at high vs. low PE risk, the PSV2/PSV1 ratio was 8.0 % higher, but these differences were insignificant (p > 0.05), and among those pregnant women who developed PE, the PSV2/PSV1 ratio was significantly higher (p < 0.001) compared to group without PE.

Conclusion. The study results evidence about the importance of evaluating ophthalmic artery blood flow parameters in pregnant women during the first prenatal screening as an additional tool for predicting PE.

Aim: to perform a comparative analysis of epithelial ovarian cancer (ОС) recurrence rate in patients with/without long-term anticoagulant therapy (АСТ) as a part of secondary prevention of thrombotic complications.

Materials and Methods. A prospective interventional non-randomized comparative study was conducted with 126 stage III–IV epithelial ОС patients. Main group patients (n = 66) received long-term АСТ (60–72 months) for secondary prevention of venous thromboembolic complications, while comparison group patients (n = 60) received no АСТ. Both groups were comparable in patient age, disease stage and amount of anticoagulant treatment. There were used direct oral anticoagulants: dabigatran, rivaroxaban and apixaban. ОС recurrence and thrombotic complications rate were assessed.

Results. OC recurrence rate was found to be 31.8 % (n = 21) in main group and 65 % (n = 39) in comparison group (p < 0.05). The incidence of thrombotic complications was comparable between groups: 18.2 % versus 16.7 % respectively. The data show a significant decline in OC recurrence risk upon long-term АСТ.

Conclusion. Long-term АСТ in patients with epithelial OC to prevent recurrent thrombosis may exert additional antitumour effect. The observed decline in OC recurrence rate supports the hypothesis that the haemostatic system is involved in the mechanisms of tumour invasion and metastasis. Further randomized trials are needed to evaluate efficacy of anticoagulants as potential modifiers of malignant neoplasm progression.

Aim: to study taxonomic diversity of the intestinal microbiome landscape in relation to neuro-immune-humoral biomarkers in patients with recurrent pregnancy loss (RPL).

Materials and Methods. A cross-sectional comparative study was conducted by enrolling 55 pregnant women with history of RPL (main group) and 60 women with physiological pregnancy (control group). All women underwent serum tumor necrosis factor-alpha (TNF-α), interleukin (IL) IL-17, cortisol and melatonin levels assessment using enzyme-linked immunosorbent assay. The taxonomic composition of the intestinal microbiota at the birth level was examined using 16S ribosomal RNA gene sequencing. The Chao1, Sobs, and ACE (Abundance Coverage Estimator) indices were used to assess α-diversity of microbial community.

Results. It was found that α-diversity of the bacterial community in patients with RPL was significantly decreased assessed by Chao1 index (p = 0.014). A significant decline in prevalence of the genera Bifidobacterium (p < 0.001), Lаchnоsріra (p = 0.032), Roseburia (p = 0.003), Соррососcus (p = 0.012) was established along with rise in Ruminососсus (p < 0.001) and Кlebsiеllа (p = 0.002) in women with RPL. Moreover, there were observed several significant relations: а positive correlation between abundance of Ruminococcus bacteria and TNF-α level (r = 0.49; p = 0.003), a negative correlation between abundance of Bifidobacterium and IL-17 (r = –0.54; p = 0.001), abundance of Lachnospira and cortisol level (r = –0.46; p = 0.002), as well as abundance of Coprococcus and melatonin level in blood serum (r = –0.58; p = 0.028).

Conclusion. It was found out that patients with RPL are characterized by dysbiotic changes in the microbiome landscape. The statistically significant correlations between some microbiota representatives and neuro-immune-humoral biomarkers suggest that dysbiotic alterations in the intestine may be involved in developing immune disorders and dysregulation of the pineal-pituitary-adrenal axis underlying RPL pathogenesis.

Introduction. Many risk factors including maternal age especially in adolescence pregnancy, gravidity, parity status, and body mass index (BMI) considered to play role in preeclampsia (PE) pathogenesis.

Aim: to analyze а relationship between numerous risk factors including BMI in adolescent pregnancies with PE, thereby gaining deeper insight into risk factors and PE impact in pregnant adolescents.

Materials and Methods. This was a cross-sectional study conducted in Hasan Sadikin General Hospital Bandung with adolescence pregnant women diagnosed with PE during 2019–2023 as the subject population. The minimum sample size was calculated using unpaired categorical analytical study sample size formula and 310 total research subjects were obtained. Data were analyzed using bivariate analysis with IBM SPSS v28 software.

Results. The results indicate significant differences in the proportions of age, gravida, gestational age, mode of delivery, and low birth weight infant between the preeclampsia and non-preeclampsia groups (p < 0.05). There were no significant differences in the proportions of extremely low birth weight, peripartum cardiomyopathy, HELLP syndrome, and pulmonary edema between the two groups (p > 0.05). No significant difference was found in the BMI proportions between the two groups (odds ratio (OR) = 1.361; 95 % confidence interval (CI) = 0.828–2.237; p = 0.223).

Conclusion. Many risk factors could play role in PE pathogenesis in adolescent pregnancies. BMI alone is not enough to be PE predictor. Further studies are needed regarding risk stratification of adolescent pregnancy in a more comprehensively.

Here, we review the current data on the relationship between in vitro fertilization (IVF) procedures and thrombotic complications by focusing on epidemiological, pathophysiological and clinical aspects. Although being a rare IVF complication (incidence is about 0.2 %), thrombosis poses a serious threat especially in patients with ovarian hyperstimulation syndrome (OHSS). The risk of thrombotic complications in OHSS is elevated markedly thereby underscoring the need for careful monitoring and prevention. Despite that arterial thrombosis is less common than venous thrombosis, it is more often associated with OHSS and arise early after ovarian stimulation. IVF is also characterized by atypical thrombosis localization targeting upper limbs, neck and cerebral veins. The risk of thrombogenesis peaks in the first trimester of IVF-related pregnancy and can persist for several weeks after OHSS resolution. Key risk factors for thrombotic complications include OHSS that elevates thrombosis risk by 100-fold; thrombophilia (both hereditary and acquired), especially in women with multiple risk factors; obesity associated with increased estrogens and procoagulant factors level; maternal age > 35 years; polycystic ovary syndrome, which increases VTE risk by five-fold. Special attention is paid to strategies for reducing the risk of thrombotic complications. Compared to fresh embryo transfer, use of revitalized embryos can prominently lower thrombosis risk due to the lack of markedly increased estrogen levels and elimination of OHSS risk.

The article discusses current methods for preserving fertility in women undergoing breast cancer (BC) treatment. It provides a detailed overview of contemporary breast cancer treatments and their impact on fertility. To prevent fertility loss, there are described key strategies such as oocyte, embryo, and ovarian tissue cryopreservation, as well as temporary suppression of ovarian function using gonadotropin-releasing hormone agonists. In addition, it analyzes factors such as lack of information, limited medical resources, and the need for immediate anticancer therapy initiation that hinder access to such methods. The importance of comprehensive patient support systems involving coordination among oncologists, reproductive specialists, and psychologists is emphasized. Special attention is paid to further development and improvement of existing methods aimed at reducing gonadotoxicity, as well as ongoing research to identify new safe and effective strategies. It is specifically stressed about importance of long-term monitoring of children born from preserved gametes and tissues to assess the safety and efficacy of such approaches. Integrating fertility preservation into the overall BC treatment strategy can markedly improve women's quality of life by increasing their chances of regaining reproductive function after completing primary treatment.

Introduction. In modern literature, the pelvic floor muscles are presented by showing their anatomical location and indicating relevant attachment points, but their combined anatomical, topographic and functional significance is described insufficiently, which the current review was aimed at.

Aim: to determine the physiological significance and anatomical units of the vagina occlusor muscle complex, topography and functions in health and in pelvic organ prolapse (POP).

Materials and Methods. The search for English-published literary sources was conducted in the international publication databases PubMed/MEDLINE, Google Scholar, Cochrane Library, and Russian-language eLibrary resource by using keywords «pelvic floor», «genital fissure», «vagina», «sphincters», «pelvic organ prolapse», «urinary incontinence», «anal incontinence» with unlimited search depth. The inclusion eligibility criteria were as follows: systematic reviews, full-text original studies examining pelvic floor anatomy and physiology containing the results of pathological, clinical and instrumental methods devoted to the anatomy and physiology of the pelvic floor, as well as monographs and textbooks. Total 53 publications were included in the descriptive review.

Results. Unlike animals, as well as the closing apparatus of the urethra and rectum consisting of internal and external sphincters, the muscle complex that compresses the genital slit and the lower third of the vagina includes five muscles. The m. bulbospongiosus of the superficial layer of the pelvic floor and m. transversus perinei superficialis, located in the perineal body, allow to keep the genital fissure closed. The external urethral sphincter located in the middle layer covers the ventral surface of the urethra and ensheath the distal part of the vagina, forming m. sphincter urethrovaginalis, that contracts to narrow both the urethra and the vagina. The deep layer is presented by m. levator ani, the medial and anterior bundles of which – m. pubovaginalis, pass along the sides of the vagina, whereas the m. puborectalis located laterally bends around the rectum as a U-shaped muscular sling – both of them close the gap between the medial legs of m. levator ani, narrowing the lower third of the vagina. All of such muscles have a close anatomical connection with adjacent organs due to their common embryonic development, and determine the stability and functional activity of the entire pelvic organs complex. Altering integrity of the specified muscle complex (rupture, in-labour overstretching) or its structural degradation characterized by loss of tone and contraction force, results in failed closing genital fissure, increased distance between the medial parts of m. levator ani in the lower third of the vagina and the loss of supporting and closing functions of the pelvic floor as well as POP development. Moreover, dysfunction of the constrictor muscles anatomically associated with neighbouring organs due to their common embryonic development, contributes to emergence of urinary and anal incontinence, despite the integrity of relevant sphincters.

Conclusion. The muscle complex that compresses the genital fissure and the lower third of the vagina is characterized by the lack of the circularmuscle and consists of five muscles having a close anatomical connection with adjacent pelvic organs. Damage to this muscle complex results in combined anatomical, topographic and functional changes in the pelvic floor, manifested by descent/prolapse of the pelvic organs and urinary/anal incontinence.

Given the increasing problem of infertility in the Russian Federation, assisted reproductive technologies (ART) have proven to be one of the most effective treatments for this condition. Notably, the introduction of ART methods, particularly in vitro fertilization (IVF), has led to markedly increased birth rates over the past two decades. Studies show that machine learning algorithms can process images of embryos to assess their quality, thus facilitating the selection of the most viable among them for transfer. There are ethical and technical barriers hindering the widespread adoption of artificial intelligence (AI) in clinical practice, including concerns over data privacy as well as a need to train specialists to deal with new technologies. AI can analyze vast amounts of data, including medical histories and research results, to more accurately predict pregnancy outcomes. This enables doctors to make more justified clinical decisions. In the future, AI algorithms will be able to analyze patient data more efficiently, helping to identify the causes of infertility at earlier stages.

Here, we discuss current theories regarding preeclampsia (PE) pathogenesis, a role of the complement system in PE onset and evaluate an impact of altered complement system on pregnancy outcomes and PE severity. The studies conducted in the field of preeclampsia have indeed raised numerous new scientific questions and hypotheses. One of the key questions is whether the complement system activation is the primary PE cause or just a consequence of one or more pathological processes linked to this syndrome.

This article highlights key stages in the life and career of the British surgeon Patrick Christopher Steptoe, who played a key role in the development of assisted reproductive technologies. Having started his career as a laparoscopy specialist, Dr. Steptoe developed minimally invasive methods for retrieving oocytes, which became critical to the success of in vitro fertilization. In collaboration with Robert Edwards, Dr. Steptoe performed the first successful IVF procedure, which in 1978 resulted in the birth of Louise Brown, the world's first test-tube baby. Innovative surgical techniques proposed by Dr. Steptoe laid the foundation for current IVF protocols.