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Obstetrics, Gynecology and Reproduction

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Vol 8, No 4 (2014)

ОRIGINAL ARTICLES

6-11 1475
Abstract
Studying of a role of gene polymorphisms during gestational process at pregnant women with obesity was the purpose. Selection 175 women with threat of interruption of pregnancy aged from 20 till 41 year (120 (68.6%) made women with an excess weight (the main group), 55 (31.4%) – with the normal body weight (group of comparison)).
Except the researches regulated by Orders of the Ministry of health care of Ukraine research of 12 genetic options of polymorphism of genes of a trombofiliya, and also polymorphism of a gene angiotenzinogena-1 (AGT Thr174Met), a gene angiotenzinogena-2 (AGT Met235Thr), mutations-1 of a sintaza of an oxide of nitrogen 3 (NOS3 C786T) is conducted by method of polimerazny chain reaction. Reliable correlation communication between existence of excess weight and arterial hypertension, a hyper coagulative syndrome, a mutation of factors of a fibrillation of F5 Leiden, F7, PAI gene-1, MTR gene is revealed: 2756 – B12-dependent methionine-sintazy. Direct correlation between polymorphism of genes of arterial hypertension and complications of the second half of pregnancy and childbirth is revealed. Thus it is proved that obesity and genetically caused trombofiliya are major factors of risk of development of complications of a gestation and the tromboembolicheskikh of complications.
12-18 60
Abstract
The purpose of our study was to evaluate morphology of the urethra and it`s supporting structures and the grade of bladder prolapsus using static and dynamic MRI (D-MRI) with phased-array coil in woman with stress urinary incontinence (SUI). We compared 30 MRI in woman with SUI and 10 controls according to the grade of the bladder prolapsus, the distortion in the periurethral, paraurethral, pubourethral ligaments, the vesicourethral angle, the retropubic space, asymmetry of pubococcygeal muscle. There was a significantly higher pubourethral ligament distortion (р=0.024), asymmetry of pubococcygeal muscle(р=0.032), larger vesicourethral angle (152.09º±10.62º), v.s. 138.8º±12.59º;
р=0.001) and retropubic space (7.8 mm v.s. 4.9 mm р=0.0402) in woman with SUI. There was no significant relationship between the grade of the bladder prolapsus in incontinent woman (р>0.05). The combined static and dynamic MRI can provide usefull information according certain structural abnormalities with specific disfunction, such as vesicourethral
angle, retropubic space increase and pubourethral ligament distortion in patients with SUI.
19-23 103
Abstract
The results of tocolytic therapy for prolongation pregnancy and delivery in pregnant women with severe appendicitis 45. In the structure of the women operated on appendicitis pregnant amounted to 5.7%. The aim of this study was to optimize obstetric tactics in women with severe appendicitis in different periods of gestation. The core group included 45 women whose pregnancy was complicated by the development of acute appendicitis. A control group consisted of 38 women with normal pregnancies. On the trimestram of gestation, patients were as follows: 14 women in the first trimester of pregnancy; 21-in the second and 10 women in the third trimester of pregnancy. Destructive forms of appendicitis in 29 (64.4%) and pregnant. Application of progestin and β- agonists for prolongation of pregnancy with acute appendicitis allows you to save the pregnancy for most women in the postoperative period. 26 (57.8%) and have
women pregnancy resulted in urgent, at 7 (15.5%) and women late preterm birth. Artificial termination of pregnancy for medical reasons was 4 patients with destructive appendicitis in the first trimester of pregnancy. In late pregnancy 8 patients performed a caesarean section at the lower end and appendectomy of medial access. Among the women in the control group 29 (76.3 per cent) have pregnancy ended urgent delivery (P<0.05). In the control group, there was a spontaneous miscarriage, women’s 3 x 2 (df=1)-0.02 p=0.8813, yates corrected x 2-0.06 r=0.8058. In small stages of pregnancy complications of appendicitis forms obstetric tactics should be aimed at preserving reproductive functions, rather than on maintaining pregnancy. Given the presence in the arsenal of highly effective antibacterial preparations at term and limited forms of peritonitis may serves as a c-section delivery.
24-26 76
Abstract
Background: the aim of the present study was to assess of the ovarian reserve of the women of late reproductive age after the conservative treatment of polycystic ovarian syndrome in adolescence. Design: the study was a longitudinal retrospective by purposive sampling. Methods: a total of 67 women of late reproductive age with confirmed primary PCOS in adolescence and 70 healthy age-matched controls were included in the study. The patients with PCOS underwent clinical investigation and conservative treatment with antiandrogens and oral contraceptive pills (OCPs) between 1984 and 1990y. and at the time of original diagnosis they were 13-18 y. Main outcome measures: the patients were collected via analysis of histories at primary diagnosis of PCOS in adolescence and at the time of the follow-up investigation of reproductive hormones was conducted. Data were compared between the study and control groups. Results: after conservative treatment PCOS patients had higher levels of anti-Müllerian hormone and greater number of antral follicles than controls (p <0.01 and p <0.05 respectively). Conclusions: our data suggest that PCOS patients who underwent conservative treatment in adolescence have the better ovarian reserve in late reproductive age than control women.

SCIENTIFIC SURVEYS

27-36 123
Abstract
Despite intensive research, venous thromboembolism still accounts for significant maternal mortality and morbidity. The article describes modern aspects of the pathogenesis, diagnosis, treatment, primary and secondary prevention of venous thromboembolism during pregnancy. Thrombophilia might be the essential pathogenetic mechanism of thromboembolism associated with pregnancy. Low molecular weight heparin (LMWH) is effective for prevention of recurrent thromboembolism and obstetric complications. Women with personal or family history of thromboembolism or with history of obstetric complications should be screened for thrombophilia.
38-41 98
Abstract
Recently there has been a great increase in the number of patients suffering from mastopathy, 30-70% in women of reproductive age, and the risk of changes in the mammary gland increases to 70% if a woman has any gynecological pathology. It is proved that in mastopathy cancers (including breast cancer) develop in 3-5 times often.
The basic principles of treatment of fibrocystic mastopathy is the normalization of hormonal levels (ratio of sex hormones in a women's blood), elimination of stress and increase of the body's resistance to stressful situations. But homeopathy is not less important in the treatment of mastopathy. We have analysed the effectiveness of homeopathic Mastopol in the treatment of mastopathy, associated with mastalgia.
42-47 167
Abstract
The role of uterine fibroids in infertility and pregnancy loss is very high. The decrease of reproductive function in patients with uterine myoma may affect a variety of factors. In most cases there is a combination thereof. Uterine fibroids can cause infertility, miscarriage, development of feto-placental insufficiency, increasing the frequency of
complications in childbirth and the postpartum period. All this necessitates timely raise the question of surgical treatment of patients with uterine myoma before pregnan

HISTORIC CASES

51-52 60
Abstract

The article highlights historic aspects of medical and research work oft he French gynecologist-obstetrician of the XVIII - XIX centuries Jean Louis Baudelocque.

CLINICAL LECTURES

48-50 87
Abstract
Cancer and Pregnancy is a challenging conflict of interests between the mother’s disease and the wellbeing of the fetus. Cancer in pregnancy is not any longer a rarity, because that disease already occur at younger age. On the other hand pregnancies are shifted into higher age groups. The incidence of cancer during pregnancy has a frequency between 0.1 % and 0.02 %. It affects reproductive behaviour too. It is not only a medical problem, it is a psychological and social problem too - to wait hopefully to a child, cancer is a dramatic threat of live for mothers and the fetus.


ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)