Obstetrics, Gynecology and Reproduction

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Vol 9, No 3 (2015)


6-10 584
The antiphospholipid antibodies (APA) exert multiple effects on the hemostasis system causing damage to all of its protective components including the endothelial barrier, natural anticoagulant function and endogenous fibrinolysis and activating the platelet of hemostasis, which is associated with numerous obstetrical complications and infertility. Objective. This study aimed at elucidating the effect of the presence of APA on the outcomes of assisted reproductive technology (ART). Materials and Methods. A total of 217 women diagnosed with infertility and planning to get pregnant using the assisted reproductive technology (ART) have been examined. Results. The results of examination demonstrated a high prevalence of circulating APA in a group of women underwent IVF failure. Conclusion. The thrombophilia can be one of the reasons of failures of in-vitro fertilization.
11-16 376
Objective: to study clinical and laboratory indicators of influence of intravenous immunoglobulin (IV-Ig) in complex therapy of pregnant women with syndrome of fetal loss syndrome. Materials and methods. Study included 63 pregnant women with fetal loss syndrome caused by APS. They were divided into 2 groups depending on therapy. The patients in group I (n=35) - received anticoagulant, antiplatelet and antioxidant therapy. The patients in group II (n=28), in addition to conventional treatment received IV-Ig. Laboratory studies included determination of antiphospholipid antibodies lupus anticoagulant, concentration of anticardiolipin antibody, antibodies to β2-glycoprotein, annexin V, phrotrombin. Diagnosis of blood thrombophilia included determination of aggregate platelet function, molecular markers of thrombophilia - TAT (fragments of thrombin-antithrombin), D-dimer (fibrin polymerization). Evaluated the content of the main subpopulations of immune cells in the peripheral blood, the absolute and relative abundance of cells with the phenotype CD3 + (T-lymphocytes). Results. The results of laboratory and clinical studies of the IV-Ig in the treatment of fetal loss syndrome, which is caused by antiphospholipid syndrome. In the group of pregnant women who received therapy IV-Ig, marked decrease in levels antiphospholipid antibodies, markers of thrombophilia, reducing the frequency of pregnancy complications and improve perinatal indicators. Conclusion. It is noted that immune-modulating effect is probably related to its positive impact on the function of T-regulatory lymphocytes.
17-21 430
Objective. It was study the frequency and a range of the genetic and acquired thrombophilia at patients with failures of in-vitro fertilization (IVF). Materials and methods. 115 women who had from 1 to 9 unsuccessful attempts of IVF were examined. Genetic thrombotic mutations, circulation AFA and level of a gomotsistein (an immunofermental method) were defined. Results. High frequency of the genetic forms of a thrombophilia influencing the level of an endogenous fibrinoliz (polymorphisms of plasminogen activator inhibitor-1 (PAI-1) - 66.9%, the tissue-type plasminogen activator (TPA) - 60.9%, fibrinogen - 47.8%), in combination with circulation of antiphospholipid antibodies (40.9%) is revealed. Conclusion. In the program of preparation for IVF of patients with unsuccessful attempts it is necessary to consider possible presence of the genetic and acquired thrombophilia.
22-27 612
Objective. A study of the effectiveness of drugs Mastopol in the treatment of diffuse benign breast disease and mastodynia. Materials and methods. The patient underwent a comprehensive examination of the breast.Treatment was carried out one of the successfully used medications for the treatment of diffuse benign breast disease, non-hormonal homeopathic remedy plant origin Mastopol. Indications for the use of Mostopol is a comprehensive treatment of fibrocystic mastopathy, mastodynia. Results. We examined 45 women aged 30-44 years, who appealed with complaints of pain in both breast. All the patients underwent a comprehensive examination, which included clinical examination, mammography, sonography of the breast and axillary regions. The entire group was discovered fibrocystic breast disease of different forms and degrees of severity. All the patients had been appointed Mastopol in standard doses. After one course of treatment (8 weeks), 43 (95,5%) patients noted a positive effect. 29 (65%) patients noted marked improvement of health, reduction or disappearance of mastalgia. 14(35%) patients emphasized the reduction of intensity of premenstrual syndrome. Conclusions. The results of these studies showed high efficacy Mastopol in the treatment of mastalgia and diffuse benign changes in the breast.The positive dynamics was achieved quickly and efficiently in most cases (95.5 percent). Signs of mastodynia were resolved after a single course of treatment. Two courses of conservative therapy yielded positive results, confirmed by objective clinical data and research sonography of the breast. The reduction of the size of cysts, reduction in the density and swelling of the breast tissue. The use of the drug Mastopol no identified side effects. Mastopol can be widely recommended for the treatment of mastodynia and diffuse benign disease (mastopathy).
28-34 424
Objective. To evaluate the efficiency of antithrombotic therapy to prevent repeated preeclampsia in patients with thrombophilia. Subject and methods. A prospective clinical study was conducted 66 patients with thrombophilia (genetic, acquired or concomitant) and with history of preeclampsia: 35 patients addressed and were followed since fertile cycle (subgroup Ia) and 31 patients addressed during pregnancy and were followed since 6-13 weeks of gestation - IIa subgroup. Control group - 50 patients without both obstetrics and gynecology and thrombotic complications in history. Therapy included LMWG (Enoxaparinum natrium), B vitamins, antioxidants and micronized progesterone. Results. The all period of pregnancy, obstetric and perinatal outcomes were better in patients receiving therapy since fertile cycle compared with group of patients whose therapy was initiated during pregnancy. Conclusion. To prevent re-PE at a subsequent pregnancy, the therapy should be start since fertile cycle, continuing during pregnancy, childbirth and the postpartum period. Therapy should include LMWH, B vitamins, antioxidants and micronized progesterone.


45-52 405
The assosiation between obesity, cardiovascular diseases and thrombosis is well-known and is caused by proinflammatory and prothombotic status in obesity. Numerous hormones and cytokines, secreted by adipocytes, influence the gene expression and function of endothelial cells, arterial smooth muscle cells, and monocytes leading to the development of an atherosclerotic plaque. Also, variety of cytokines produced by adipocytes controls endothelial function, hemostatic and fibrinolytic systems, platelet function, affecting progression of thombus formation. Nowadays,pathogenetic mechanisms of this relationship are under active study. Thrombophilia is another independent risk factor of tromboembolic complications.
54-65 408
Metabolic syndrome is widespread among women of reproductive age. Metabolic syndrome is associated with at higher risk of developing various obstetric complications including severe pre-eclampsia. The hereditary or acquired forms of thrombophilia, proinflammatory status may play an important role in impaired invasion cytotrophoblast and impaired placental development. Pre-eclampsia is seen as a complication of pregnancy, which is due to impaired invasion cytotrophoblast and impaired placental development.


35-39 456
Preeclampsia is a serious complication of pregnancy and one of the leading causes of maternal mortality. According to modern concepts, the key link in the pathogenesis of preeclampsia is an endothelial dysfunction leadind to persistent prothrombotic hemostasis state. Markers and predictors of preeclampsia considered hypercoagulation, hyperagregation and hyperhomocysteinemia. Women with the history of preterm labor and preeclampsia was treated by antithrombotic correction started on pregravid stage. Pregnancy successfully completed on time delivery without hypertensive complications.


66-67 377
The article highlights historic aspects of medical and research work of the British obstetrician of the XVIII century William Smellie

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