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Obstetrics, Gynecology and Reproduction

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Vol 9, No 4 (2015)
https://doi.org/10.17749/2313-7347.2015.9.4

ОRIGINAL ARTICLES

6-17 107
Abstract
Objective - to establish a hysterectomy role in formation of secondary ovarian failure and to estimate possibility of application of DHEA. Materials and Methods. Sexually mature female rats outbred Wistar. Main group: 1a - hysterectomy + salpingectomy (n=24), Ib - hysterectomy (n=6), Ic - salpingectomy (n=6). Group of comparison - hysterectomy + salpingectomy + DHEA for 4 weeks after surgery (n=12). Intact control (n=12). Enzyme immunoassay serum concentrations anti-Müllerian hormone (AMH) and follicle stimulating (FSH) hormone, testosterone (T). Results. Shows statistically significant reductions AMH after operation at all time experience (2-10-30-40 days), increased FSH, only the end of the experiment (day 40), only the reduction of T by 10 day of the experiment compared to the control. Hysterectomy was not significantly altering the concentration of AMH, FSH and T on day 10. Salpingectomy significantly reduced the concentration of AMH and T, and has no effect on FSH. Use of DHEA 1 mg / day for 28 days did not alter the concentrations of FSH and T significantly increases AMH compared to animals after surgery, but still significantly lower than that in the control. Conclusion. Isolated hysterectomy does not substantially affect the functional ovarian reserve. Isolated salpingectomy, and also the combined operation volume (hysterectomy + salpingectomy) result in secondary ovarian failure. Effect of DHEA on the function of the gonads (AMH) remains uncertain.
18-24 73
Abstract
Objective. To determine the diagnostic value of the concentration of cytokines and growth factors contained in the biological fluids of patients with external genital endometriosis (EGE). Materials and Methods. Clinical data were evaluated and the concentration of IL-1 β, IL-6, IL-8, IL-10, α 2-macroglobulin, vascular endothelial growth factor (VEGF) in 18 patients with EGE. Results. Significant differences were found between the concentration of the studied markers in venous blood and peritoneal fluid (PF). We found a relationship between pain of patients with EGE and the concentration of IL-10 (r=0,480 p=0,135), VEGF (r=0,478 p=0,277) and α 2-macroglobulin in the PF (r=0,554, p=0,049). The dependence between the concentration of IL-6 in the PF and the prevalence of pathological process in EGE (r=0,560, p=0,005). We found significant increase of the concentration VEGF in the PF of patients with EG compared with the control group. Conclusion. The data obtained allow the use of research concentration of markers in the peritoneal fluid of patients with EGE to predict the future course of the disease.
25-30 69
Abstract
Objective. To increase efficiency and to develop pathogenetically substantiated treatment regimen of abnormal uterine bleeding. Materials and Methods. Analysis of 96 cases of abnormal uterine bleeding among women of reproductive age with combined extragenital pathology. On the background of a standard survey further determination of hormones in the blood (cortisol), the expression of anxiety on the Hamilton Anxiety Scale. On the background of the standard hemostatic therapy in a hospital environment 48 women (group I) were additionally prescribed melatonin, 48 women (group II) were prescriebed standard treatment. Control group III - 23 healthy women. Results. The use of the drug melatonin (3 mg №2) in the treatment of abnormal uterine bleeding among women of reproductive age with combined extragenital pathology promotes considerable reduction of anxiety and the growth of cortisol level, which accelerates the formation of the adaptation syndrome, thereby increasing the effectiveness of the treatment.

SCIENTIFIC SURVEYS

36-45 86
Abstract
Metabolic syndrome is widespread among women of reproductive age. Metabolic syndrome is associated with at higher risk of developing various obstetric complications. The hereditary or acquired forms of thrombophilia may play an important role in impaired invasion cytotrophoblast and impaired placental development. It may lead to fetal loss syndrome, pre-eclampsia, intrauterine growth retardation and other obstetric complications in women with metabolic syndrome The earlier antithrombotic prophylaxis is initiated, the better the outcome of pregnancy will be.
46-54 135
Abstract

The problem of rehabilitation of cancer patients continues to be actual. Development of methods of therapy of malignant tumors has improved the results of survival of patients. At the same time feature of the applied methods are numerous complications. The rehabilitation course is necessary for all oncological patients who received radical surgeries, radiation and medication therapy. The existing directions of the rehabilitation help to onсogyneсologic patients are limited to treatment of an oncopathology, prevention and treatment of climacteric disturbances, psychological assistance and, in some cases, physiotherapeutic procedures. It is expedient to create the system of the rehabilitation help to cancer patients allowing to provide consecutive stage-by-stage rehabilitation of patients according to individually developed program.

55-65 111
Abstract
Mitochondria play leading role in senescence program realization. One of the early manifestations of this process is loss of reproductive function in female (menopause). In this review we discuss up-to-date data on basic mitochondria functions and their possible role in development of premature ovarian insufficienсy and morbid conditions associated with this state, that are typical for ageing organism. Besides performing function of conversion of free energy by cell respiration substrates oxidation mitochondria control survival and death of somatic cells and gametes maintaining optimal level of reactive oxygen species in cells. Oxidative stress results in selective death of specialized cells; organs and tissues functionality disturbance; leads to development of cardiovascular, locomotor and nervous disorders. The main reason of oxidative stress is mitochondrial disfunction induced by disbalance between reactive oxygen species production and their utilization by antioxidant system. On the other hand mitochondria play central role in intracellular signal transmission and maintain functional state and cellular structure of tissues, organs and systems of an organism controlling cell proliferation, differentiation and apoptosis. Finally mitochondria define largely immune response in case of infections and tumoral transformation and control sex hormones level taking part in steroidogenesis. It was found that high level of damaged mitochondrial DNA, decrease of its copy number and increase of reactive oxygen species production in ovarian tissue cells are typical for women suffering from premature ovarian insufficienсy. Chronic oxidative stress leads not only to oogenesis disturbance and decrease of oocyte maturation probability but promotes also cardiovascular diseases, osteoporosis and other delayed consequences of estrogen deficit development in case of this state.
66-72 95
Abstract
Objective. To highlight the modern views on the approaches to the treatment of infertility in endometriosis ovaries. Subject and methods. A review of 30 domestic and foreign sources, on the problem of endometriosis included in the PUBMED and Russian Science Citation Index database. Results. Endometriosis should be treated as a chronic disease that requires long-term development plan for the management of patients in order to maximize the use of drug treatment and elimination of repeated surgical interventions. Using the most gentle tactics of surgical treatment and allow the use of agonists of gonadotropin-releasing hormone preserve ovarian reserve of women of reproductive age and contribute to pregnancy. Conclusion. Given the complexity and controversial nature of many issues related to the etiology, pathogenesis and treatment of endometriosis, it is necessary to develop a unified system concept of a multidisciplinary approach to the tactics of patients with this disease.

CLINICAL CASE

31-35 100
Abstract

The combined thrombophilia can be one of the reasons of failures of in-vitro fertilization. This medical case shows us that 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 at patients.

HISTORIC CASES

88-90 92
Abstract
The article highlights historic aspects of medical and research work of the Soviet obstetrician and gynecologist Josef Jordaniya.
91-92 54
Abstract
The article about honorary to Professor Ignaz Semmelweis, the savior of the mothers.

CLINICAL LECTURES

74-85 75
Abstract
The article describes some inherited disorders (Marfan syndrome, Ehlers-Danlos syndrome, Osler-Weber-Rendu disease) that affects the connective tissue with prominent manifestations in the skeletal, ocular, and cardiovascular systems during the pregnancy. The present article aims to provide an overview of these rare but very important hereditary disorders. Diagnosing of these disorders can be difficult because the symptoms can vary significantly from person to person. There are clinical criteria and molecular methods of diagnostics. The pathogenesis of these inherited connective tissue disorders has not been fully elucidated. Pregnancy can be dangerous in such patients due to the high risk of lifetreating complications. Cesarean section is preferred in women with inherited connective tissue disorders.
86-88 63
Abstract

Female sexual dysfunction affect up to 43% of women causing a "distress" or a psychological strain for the patients. A variety of chronic diseases in addition to menopause and different drugs represents the risk factors to a female sexual dysfunction. Since 2015 the FDA has approved Flibanserin for the treatment of female libido although several other drugs have been proven efficacious.



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