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Obstetrics, Gynecology and Reproduction

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Vol 4, No 2 (2010)

GYNECOLOGY 

6-9 265
Abstract

Dydrogesterone is a gestagen with proven pregnancy maintaining efficacy, which has been in common medical practice for more than 15 years in the Russian Federation and for more than 45 years outside of Russia. Dydrogesterone possesses the highest selectivity towards progesterone receptors among all progestins. The presence of an immunomodulating effect is a distinctive pharmacological feature ofdydrogesterone. This review touches upon the metabolism and biological effects ofdydrogesterone, as well as its use in complex pregnancy maintaining therapeutic regimens.

10-15 330
Abstract
Polycystic ovarian syndrome (PCOS) is a rather common disease which represents one of the most topical issues of gynecological endocrinology. This review article presents modern data on etiology and pathogenesis of PCOS and provides substantiation for frequent combination of hyperandrogenia and insulin resistance during PCOS. Also, considerations are given to the characteristic clinical manifestations of PCOS and modern approaches to its diagnosis and treatment. The latter includes drugs which affect the neuromediator systems (sibutramine, orlistat), drugs of the insulin sensitizing group (metformin, progestagens or low dose, single phase, third generation oral contraceptives (COC) combined with progestagens), synthetic anti estrogens (clostilbegit) and other medications. The outlook and methods of surgical intervention, as well as treatment tactics during infertility at the backdrop of PCOS, are addressed.
16-20 156
Abstract
In order to analyze the system of medical care organization during pregnancy and labor, and to evaluate the effect of organization of obstetric and resuscitation aid to females on the parameter of maternal mortality (MM), the updated information on organization of medical care for pregnant, maternity patients and new mothers over the period of 2006 2009 in 85 subjects of RF, has been assessed. The assessment was carried out by level I obstetric aid institutions (obstetric departments of central district hospitals), level II institutions (inter regional and urban maternity hospitals, perinatal centers, maternity departments of urban multidisciplinary hospitals) and level III institutions (provincial, regional and republican perinatal centers, maternity homes, teaching hospital clinics and federal scientific research institutes). A statistically significant, strong and direct relationship was found between the percentage of obstetric beds in the level I obstetric institutions (r = 0.81), fraction of labors in the level I inpatient institutions (r = 0.99), percentage of beds for pregnant and maternity patients not provided for by round the clock on call service by hospital obstetrician gynecologist (r = 0.84) on the one hand, and the MM parameter on the other. There was a strong inverse relationship between the fraction of labors occurred in the level III obstetric care institutions (r = 0.89), availability of regional maternity home (department), perinatal center (r = 0.90), obstetric distance consultancy center (r = 0.89), percentage of obstetric care institutions equipped with departments (wards) of resuscitation and intensive care (r = 0.99), on the one hand, and the MM parameter on the other. Therefore, for prophylaxis and MM reduction it is necessary to implement modern organizational technologies of providing medical care for pregnant, maternity patients and new mothers based on a three level system organization, in which the perinatal centers take the leading role.
21-25 262
Abstract
It is known that pregnancy monitoring in patients with excess weight or obesity is associated with many problems due to increased risk of occurrence of serious obstetric and somatic complications in such patients. The article gives practical recommendations over management of such patients (pregnancy is the only period in life of obese female when she is allowed to gain weight). The medicinal therapy should be administered with care. Reasonable choice of food products allows better control of pregnancy course. The optimal labor time for obese patient is 38 weeks, and the method of delivery is defined according to obstetric indications.
26-27 143
Abstract
Nowadays, during rehabilitation of oncologic patients of fertile age, one of the main tasks is the restoration and maintenance of menstrual function after radical treatment to recover patients fertility. The main issue faced by obstetricians and gynecologists during management of pregnancy in patients who had undergone invasive treatment of pre malignancy and early cervical cancer, is the threat of prematurity and premature labor. There is no unanimous opinion about tactics of labor management in such females. In order to recover normal ovulatory menstrual cycles the application of combined hormonal contraceptives (CHC) for 6 months is indicated.
28-32 399
Abstract
Benign alterations of mammary glands are the most common diseases in women. The fibrocystic breast disease (FCBD) is the most common benign disease of mammary glands at that. One of the etiologic factors of breast disease occurrence are believed to be conditions which are due to reduced progesterone level at the backdrop of excess estrogen level, which brings about proliferation of mammary gland tissue and disorders of its receptor apparatus. The most characteristic clinical manifestations of FCBD are breast tenderness (mastodynia) with possible irradiation, sensation of breast size enlargement, breast engorgement and swelling. Often, the mastopathy symptoms are combined with pre menstrual syndrome. Methods of treatment of mammary gland diseases are selected individually, taking into account factors affecting the pathological condition. Currently, the plant derived medications are widely used for treatment, such as Mamoclam andMastodion, as well as a transdermal preparation Progestogel. In the FCBD females on a long term COC treatment an improved mammary gland condition is observed. This treatment effect is due to normalization of hormonal parameters and menstrual period, reduction of rate of functional ovarian cysts' formation and frequency of inflammatory genital diseases.


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