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Objective: to make analysis of isolated deterioration of blood flow in the pool of uterine arteries in low-risk pregnancy after 18-week gestation, to detect connection of blood flow deterioration with infection processes of different location in the organism of pregnant women.
Methods. Doppler screening research was made as well as analysis of spectrograms of uteroplacental and fetal blood flow of 357 pregnant women.
Results. Low-risk pregnancy was accompanied by high frequency of hyperdynamic deterioration in the system of "mother-placenta-fetus" (14%), most frequently was detected the reduction of perfusion data of uteroplacental blood flow (67,9%) with almost absolute dominance (prevalence) of one-sided deterioration; high correlation dependence was revealed between reduction of uteroplacental blood flow and existence of extragenital chronic infection foci (71,4%); asymptomatic bacteriuria and infection-and-inflammatory disease of laryngological organs; causal treatment improved hemodynamic rates, with idiopathic forms of uteroplacental perfusion deterioration, pathogenic treatment is recommended, dipyridamol – 75 mg daily (25 mg three times a day) is a chosen medicine.
Conclusion. Isolated one-sided deterioration of uteroplacental blood flow during low-risk pregnancy may be considered as the mark of chronic infection foci in the body of a pregnant woman; well-timed diagnostics and causal treatment allow to avoid progressive deterioration of hemodynamic rate.
The aim of this study is assessment of hemostatic parameters in pregnant women with retrochorial hematoma (RCH).
Materials and Methods. The study involved 153 pregnant women during the first trimester. The first group comprised 90 patients with RCH, and the second group is the control group, comprised 63 pregnant women with normal pregnancy.
Results. The research results show, that soluble fibrin monomer complex (SFMS) and D-dimer indicators of pregnant women with RCH were higer in comparison with data of the second group (p<0,001).
Conclusion. Higher values of SFMC and D-dimer tend to be high probability predictors of retrochorial hematoma and have a great meaning for preclinical diagnosis of retrochorial hematoma.
Objective. The research objective is the development of effective method for the treatment of complicated ectopia of the cervix, allowing to reduce the frequency of relapses.
Materials and methods. A comprehensive examination of 86 women with complicated ectopia of the cervix has been undertaken. In the main group (n=45) our proposed method of treatment of ectopia of the cervix has been applied, which, in addition to the performance of coagulation, involves two successive stages: preparing for coagulation and treatment in the postoperative period including Galavit (patent for invention № 2568768). In the comparison group (n=41) coagulation ectopia of uterine cervix was preceded by empirical antibiotic and antiviral therapy. Diagnostic measures included bacteriological and cytological examination, HPV testing, extended colposcopy, PCR diagnostic and ELISA blood test for the detection of causative agents of urogenital infections.
Results. The analysis of the postoperative period and control the colposcopy showed that in the majority of cases in the main group the reparative process ended by the end of the 3rd week (62.2%), the full impact of all the patients was recorded at the 5th week after the treatment (100%), the relapse has not been revealed within 2 years. In the comparison group the slowing down of terms of epithelialization of the wound surface of the uterus after coagulation has been noted, the lack of treatment effect has been found in 9.8% of patients, and the relapse within 2 years and 17.1% of women has been stated.
Conclusion. The developed method allows to increase the efficiency of treatment by sequential combined effects on cause and effect of pathological changes on the cervix: the elimination of etiopathogenetic factors ectopia of the cervix, coagulation of the pathological section, stimulation of the immune system and reparative processes.
Objective. To substantiate indications for a differential approach in the treatment of patients with atypical endometrial hyperplasia.
Materials and Methods.The results of surgical treatment in 132 patients with atypical endometrial hyperplasia have been studied.
Results. Post-operative diagnosis was:endometrial cancer – in 19%, atypical hyperplasia – in 35%, simple and complex hyperplasia – in 33%, only atrophic endometrial changes – in 13% of patients. The tumor was within the endometrium in 5 patients, the superficial invasion of the myometrium (1-2 mm) were in 8 patients, invasion to half of the myometrium – in 9 patients, invasion of more than half of the myometrium – in 3 patients.
Conclusion. The guestions of tactics of treatment of atypical endometrial hyperplasia is under discussion.
Objective: to investigate health and social factors leading to the emergence of threatening preterm birth.
Material and methods: This study was designed to evaluate the significance of social conditions, professional and material factors, obstetric and somatic history in 191 singleton spontaneous gestations, included 117 women with threatened preterm labor (О47.0 in ICD) and 74 women with physiological pregnancy. Inclusion criteria for the main group were abdominal pain and structural changes in the cervix (maturation and shortening less than 2 cm). Medical records were also a source of information about the complications and the outcome of pregnancy. We calculated odds ratio and produced a ranking number of risk factors threatened preterm labor.
Results: average general education, signs of a threatened abortion in the second trimester, smoking during pregnancy, asymptomatic bacteriuria and the presence of immunoglobulin G (IgG) antibody to Cytomegalovirus (CMV) are the most significant risk factors for threatened preterm labor.
Conclusion. It is necessary to conduct preconception preparation of women with above mentioned poor factors, as well as measures aimed at elimination of controllable risk factors, to reduce the likelihood of threatened preterm birth.
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