Obstetrics, Gynecology and Reproduction

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Vol 6, No 3 (2012)


6-13 362
Objective: The purpose of this study is to elucidate the opportunities of magnetic resonance imaging (MRI) for local staging perioperative evaluation in patients with cervical cancer.Materials and methods: 253 253 patients with cervical cancer were included in study. All patients underwent examination and treatment in the Herzen Moscow Research Cancer Institute. Average age of patients was 35 + 5.6 years (21-67 years). Patients were divided int two groups: I-group included 114 woman, in which patients underwent surgical treatment and 56 patients on chemoradiation therapy, that preceded the surgery; II-group included 83 patients, in which the first stage of treatment was neoadjuvant therapy. MRI was performed in all patients within one week before radical surgery. MRI results have been compared with the histopathological report of the hysterectomy specimen. Results: The accuracy, sensitivity and specificity of MRI for perioperative evaluationof cervical cancer local staging in I group were 87%, 67%, 81%, positive predictive values (PPVs) and negative predictive values (NPVs) were 94% and 56%, respectively. For II group accuracy, sensitivity and specificity of MRI were 72%, 90%, 83%, PPVs and NPVs were 83%. Conclusion: MRI has a high diagnostic performance in preoperative staging of cervical cancer, content regardless of neoadjuvantt herapy. MRI allows to optimize the individual treatment plan in patients with cervical cancer.
14-17 365
The article presents the results of comparative study of, dedicated to evaluation of clinical and laboratory efficacy of bacterial vaginosis local therapy in pregnant women with obesity.
18-22 540
This article presents the issues on combined oral contraceptives use in prolonged regimen.
23-27 579
In 140 women of reproductive age with chronic endometritis by ultrasound with impulse dopplermetry examined the nature of the blood flow in the spiral and uterine arteries. A typical condition for patients was dilatation arcuate veins, set at 80% of the women, accompanied by pain in the lower abdomen varying severity. Combined extension arcuate veins and veins parametrium was observed in 15% of patients. In addition to chronic pelvic pain have been observed dyspareunia and dysmenorrhea. Every third patient along with the dilatation veins found increasing resistance index in the uterine and spiral arteries. For correction of impaired blood flow in the complex treatment included venotonics Flebodia 600, having a pronounced angioprotective effect. In the course of 3-6 months of treatment produced normalization of venous and arterial blood flow of the uterus and much more effective the treatment compared with patients who received no drug.
28-33 415
The study of thrombocyte parameteres in healthy women in reproductive age (n=29) and pregnant women in third trimester with normal ongoing pregnancy (n=20) and with gestosis (n=38) was conducted. The relative breadth of distribution by volume(PDW, fl), share of cells with volume more than 12 fl (P-LCR, %) and relative quantity of immature thrombocytes (IPF, %) were investigated. It was established that significant decrease of thrombocytes number takes place in pregnants compared to healthy women of reproductive age. The most significant changes were observed in women with moderate and severe gestosis. The reliable increase of relative breadth of thrombocyte distribution by volume in this group of pregnant women was also detected. This may be associated with growth of number of big and, probably, immature and functionally active thrombocytes. Thus, increase in number of immature thrombocytes, occurring in response to endothelium lesions as a part of gestosis pathogenesis, may serve as adaptation marker of thrombopoeisis system.
34-38 442
CNS hypoxic-ischemic lesion is one of the causes of newborns invalidism in perinatal period. Under the «perinatal hypoxia» the complex of symptoms caused by oxygen insufficiency of fetus and newborn is considered. Combined prenatal and early neonatal impact of hypoxia is considered as a perinatal hypoxic-ischemic lesion. Regeneration phases that have place after perinatal ischemia are reperfusion phase (±0-4 h), latent phase (0-8 h), phase of secondary energy disorder (8-72 h) and late phase (>72 h), when brain electric activity decreases and seizures take place. The first phase in further development of pathologic process is an acute period of 1 month, associated with CNS hypoxic-ischemic lesion. The second phase (2nd-3 rd months) are characterized with decrease in neuronal loss, reduction of neurologic disorders. The third phase (3-6th months) is characterized with spastic events. In some of the children the progress of the second phase is fixing in the same time, it is shown by decrease in neurologic disorders. The final forth phase has no timing limits and is characterized with children’s cerebral paralysis as an outcome, syndrome of minimal brain dysfunctions, astenoneurotic syndrome, hydrocephalic syndrome, syndrome of motion disorders, epileptic disorders, psychomotor and prespeech development delay or, in case of good outcomes of pathologic process, regeneration of functions may occur. Accurate evaluation of degree of CNS perinatal hypoxic-ischemic disorders with routine methods of clinical, instrumental and laboratory investigations is not always possible. Perinatal hypoxic-ischemic CNS disorders are always associated with hematoencephalic barrier transparency disorders and with release of neurospecific proteins in blood flow. Therefore dynamic evaluation of neurospecific proteins in blood serum may be reasonable for evaluation of CNS lesion degree and disease prognosis.
39-44 356
Cytomorphological features of the chorion and risk factors for spontaneous abortion in the first trimester are studied. A total of 98 pregnant women were divided into 2 groups: the 1st (main) group - 38 pregnant women with spontaneous abortion in 1 trimester (38.78%), 2nd (control) group - 60 pregnant women with induced abortion 1 trimester (61,22%). One of the major risk factors for spontaneous abortion was a chronic persistent viral infection: expression of the investigated agents (Herpes simplex virus types 1 and 2, Cytomegalovirus, a virus Epstein-Barr), reached 84.2% and 88.33%, which, in the absence of inflammatory manifestations in the tissues of the chorion, reflected a significant infection of women and, probably, their predisposition to miscarriage. The results of serological investigations of studied agents not always indicated the infection of chorionic structures with these pathogens. Chronic viral infections had persistent subclinical character. Therefore the great importance in predicting of their effects on pregnancy had evaluation of the percentage of leukocytes, leukocyte index of intoxication and platelets. The most significant anamnestic risk factor for spontaneous abortion was spontaneous termination of previous pregnancies. Morphological changes in the structures of the chorion in spontaneous abortion in first trimester were heterogeneous, but most were caused by infectious disorders caused by pathogens TORCH-complex (70%). In determining the localization of pathogens chorionic tissues revealed expression of the most frequently studied pathogens in the trophoblastic epithelium and stromal cells of the villi, indicating on penetration of pathogens in the placenta.
45-48 322
Pathomorphological and immunohistochemical studies of endometrium were performed. The higher proliferative activity of the VEGF and the higher production of transformation growth factor β1 (TGFβ1), fibronectin and liziloxydaza in patiens with atypical hyperplasia of endometrium and chronic endometritis testifies the presence of cellular hypoxia, disturbance of intercellular and extracellular interaction and can be considered as the negative prognostic factor.
49-55 334
Menopause is usually accompanied by vividly expressed clinical symptoms and the condition of hypomagnesemia. During the course of oral magnesium preparations therapy, the health normalization of the patients takes place, as well as the magnesium concentration in blood also comes to the norm. It seems to be reasonable to appoint the magnesium preparations to women with normal quality of life, if there is a necessity of isolated correction of menopausal disorders with light or medium severity, and also to the patients with hard severity of the disease with a predominance of psychoemotional disorders, in combination with contraindications to the standard hormone replacement therapy or when the patient refuses from receiving the hormone replacement therapy.
56-59 558

In article the question is a case of extrauterine pregnancy in term of 21-22 weeks in the rudimentary horn of a uterus in term of 21-22 weeks interrupted because of break of a horn with an intrabelly bleeding. The operation and tactical approaches to conducting the given case are described.

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