Aim: to study ophthalmic artery blood flow parameters for predicting preeclampsia (РЕ) development, as well as compare prognostic value of their changes with calculated PE risk during prenatal screening.

Materials and Methods. A prospective cohort comparative study was conducted by enrolling 80 pregnant women divided into two groups: per 40 subjects at high or low РЕ risk based on first-trimester prenatal screening assigned to main group and control group, respectively. Ophthalmic artery blood flow parameters (assessing the average magnitude from right and left examined vessels) was conducted from 11 to 13⁺⁶ weeks of pregnancy using Doppler ultrasound. Peak systolic velocity 1 (PSV1), peak systolic velocity 2 (PSV2), pulsatility index, and resistance index were assessed. Analysis of pregnancy course and outcomes was carried out.

Results. In main group (high РЕ risk), 27 (67.5 %) patients had a normal course of pregnancy and term delivery (38–40 weeks). The remaining patients experienced hypertensive disorders and РЕ. Of the 40 women in main group, 25 (62.5 %) had vaginal deliveries, while 15 (37.5 %) underwent cesarean sections, 13 (86.7 %) subjects of those had indications related to РЕ and fetal growth restriction (FGR). In control group (low РЕ risk), 38 (95.0 %) women also had term delivery, with 31 (77.5 %) subjects having vaginal delivery and 9 (22.5 %) undergoing cesarean sections for indications unrelated to РЕ and FGR. Of the 80 patients from both study groups, РЕ developed in 10 (12.5 %) subjects: 2 cases (5.0 %) in low-risk PE group and 8 (20.0 %) in high-risk PE group. Early-onset РЕ (before 34 weeks of gestational age) was diagnosed in 2 patients (20.0 %) out of 10, whereas late-onset РE (after 34 weeks of gestational age) was diagnosed in 8 (80.0 %) subjects suggesting late PE predominance (ratio 1:4). PSV1 magnitude tended to insignificantly increase in control group. Pulsatility and resistance indices also did not reveal significant differences. In patients at high vs. low PE risk, the PSV2/PSV1 ratio was 8.0 % higher, but these differences were insignificant (p > 0.05), and among those pregnant women who developed PE, the PSV2/PSV1 ratio was significantly higher (p < 0.001) compared to group without PE.

Conclusion. The study results evidence about the importance of evaluating ophthalmic artery blood flow parameters in pregnant women during the first prenatal screening as an additional tool for predicting PE.

Aim: to study taxonomic diversity of the intestinal microbiome landscape in relation to neuro-immune-humoral biomarkers in patients with recurrent pregnancy loss (RPL).

Materials and Methods. A cross-sectional comparative study was conducted by enrolling 55 pregnant women with history of RPL (main group) and 60 women with physiological pregnancy (control group). All women underwent serum tumor necrosis factor-alpha (TNF-α), interleukin (IL) IL-17, cortisol and melatonin levels assessment using enzyme-linked immunosorbent assay. The taxonomic composition of the intestinal microbiota at the birth level was examined using 16S ribosomal RNA gene sequencing. The Chao1, Sobs, and ACE (Abundance Coverage Estimator) indices were used to assess α-diversity of microbial community.

Results. It was found that α-diversity of the bacterial community in patients with RPL was significantly decreased assessed by Chao1 index (p = 0.014). A significant decline in prevalence of the genera Bifidobacterium (p < 0.001), Lаchnоsріra (p = 0.032), Roseburia (p = 0.003), Соррососcus (p = 0.012) was established along with rise in Ruminососсus (p < 0.001) and Кlebsiеllа (p = 0.002) in women with RPL. Moreover, there were observed several significant relations: а positive correlation between abundance of Ruminococcus bacteria and TNF-α level (r = 0.49; p = 0.003), a negative correlation between abundance of Bifidobacterium and IL-17 (r = –0.54; p = 0.001), abundance of Lachnospira and cortisol level (r = –0.46; p = 0.002), as well as abundance of Coprococcus and melatonin level in blood serum (r = –0.58; p = 0.028).

Conclusion. It was found out that patients with RPL are characterized by dysbiotic changes in the microbiome landscape. The statistically significant correlations between some microbiota representatives and neuro-immune-humoral biomarkers suggest that dysbiotic alterations in the intestine may be involved in developing immune disorders and dysregulation of the pineal-pituitary-adrenal axis underlying RPL pathogenesis.

Introduction. Many risk factors including maternal age especially in adolescence pregnancy, gravidity, parity status, and body mass index (BMI) considered to play role in preeclampsia (PE) pathogenesis.

Aim: to analyze а relationship between numerous risk factors including BMI in adolescent pregnancies with PE, thereby gaining deeper insight into risk factors and PE impact in pregnant adolescents.

Materials and Methods. This was a cross-sectional study conducted in Hasan Sadikin General Hospital Bandung with adolescence pregnant women diagnosed with PE during 2019–2023 as the subject population. The minimum sample size was calculated using unpaired categorical analytical study sample size formula and 310 total research subjects were obtained. Data were analyzed using bivariate analysis with IBM SPSS v28 software.

Results. The results indicate significant differences in the proportions of age, gravida, gestational age, mode of delivery, and low birth weight infant between the preeclampsia and non-preeclampsia groups (p < 0.05). There were no significant differences in the proportions of extremely low birth weight, peripartum cardiomyopathy, HELLP syndrome, and pulmonary edema between the two groups (p > 0.05). No significant difference was found in the BMI proportions between the two groups (OR = 1.361; 95 % CI = 0.828–2.237; p = 0.223).

Conclusion. Many risk factors could play role in PE pathogenesis in adolescent pregnancies. BMI alone is not enough to be PE predictor. Further studies are needed regarding risk stratification of adolescent pregnancy in a more comprehensively.

Aim: to study the features of lichen sclerosus (LS) epidemiology in girls from the Republic of Bashkortostan (RB).

Materials and Methods. A retrospective cohort study was conducted. The authors analyzed LS incidence in girls aged 0 to 18 years, the data provided by two pediatric gynecological department, which in different years served all RB girls with gynecological pathology. A comparison of indicators recorded during the two equal and comparable time periods was carried out: the first 9 years of operation (from 1996 to 2004) at the Department of Pediatric Gynecology of the Clinical Hospital of Emergency Medical Care, Ufa and the first 9 years of operation (from 2015 to 2023) at the Gynecological Department of the Republican Children's Clinical Hospital, Ufa.

Results. Lichen sclerosus in RB girls cannot be attributed to orphan disease, since its incidence rate over the past 9 years comprised 0.46 ‰, i.e., 4.6 % per 100 girls. Over the 19-year follow-up (2004–2023), the accumulated LS incidence in RB girls aged 0 to 18 years increased from 0.22 to 0.46 ‰, and in Ufa – from 0.35 to 0.65 ‰.

Conclusion. In recent years, a significant increase in LS incidence in girls has been observed in the RB. Most LS patients are in the prepubertal childhood period.

Introduction. One out of 10 patients with preterm labor exhibits signs of intra-amniotic inflammation, which often occurs subclinically and results in increased risk of premature rupture of membranes (PROM).

Aim: to identify predictors of unfavorable perinatal outcomes associated with PROM.

Materials and Мethods. The single-center retrospective cohort study was conducted from January 1 to November 1, 2023 by enrolling patients between 28 0/7 and 36 6/7 weeks of gestation with PROM. A total of 176 maternal and neonatal medical records were analyzed. Two groups of neonates were identified:Group 1 – neonates with favorable outcomes at the time of hospital discharge; Group 2 – fetuses or neonates with unfavorable outcomes at discharge (including antenatal fetal death, neonatal death, grade 3 intraventricular hemorrhage, periventricular leukomalacia, severe bronchopulmonary dysplasia, or surgical-stage necrotizing enterocolitis). There were analyzed maternal medical histories, pregnancy and delivery data, amniotic fluid index (AFI), maximum vertical pocket of amniotic fluid, severity of respiratory failure and central hemodynamic disturbances in premature neonates, as well as incidence rates for those born to mothers with PROM. Multivariate analysis was conducted to identify factors associated with neonatal outcomes.

Results. Antenatal fetal death was recorded in 7 of 176 cases (3.9 %), and neonatal mortality among live-born infants comprised 7 of 169 (4.1 %). Median gestational age at delivery in Group 2 was 193.0 days [IQR: 180.0–198.0], significantly lower than in Group 1 (238.0 days [IQR: 223.5–247.0], p < 0.001). Chorioamnionitis (p < 0.001) and anhydramnion (p = 0.003) were significantly more frequent in Group 2. Neonates in Group 2 required tracheal intubation (p < 0.001), surfactant therapy (p < 0.001), mechanical ventilation (p = 0.029), and high-frequency oscillatory ventilation (p < 0.001) more often within the first 72 hours of life. NEOMOD (Neonatal Multiple Organ Dysfunction) scores were significantly higher in this group (p < 0.001). In Group 2, Ureaplasma parvum in nasopharyngeal swabs was more frequently found by using polymerase chain reaction (p = 0.015).

Conclusion. Predictors of adverse outcomes in fetuses and preterm neonates with PROM consisted of anhydramnios, chorioamnionitis, lower gestational age and birth weight, cesarean delivery, elevated maternal C-reactive protein (CRP) and white blood cell count prior to delivery, an AFI ≤ 32.0 mm, higher NEOMOD scores, presence of diffuse ecchymosis at birth, detection of neonatal Ureaplasma parvum, lower hemoglobin levels, as well as increased procalcitonin and CRP levels within the first 72 hours of life.

Given the increasing problem of infertility in the Russian Federation, assisted reproductive technologies (ART) have proven to be one of the most effective treatments for this condition. Notably, the introduction of ART methods, particularly in vitro fertilization (IVF), has led to markedly increased birth rates over the past two decades. Studies show that machine learning algorithms can process images of embryos to assess their quality, thus facilitating the selection of the most viable among them for transfer. There are ethical and technical barriers hindering the widespread adoption of artificial intelligence (AI) in clinical practice, including concerns over data privacy as well as a need to train specialists to deal with new technologies. AI can analyze vast amounts of data, including medical histories and research results, to more accurately predict pregnancy outcomes. This enables doctors to make more justified clinical decisions. In the future, AI algorithms will be able to analyze patient data more efficiently, helping to identify the causes of infertility at earlier stages.

The article discusses current methods for preserving fertility in women undergoing breast cancer (BC) treatment. It provides a detailed overview of contemporary breast cancer treatments and their impact on fertility. To prevent fertility loss, there are described key strategies such as oocyte, embryo, and ovarian tissue cryopreservation, as well as temporary suppression of ovarian function using gonadotropin-releasing hormone agonists. In addition, it analyzes factors such as lack of information, limited medical resources, and the need for immediate anticancer therapy initiation that hinder access to such methods. The importance of comprehensive patient support systems involving coordination among oncologists, reproductive specialists, and psychologists is emphasized. Special attention is paid to further development and improvement of existing methods aimed at reducing gonadotoxicity, as well as ongoing research to identify new safe and effective strategies. It is specifically stressed about importance of long-term monitoring of children born from preserved gametes and tissues to assess the safety and efficacy of such approaches. Integrating fertility preservation into the overall BC treatment strategy can markedly improve women's quality of life by increasing their chances of regaining reproductive function after completing primary treatment.

Introduction. By enhancing detection accuracy, therapeutic effectiveness and minimizing side effects, nanotechnology may contribute to improve diagnostics and treatment of patients with female reproductive system cancer.

Aim: to summarize current literature data and assess а role of nanotechnology in treatment of cervical cancer (CC), ovarian cancer (OC), endometrial cancer (EC) and reveal gaps requiring further research.

Materials and Methods. The search was carried out in the electronic databases PubMed/MEDLINE, Google Scholar and eLibrary using the following keywords: “gynecological cancer”, “targeted therapy”, “cervical cancer”, “ovarian cancer”, “endometrial cancer”, “nanotechnology”, “nanoparticles”. All works were published between 2011 and 2024.

Results. Nanocarrier-based drug delivery systems represent a promising approach to the treatment of female reproductive system oncology, providing precise drug delivery directly to tumor cells. Such systems, including liposomes, nanoparticles, micelles, and dendrimers, are characterized by advanced efficiency, reduced toxicity, as well as the opportunity for controlled release of active components. Nanotechnologies increase the effectiveness of vaccines by prolonging their half-life, affect the СС microenvironment and potentiate the antitumor immune response with minimal toxicity. Nanovaccines are capable of delivering antigens and adjuvants directly to immune cells, enhancing immune response and improving ОС treatment results. Nanotechnologies show prominent potential in improving EC treatment despite that their role in this context remains understudied compared to other types of female reproductive system cancer.

Conclusion. Nanoparticles can carry both conventional drugs as well as protein- and nucleic acid-based systems directly to cancer cells. However, only a few nanoparticle-based treatments for female reproductive system cancer have been approved for use. The field is making significant progress toward more effective and widely available treatments.

Aim: to systematize and analyze current data on the use of minimally invasive and robot-assisted interventions in the treatment of gynecologic malignant tumors in reproductive age women who wish to preserve fertility.

Materials and Methods. The search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, and eLibrary databases among the primary sources published from 01.01.2000 tо 28.02.2025. There were retrieved keywords and MeSH (Medical Subject Headings) terms including: “robotic surgery”, “robot-assisted surgery”, “fertility preservation”, “gynecologic cancer”, “cervical cancer”, “endometrial cancer”, “ovarian cancer”, “reproductive age”, “minimally invasive surgery”, “uterine transplantation”, as well as the corresponding Russian terms. Original studies focusing on oncologic and reproductive outcomes in women under the age of 45 were included in the analysis. The methodology followed the PRISMA guidelines. The final analysis included 53 publications.

Results. The data evidence about the effectiveness and oncologic safety of fertility-preserving approaches in early-stage cervical, endometrial, and ovarian cancer. Robot-assisted interventions vs. conventional techniques demonstrated comparable or superior outcomes in fertility preservation with fewer complications and faster recovery. Additional topics addressed include ovarian transposition, uterine transplantation, and alternative fertility preservation strategies.

Conclusion. Robot-assisted surgery extends the potential for fertility-sparing treatment of gynecologic malignant tumors in reproductive age women. Such interventions should be performed in specialized centers by multidisciplinary teams. Further research is needed to standardize treatment protocols and evaluate long-term oncologic and reproductive outcomes.

Introduction. Nectin-4, a cell adhesion molecule of the immunoglobulin superfamily (IgSF), has been extensively studied in oncological diseases. Nectin-4 is involved in the formation of intercellular connections and promotes tumor cell proliferation, migration and chemoresistance. Upregulated nectin-4 expression has been detected in various malignant neoplasms, including tumors of the female reproductive system – ovarian, endometrial, cervical cancer, as well as rare tumors of the vulva, vagina and fallopian tubes.

Aim: to summarize current data on nectin-4 role in the pathogenesis, diagnostics, prognosis and therapy of malignant tumors of the female reproductive system, and to assess the prospects for its clinical use in personalized medicine.

Materials and Methods. A search for relevant publications was conducted in the PubMed/MEDLINE, Scopus, Web of Science, Embase and eLibrary.ru databases beginning from January 2000 to December 2024. The inclusion criteria covered original and review articles devoted to nectin-4 in gynecological oncology. Key words in Russian and English, Boolean operators, and filtering by full-text, subject matter, and quality of research were used. From the 3955 identified publications, 65 were included in the review.

Results. Nectin-4 expression is associated with enhanced tumor cell proliferation, migration, and chemoresistance, whereas its involvement in generating tight intercellular junctions promotes the development of chemoresistant spheroids. In ovarian cancer, upregulated levels of nectin-4 messenger RNA (mRNA) and serum protein demonstrated high diagnostic and prognostic significance, especially in combination with traditional markers such as cancer antigen 125 (CA-125). In endometrial cancer, nectin-4 expression correlates with a deficiency of the mismatch repair system (MMR genes) MSH2/MSH6 genes and lowered progression-free survival. In cervical carcinoma, nectin-4 is related to drug resistance, thereby positioning it as a promising target for novel treatment strategies. The latter using nanoquinacrine and antibody-drug conjugates (ADCs) such as 9MW2821 and ADRX-0706, are currently undergoing clinical trials. Additionally, nectin-4 has shown relevance in non-malignant reproductive disorders such as endometriosis and preeclampsia.

Conclusion. Nectin-4 demonstrates high clinical significance as a diagnostic and prognostic marker in gynecological malignancies. Its expression is associated with aggressive disease progression and drug resistance, especially in ovarian, endometrial and cervical cancers. Clinical trials with nectin-4-targeted drugs, including ADCs, are underway. Thus, nectin-4 represents a promising target for the development of personalized diagnostic and therapeutic strategies in gynecological oncology.

Introduction. Breast cancer (BC) is the most common oncology pathology that holds a leading place among the causes of cancer death. Early diagnosis is critically important for successful treatment. Current molecular genetic research has revolutionized oncology allowing to classify breast cancer into various subtypes and, thereby, radically changing the approach to therapy.

Aim: to analyze the literature data on up-to-date information regarding the molecular genetic BC markers and the prospects of their use for BC diagnostics and treatment.

Materials and Methods. In accordance with the PRISMA guidelines, a systematic search was conducted in the PubMed/MEDLINE, eLibrary, and Google Scholar databases using Russian and English keywords: «breast cancer», «early breast cancer», «molecular markers of tumor cells», «chemotherapy», «hormone therapy», «estrogen and progesterone receptors», «triple-negative breast cancer», «neoadjuvant chemotherapy», «complete pathological response», «immunohistochemistry». Peer-reviewed publications in Russian or English containing original data on BC molecular diagnostics were included, with total of 39 publications selected for analysis.

Results. High diagnostic and prognostic value was found for mutations in the BRCA1/2, PIK3CA,TP53, CHEK2, PALB2, and ESR1 genes, as well as for the expression of PD-L1, TILs (tumor-infiltrating lymphocytes), and Foxp3+ regulatory T cell levels. Modern technologies such as liquid biopsy, analysis of circulating tumor cells, and circulating tumor DNA allow for real-time tumor molecular profiling. This markedly expands the potential for personalized treatment strategies. HER-2-low subtype and ESR1 mutations require individualized therapeutic approaches.

Conclusion. BC molecular markers have become a cornerstone for accurate diagnosis, risk stratification, and personalized therapy. Despite substantial research advances, the accessibility of molecular diagnostics, standardization of procedures, and integration of innovative technologies into clinical practice remain pressing issues. Systemic support is needed to implement molecular techniques into standard care protocols and ensure their broader application in real-world oncology settings.

Sexual dysfunction is one of the most common and underestimated issues observed in women undergone treatment for malignant neoplasms of the female reproductive system. Here, we review current data on the impact of surgical treatment, radiation therapy, and chemotherapy on patients’ sexual health, including symptoms such as vaginal dryness, dyspareunia, decreased sexual desire, and dissatisfaction with intimate life. Special attention is paid to the importance of screening for sexual dysfunction at all stages – from diagnosis to long-term survival. We discuss modern approaches to managing sexual dysfunction, including hormonal and non-hormonal therapies, vaginal moisturizers and lubricants, use of vaginal dilators, pelvic floor physical therapy, psychosocial counseling, and local anesthetic application. The effectiveness of multidisciplinary programs implemented in specialized sexual health clinics is highlighted, along with the growing importance of telemedicine and online resources for patients living in areas with limited access to specialized care. The article also addresses sexual health inequity access to services among marginalized groups, including individuals with low socioeconomic status, residents of rural areas, and members of sexual and gender minority communities. The need to increase awareness among healthcare professionals, integrate sexual health screening into routine oncology practice, and develop individualized rehabilitation programs to improve the quality of women’s life after gynecologic cancer treatment is emphasized.

Introduction. Malignant neoplasms of the female reproductive system (ovarian, endometrial, and cervical cancers) account for a significant proportion of female oncology morbidity and mortality. Standard treatment methods, including surgery, chemotherapy, and radiotherapy, show limited efficacy in recurrent and drug-resistant tumors. The development of immunotherapy, particularly immune checkpoint inhibitors (ICI), has opened new therapeutic avenues; however, their clinical effectiveness in gynecologic oncology remains suboptimal. In connection with this, it has increased an interest in novel targets, notably TIGIT (T-cell immunoglobulin and ITIM domain), a co-inhibitory receptor expressed on T-cells and natural killer cells (NK-cells), which plays a key role in establishing an immunosuppressive tumor microenvironment.

Aim: to systematize current data on the biological function of TIGIT and relevant ligands, its role in immunosuppression in malignant neoplasms of the female reproductive system as well as evaluate a therapeutic potential of its blockade during a personalized immunotherapy.

Materials and Methods. This review was conducted according to the PRISMA methodology. There was performed a systematic literature search for publications from 2013 to 2024 in the databases PubMed/MEDLINE, Scopus, Web of Science, Embase, Google Scholar, and ClinicalTrials.gov. A total of 91 scientific sources and 7 registered clinical trials were included. Original studies, meta-analyses, reviews, guidelines, and clinical trial reports were analyzed.

Results. TIGIT interacts with several ligands (CD155, CD112, Nectin-4, Fap2), leading to suppression of NK-cells and CD8+ T-cells activity, macrophage polarization toward M2 phenotype, activation of regulatory T-cells (Treg), and impaired antigen presentation. TIGIT is co-expressed with PD-1 (programmed cell death protein 1) and CD96, forming a suppressive signaling network. Its elevated expression is associated with disease progression in ovarian, endometrial, and cervical cancers, reduced cytotoxicity of tumor-infiltrating lymphocytes (TIL), and poor prognosis. TIGIT blockade, especially in combination with PD-1/PD-L1 (programmed cell death ligand 1), restores effector cell function and enhances antitumor immunity in preclinical and clinical studies.

Conclusion. TIGIT is a promising immunotherapeutic target in malignant neoplasms of the female reproductive system. Its blockade may improve treatment outcomes in patients with recurrent and resistant cancert ypes. Combined approaches involving anti-TIGIT agents require further clinical validation but even today they offer new directions in targeted therapy and personalized management in gynecologic oncology.

Introduction. According to the average statistical data, the incidence of ovarian tumors in children comprises about 4.6 %. In the adolescent population, ovarian epithelial tumors confidently hold a leading place. One of their histological subtypes is presented by mucinous cystadenoma. Due to the frequent asymptomatic course or the absence of specific clinical features, such cysts can long persist in the abdominal cavity and reach significant sizes. In the latter case they can manifest with the symptoms of serious complications such as obstruction of the urinary tract and the intestines, pedunculated masses torsion, ovarian torsion, rupture of cysts, etc. Thus, the main insidiousness of ovarian tumors lies in the delayed diagnostics and omitted surgical opportunities for ovary preservation.

Aim: to present a clinical case of a teenage girl with giant ovarian cystadenoma complicated by hydronephrosis due to ureteral compression.

Case presentation. A female patient R., 17 years old, was admitted to the surgical department on 12.02.2025, with complaints of abdominal enlargement, abdominal pain lasting over 4 months, frequent urinal miction and algodismenorrhea. Medical history dated of January 2025 showed that imaging research methods performed in different organizations revealed a multilocular cyst of the abdominal cavity – a mucinous cystadenoma of the left ovary, sized 193×195×271 mm, complicated by hydronephrosis of the right kidney. Physical examination revealed a local abdominal pain in the umbilical region as well as increased abdominal volume. General blood test found signs of mild iron deficiency. Blood screening tests for serum alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG) and cancer antigen-125 (CA-125) levels allowed to exclude oncological pathology.

Results. Further surgical treatment was performed. On 17.02.2025, patient R. underwent laparoscopic cystectomy. The passage of urine quickly returned to normal after removal of obstruction cause. A follow-up ultrasound examination on the day 7 post-surgery showed that the pelvis of the right kidney was markedly decreased. The postoperative period was unremarkable. Patient R. was discharged on day 8 with improvement. Recommendations were provided.

Conclusion. A clinical case presented here demonstrates an opportunity for developing complication such as hydronephrosis related to bulky ovarian cyst in adolescents. The surgical treatment confirms that even in case of giant cysts, cystectomy along with preserving maximum volume of the ovarian tissue may be performed thereby allowing to exert reproductive function in the future. However, such surgical treatment option should be performed only with confidence in benign tumor origin and presence of viable ovarian tissue.