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Obstetrics, Gynecology and Reproduction

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Vol 8, No 1 (2014)

ОRIGINAL ARTICLES

6-11 77
Abstract
Investigation of dynamics of serum glial fibrillary acid protein (GFAP) concentration within the first 6 months of life of neonates with cerebral ischemia has both scientific and practical implications. Materials and methods. 49 neonates with perinatal hypoxic-ischemic lesion of the CNS and gestational age 32-41 weeks have been examined
between the ages of 1 and 24 weeks of life. 28 healthy term infants comprised the control group. The neonates were assigned to one of the following groups: babies with Apgar score of 1-3 points one minute after birth (group A 1-3), 4-6 points (group А 4-6) and 7-9 points (group А 7-9); neonates with gestational age (GA) GA 32-33 weeks, GA 34-36 weeks and GA 37-40 weeks; newborns with intraventricular hemorrhages (IVH group) and periventricular leukomalacia (PVL group). Quantitative analysis of serum GFAP was carried out using the immunoenzymatic assay (IEA). Results. We have
found a significantly increases serum GFAP concentration among neonates aged one week in groups А 1-3, А 4-6 and А 7-9 as compared to control group. Serum GFAP concentration in infants of the GA 32-33 group was significantly higher compared to the GA 34-36 and GA 37-41 groups and control group. The differences between the IVH group and PVL group were not significant during the first week of life although the mean GFAP values were somewhat lower in the PVL group compared to the IVH group. We have found the phenomenon of delayed increase of the GFAP concentration in neonates aged 3 weeks. Conclusion. Determination of serum GFAP concentration can be used for the verification of severity and type of CNS lesion in newborns at different gestational ages.
12-14 60
Abstract
Abnormal uterine bleeding (AUB) is one of the main clinical symptoms of the diseases of female internal reproductive organs. AUB cannot be considered as the specific symptom of a particular disease. To know the causes of AUB is necessary for rational treatment strategy. Aim. to study the peculiarities of endometrial state of the patients suffering from AUB and the combination of different forms of pathological endometrial (E) changes on the background of AUB. Material. the results of histological examination of endometrium (E) samples taken from 688 patients. Results. the structure of pathological changes of endometrium in case of AUB was identified. Conclusion. complex endometrial hyperplasia and atypical endometrial hyperplasia occur without any regularity on the background of various changes of E reflecting the state of both hypo- and hyper-estrogenia.
15-25 116
Abstract
Currently due to reduction of direct causes of maternal mortality increasing interest of scientists cause arterial thrombotic complications. Pregnancy-related stroke is a rare event, however, when it occurs, may be life threatening and there may be implications for management of the patient and delivery. The mechanisms and risk factors for ischemic stroke related to pregnancy and in women of childbearing age remain unclear. Pathogenesis of so severe complication in young women is not fully understood, however, there is a concept thrombosis or cerebral embolism, which can develop on the background of well-known population-based risk factors such as hypertension, metabolic syndrome, smoking, heart rhythm disorders, valvular heart disease or in relation to typical obstetric pathologies, such as preeclampsia, massive obstetrical bleeding, septic complications, amniotic fluid embolism. In recent years, there is increasing interest in the role of thrombophilia in the pathogenesis of ischemic stroke, however, data on this issue is
even more limited and contradictory than for venous thrombosis. Methods of prevention of recurrent stroke and strategies of pregnancy and delivery management in women with history of ischemic stroke are also contradictory.
26-30 104
Abstract
The antiphospholipid antibodies (APA) exert multiple effects on the hemostasis system causing damage to all of its protective components including the endothelial barrier, natural anticoagulant function and endogenous fibrinolysis and activating the platelet phase of hemostasis, which is associated with numerous obstetrical complications and
infertility. The question is, what is the frequency of circulating APA in women who underwent IVF failure and whether there is a relationship between the presence of APA and poor reproduction outcome? This study aimed at elucidating the effect of the presence of APA on the outcomes of assisted reproductive technology (ART). A total of 267 women diagnosed with infertility and planning to get pregnant using the assisted reproductive technology (ART) have been examined. The results of examination demonstrated a high prevalence of circulating APA in a group of women who underwent IVF failure. High titers of APA were found in 42.1% of female patients who had undergone IVF failure. The fraction of women in whom fertility treatment using ART succeeded was 19.1%.
31-33 68
Abstract
The article describes the examination data of pregnant women with fetal loss syndrome in anamnesis which were analyzed for the circulated antiphospholipid antibodies. Reviewed approaches to prevention of obstetrics complication and antithrombotic prophylaxis with LMWH.
34-36 85
Abstract
The article describes the examination data of pregnant women with severe preeclampsia, which were analyzed for the presence of genetic thrombophilia. Reviewed approaches to prevention of obstetrics complication and antithrombotic prophylaxis with LMWH.
37-46 79
Abstract
The purpose of our study was to improve th e quality of pelvic organ prolapse (POP) diagnostic using static and dynamic MRI. We com pared 60 MRI in woman with POP and 20 controls according to the grade of prolapses and pelvic floor relaxation, asymmetry of pubococcygeal and puborectalis muscle. According to the prevalent component of the
prolapsus, the patien ts divided: сystocele – 21 (35%), сystourethrocele – 9 (15%), urethrocele – 3 (5%), vaginal prolapse – 6 (10%), uterine prolapse – 6 (10%), enterocele – 3 (5%), rectocele – 12 (20%). Measurements of the supporting structures were significant (p<.05) in the identification of pelvic floor laxity. The combined static and dynamic MRI can
provide useful information according certain structural abnormalities with specific disfunction, and could be necessary for surgeons as a complement method in planning operation technique.
47-50 186
Abstract
The condition of the patient with 32 week pregnancy associated with complicated with preeclampsia and HELLP syndrome severe gestosis pathogenetically based therapy was worsening as severe gestosis symptoms remained, proteinuria increased to 2,1 gram per liter, thrombocytes slided to113х109/l. After cesarean section carried out in critical condition the condition of the patient worsened: during first 24 hours of postsurgery ALT was 792 u/l, AST was 1165 u/l, by the end of the second 24 hours D-dimer made up 3222 ng/ml, ferment content decreased(ALT 545 u/l, AST 341u/l). In the clinical HELLP syndrome course as high levels of D-dimer as 6086 ng/ml during the third 24 hours, during the fifth 24 hours-4392 ng/ml were marked. Early diagnostics and timely surgery, pathogenetically based
gestosis heparin therapy insured favourable outcome of the HELLP syndrome of the patient.
51-53 81
Abstract
A combination of multigenic thrombophilia with antiphospholipid syndrome is a high risk factor as venous and / or arterial thromboembolism, and a variety of obstetric and perinatal complications.
39
Abstract
The condition of the patient with 32 week pregnancy associated with complicated with preeclampsia and HELLP syndrome severe gestosis pathogenetically based therapy was worsening as severe gestosis symptoms remained, proteinuria increased to 2,1 gram per liter, thrombocytes slided to113х109/l. After cesarean section carried out in critical condition the condition of the patient worsened: during first 24 hours of postsurgery ALT was 792 u/l, AST was 1165 u/l, by the end of the second 24 hours D-dimer made up 3222 ng/ml, ferment content decreased(ALT 545 u/l, AST 341u/l). In the clinical HELLP syndrome course as high levels of D-dimer as 6086 ng/ml during the third 24 hours, during the fifth 24 hours-4392 ng/ml were marked. Early diagnostics and timely surgery, pathogenetically based gestosis heparin therapy insured favourable outcome of the HELLP syndrome of the patient.

SCIENTIFIC SURVEYS

54-59 159
Abstract
Cerebral venous thrombosis is a rare, life-threatening condition, which has now become more frequently diagnosed by advances in imaging techniques. The most common risk factors for cerebral venous thrombosis include pregnancy, postpartum period, use of oral contraceptives. Proved a leading role in the pathogenesis of thrombophilic states of cerebral thrombosis, especially FV Leiden mutation and prothrombin G20210A. The article highlights the pathogenesis, differential diagnosis and therapy of cerebral venous thrombosis in obstetric practice, as well as problems of pregnancy management in patients with history of cerebral venous thrombosis.
60-67 870
Abstract
Metabolic syndrome is widespread among women of reproductive age. Metabolic syndrome is associated with at higher risk of developing various obstetric complications. The endothelial dysfunction, proinflammatory status and thrombophilic status may play an important role in impaired invasion cytotrophoblast and impaired placental development
in women with metabolic syndrome.
68-73 175
Abstract
Prevalence of the metabolic syndrome (MS) is growing all over the world, including women of reproductive age. There is evidence that the presence of MS is associated with hypercoagulation, deficiency in the system of fibrinolysis, increase in platelets activity and, as a consequence, an increased risk of thrombosis. Nowadays genetic and metabolic disorders that underlie the relationship between MS and thromboembolic complications are under active study.
74-79 71
Abstract
Operative delivery is a radical and the only method of treatment of preeclampsia. Severe cases of gestosis show increase in blood coagulation potential and DIC syndrome symptoms appear. Hemostasiological tests, fresh frozen plasm transfusion are important to prevent coagulopathic bleeding. Intensive preeclampsia therapy includes also correction of hypovolemia disorder, relieving peripheral arteriole spasm, control over protein and water-salt metabolisms, improvement of microcirculation and uterine blood circulation, renal blood flow, long term intravenous infusion of magnesium sulfate.


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