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Obstetrics, Gynecology and Reproduction

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Vol 8, No 3 (2014)

ОRIGINAL ARTICLES

6-10 97
Abstract
Endometriosis, with more than centenary history, remains a challenge in our day. One of the more common options is adenomyosis, the share of which amounts to 80%. The aim of the study was to evaluate the clinical effectiveness and tolerance to resolve with chronic pelvic pain syndrome of adenomyosis the use of progestogen-new generation dienogest in a dose of 2 mg for 6 months. The study included 44 (n=44) women of reproductive age with a diagnosis of adenomyosis with chronic pelvic pain syndrome of various degrees of severity, whose average age was on average 36 yo 2 years who received therapy with dienogest in a daily dose of 2 mg for 6 months. The results showed high therapeutic
efficiency dienogest in the treatment of pelvic pain caused by adenomyosis.
11-17 77
Abstract
The aim of this research was studies character of clinical course of gestation and immunological markers in pregnant women with gestational hypertension and pre-eclampsia. In150 pregnant women with gestational hypertension and pre-eclampsia (basic group I) and 50 healthy pregnant women at the same gestational period (control group) was studies clinical course of gestation and plazma levels of twelve natural autoantibodies. The levels of autoantibodies throughout pregnancy were analyzed with an ELISA assay. First gestational trimester with hypertensive disorders accompanied with different complications in 62% of cases ,every second woman (50%) has complications during second trimester while pregnancy-induced hypertension and third trimester at pregnancy-induced hypertension has complications in 56,7% of cases ,and every third woman has fetoplacental insufficiency. The levels of В-2QP, S-100 and ANCA autoantibodies increase during pregnancy in women with gestational hypertension and pre-eclampsia. Quantification of the value of the level of autoantibodies directly depends on the severity of hypertensive disorders.
18-21 81
Abstract
We studied the indexes of antioxidative defence – the concentration of active form of enzymes ceruloplasmin (CP) and transferin (TF) and NO-capacity of the protein of blood in 60 women with external endometriosis by method spectroscopy. The concentration of active form of ceruloplasmin was increased and the concentration of transferin was decreased in women with external endometriosis; the index CP/TF was increased. The NO-connective capacity of the
blood was significant increased in this group of women comparing with their relatives and the control (healthy women) group. These changes are the result of the breach of balance in the system oxidant\antioxidant and the development of oxidative stress in this group of women.
22-25 75
Abstract
Purpose – analysis of the course of labor in 42 healthy primigravidas with a singleton full-term pregnancy to detect the risk of shoulder dystocia. All pregnancy came naturally. Indications for elective cesarean section was not. In 22 labor has begun its own, in 20 – induced. Risk of shoulder dystocia may be induction of labor, strengthening labor, lithotomy, early handling and vain attempts. The induction of labor should not be a routine method of delivery for the prevention of shoulder dystocia.
26-30 77
Abstract
The results of dynamic studies of the stress hormoneof prolactin and indicators of endogenous intoxication in pregnant women having undergone surgery for acute appendicitis are presented. The scientific justification for additional use of discrete plasmapheresis on 3rd and 5th days after an operation in the complex of therapeutic measures that contribute to the preservation of stable concentration of prolactin and allows 2 times to reduce the frequency of pregnancy loss is given.
31-38 540
Abstract
Сurrently optimization of therapy approaches is the actual in management of women with abnormal uterine bleeding combined with extragenital pathology. Study objective: to increase the treatment effectiveness of abnormal uterine bleeding in fertile women with presence of concomitant extragenital pathology by studying the hormonal levels
and to develop pathogenetically substantiated treatment regimen. Materials and  Methods: a prospective trial of 96 fertile women with abnormal uterine bleeding concomitant extragenital pathology. All patients received a standard hemostatic
therapy, 48 women additionally administered melatonin (Group 1), and 48 women received standard therapy without melatonin (group 2). 23 patients without any gynecologic and extragenital pathology comprised Group 3 (control group). Results: melatonin usage during treatment of uterine bleeding in fertile women with combined extragenital pathology: to increasing levels of cortisol, which indicates the possibility of a more rapid formation of the adaptation syndrome; stabilizes the endogenous melatonin; normalizes the ratio of estrogen and progesterone levels, optimizing hormonal balance, regardless of the original background and level of the breach, and thus increases the efficiency of the treatment of uterine bleeding, which is important for practical medicine.
40-42 60
Abstract
There was carried out the spectrometric examination of blood serum of women with benign and neoplas- tic diseases of uterine cervix; the diagnosis was histologically verified. Being minimally invasive method, infrared spectrometry has proved high specificity and sensitivity in comparison with standard examination methods and it has to find wide usage in obstetrician-gynecologist’s every day practice.
43-46 61
Abstract
Of the significant variation in the frequency of cervical strain caused by the scar with a mixed assessment of traumatic deformities on examination did not reflect the degree of scar deformities. This is facilitated by the shortcomings of the existing classification, which unfortunately did not affect the volume of surgical tactics and does not take into
account newly emerging pathological conditions of the mucous membrane. In view of the above, the authors proposed to supplement the existing classification of scar deformities of the cervix, which allow you to develop standard approaches to the treatment, depending on the degree of deformation and the reproductive function of women. Scar deformity of 1
degree of old single or multiple lateral cervical tears up to 2 cm deep. Cervical canal is partially preserved and is a cone with vertex at the internal OS. Eversion of cervical mucous is usually limited to the bottom of its Division. Scar deform of 3 degree-old tears reaching to the body of the uterus with assymetric hypertrophy of lip dystopic cervix in combination
with dysplasia and HPV. SCAR deformation degree 4-old tears reaching to the body of the uterus, combined with the failure of the pelvic floor.
47-52 56
Abstract
Ethics is an essential dimension of obstetric practice. There is defined medical ethics and the fundamental ethical principles of beneficence and respect for autonomy. We then show how these two principles should interact in obstetric judgment and practice with emphasis on the core concept of the foetus as a patient. We then describe the professional responsibility of obstetric ethics. Obstetricians have beneficence based and autonomy-based obligations to the pregnant patient and beneficence-based obligations to the foetal patient.The result is evidence- based clinical judgement about diagnostic and therapeutic measures that are reliably expected to result in a greater balance of clinical goods over clinical harms. The pregnant woman's autonomy is empowered by offering or recommending medically reasonable alternatives. The informed consent process should be used as a preventive ethics tool.

SCIENTIFIC SURVEYS

53-58 72
Abstract
Ovarian hyperstimulation syndrome (OHSS) is a relatively common complication of ovarian stimulation. The pathophysiology of OHSS is characterised by increased capillary permeability. As a consequence of this, there is a fluid shift into third-space causing hemoconcentration, it may contribute to hypercoagulable state, with increased risk
of venous thromboembolism. The article presents modern data on prevention of thromboembolic complication in OHSS patients with special focus on dosage and duration of thromboprophylaxis.
59-64 52
Abstract
This article is focused on the pathophysiology, prevalence , clinical manifestations, diagnosis, and treatment C deficiency with increased risk of thrombosis. Activated protein C (aPC) exerts its anticoagulant activity through inactivation of coagulation factors Va and VIIIa. Aside its anticoagulant property, aPC demonstrates anti-inflammatory and cytoprotectiveeffects, which are mediated through the endothelial protein C receptor and the protease-activated receptor-I (PAR-1). Studying and understanding the biological function of APS makes it possible to control coagulation and inflammation and to apply protein C preparations as anticoagulant and cytoprotective drugs in a physicians clinical
practice.

HISTORIC CASES

76-78 114
Abstract
This article describes the historical aspects of life, medical and scientific practice of the Italian obstetrician Eduardo Porro, as well as his invaluable contribution to obstetrics.

CLINICAL LECTURES

65-70 78
Abstract
The article gives an overview of the forms of anemia, the impact of anemia in pregnancy and obstetric complications. Overwieved the main approaches to the treatment of anemia during pregnancy. A comparative analysis of the use of drugs of ferrous and ferric iron. Discussion of the possibilities given relief thrombophilic conditions in combination with anemia. Formulated the main principles of survey of pregnant women with anemia, as well as the treatment of anemia in pregnant and postpartum women.

PEDAGOGY

71-75 48
Abstract
The article considers the problem of professional-pedagogical competencies development of the Higher Medical School teacher. It is revealed dependence of improving quality of students’ professional training from the level of the teacher’s psychological-pedagogical and methodical competence. The article describes the process of teacher’s developing of the new didactic means – «Student’s Study-book» and «Student’s Collection of reference tables and reference cards» as the index of teacher’s professional-pedagogical competencies development.


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