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Reproductive Endocrinology     Open Access   (Followers: 2)
Journal Cover Reproductive Endocrinology
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 2309-4117 - ISSN (Online) 2411-1295
   Published by Trilist Publishing Homepage  [1 journal]
  • Maintaining the quality of life and social activity of women in the
           post-reproductive period

    • Authors: В. В. Камінський, Ю. Г. Антипкін, Т. Ф Татарчук
      Pages: 9 - 12
      Abstract: Taking into account the increase in the proportion of women in the post-reproductive age in society and the increase in the retirement age, it becomes necessary to preserve their professional and social activity. As of 2016, in the structure of the female population of Ukraine, women over 50 years are 46.7%, respectively, the number of women over 45 years is more than half. However, today the problems of women of post-reproductive age are paid insufficient attention both by society, and by the media and social organizations.The issue of maintaining the life quality and social activity of women in the post-reproductive period was discussed on April 5, 2017 in Kiev at an expert council meeting in which leading experts in obstetrics and gynecology, cardiology, family medicine and oncology participated. As noted at the meeting, the relevance of this topic is primarily due to the deterioration of the life quality due to the cessation of ovarian function and the appearance of symptoms of menopause, along with an increase in the incidence of cardiovascular diseases, oncological pathology, and type II diabetes at post-reproductive age.In this regard, at the meeting of the expert council it was proposed to implement the social and information project “Femininity of the future”, within the framework of which in the next 3 years (2017–2019) in 18 regions of Ukraine a number of measures aimed at preserving the life quality and social activity of women in the post-reproductive period. In particular, among them is the development of methods that reduce the risk of developing diseases, increase the level of knowledge of patients and doctors of different directions on modern approaches to the prevention, diagnosis and treatment of menopausal disorders in women, a large-scale educational program on the preservation of life quality, social activity of women in the post-reproductive period and with respect to methods for reducing the risk of cardiovascular pathology, oncological diseases.
      PubDate: 2017-09-14
       
  • Endometrial polyps: new strategies for effective treatment

    • Authors: Т. Ф Татарчук, Д. Г. Герман
      Pages: 14 - 22
      Abstract: The work is devoted to the issue of effectiveness improvement in treatment of endometrial polyps (EP) in women of reproductive age.Study objective: to evaluate the clinical efficacy of the Allokin-alpha in combination with dydrogesterone for the treatment of EP in women of reproductive age.Study design: the study involved 70 patients aged 18–35 years: 34 patients with EP (group I), 30 patients with EP and chronic endometritis (CE) (group II) and 30 patients of the control group (group III). Subgroup Ia (n = 15) received dydrogesterone for the treatment, Ib (n = 19) – dydrogesterone and Allokin-alpha, IIa (n = 17) – dydrogesterone and antibiotic, IIb (n = 19) – dydrogesterone, antibiotic and Allokin-alpha.Study methods: group I and II were diagnosed by hysteroscopy with histological confirmation, endometrial samples from healthy women were obtained by aspiration biopsy. Bacteriological examination of the endometrium was performed by PCR and by cultivating aerobic and anaerobic microorganisms on special growth media. The endometrial sections were immunostained with monoclonal antibodies against the specific markers of plasmacytes (CD138), NK cells (CD56, CD16), cellular marker for proliferation (Ki-67).Study results: Endometrial samples of women with EP (isolated or in conjunction with CE) were characterized by significantly higher detection of Candida spp. – 21% (p = 0,012), and Herpes viruses type 1, 2, and 6 – 17% (p = 0,016). Compared with the normal endometrium, isolated EP contained a lower density of CD56 and CD16, EP in conjunction with CE had a higher density of CD138 along with a lower density of CD16.Dydrogesterone therapy in combination with Allokin-alpha was effective in correcting local immune disorders in the endometrium, normalizing proliferative processes and eliminating infectious agents in the uterine cavity.
      PubDate: 2017-09-14
       
  • Concomitant endometriosis and leiomyoma in women of reproductive age

    • Authors: М. Б. Запорожченко, А. В. Сидоренко, Д. Ю. Парубина
      Pages: 24 - 30
      Abstract: Endometriosis and leiomyoma commonly co-exist inside one uterus. Specialized surgical centers report detection frequency of comorbid endometriosis during surgery or laparoscopy that varies from 20 to 87% in patients with symptomatic fibroids.In authors practice the histological study of surgery samples from patients diagnosed with symptomatic fibroids (113 hysterectomies) revealed concomitant endometriosis in 26.5% cases.Clinical and morphological analysis showed that in patients with multiply fibroids, large volumes or submucous myomas comorbid adenomyosis doesn’t interfere significantly with the clinic course. But in cases of small-size solitary intramural or subserosis fibroids the clinic of symptomatic myomas is determined by the comorbid adenomyosis of diffuse-nodular or diffuse-lesion forms and 2–3 stages.Thus, endometriosis associated with leiomyomas causes more severe course of comorbidity. Patients with symptomatic fibroids are exposed to higher risk of endometriosis development, which must be kept in mind when planning the surgery treatment.
      Authors propose to enhance laparoscopic myomectomy with target revision of pelvis to reveal possible endometriosis, because laparoscopy provides the best opportunity to visualization of endometriosis lesions.The choice of pharmacotherapy of concomitant uterine pathology is limited. Gonadotropin-releasing hormone agonists is the only currently available group of drugs that labeled both for the treatment of endometriosis and fibroids. Selective progesterone-receptor modulator ulipristal acetate due to its unique antiproliferative and selective proapoptotic effect on the leiomyomas cellular component is very promising in the uterine-sparing therapy of myomas. In addition, it has pharmacodynamic effects on the endometrium, including antiproliferative effects that may contribute to the treatment of endometriosis. Clinical trial of ulipristal on this indication is ongoing (NCT02213081). For the present, in the absence of approved algorithms for the treatment of co-morbid pathology, the individual approach with combining preparations of different classes is relevant.
      PubDate: 2017-09-14
       
  • Ultrasonographic evaluation of ovulation stigma and prognosis of growth
           outcomes of the dominant follicle

    • Authors: О. В. Булавенко, В. В. Дощечкин
      Pages: 36 - 43
      Abstract: Study objective: To study the relationship of ultrasonographic changes in the walls of the dominant follicle with the outcomes of its growth – ovulation or persistence.Study design: Prospective cross-sectional study.Patients, Methods, Settings: Upon results of sonographic one cycle pre-assessment, 96 women from subfertile couples were distributed into two groups. Main group – 78 women with documented ovulation. Comparison group consisted of eighteen women with various clinical forms of follicle persistence. Ovulation stigma identification was performed by transvaginal ultrasonography using the technique of Mobile Hydroacoustic Window (TVS+MHAW) with standard 6–10 MHz probes. Three sources of fluid were used for the building of mobile hydroacoustic window: antral fluid, contents of ovulation stigma and the fluid located close to ovary apex. Subtle structures of follicle walls were assessed at the interface of liquid and dense medium in the area of ovary apex.Results, Discussion: In 52 cases (66.6%) two main types of ovulation stigma – Bleb-type and Flat-type were identified, in 48 (61.5%) and 4 (5.1%) cases, accordingly.In the rest of 26 (33.3%) ovulating women it was not possible to identify the stigma sonographically. In 18 (18.8%) cases anovulatory cycles were presented: LUF in 10 (10.4%) cases, follicular regression in 6 (6.3%) and haemorrhagic cysts developed in two cases (2.1%). Local thinning of follicular walls in the area of stigma (91%), appearance of small amount of fluid near the ovary apex (93.6%) and elongated or cone-like shape of the pre-ovulatory follicle (59%) were the most prevalent sonographic signs of stigma formation. Stages of sonographic changes of the structure of forming ovulation stigma were detected and described. New sonographic sign of ovulation stigma, – the phenomenon of Constriction Ring (30.8%), characterizing the closing stage of stigma formation was described. Mean growth and regression rates were calculated for dominant follicles. The increase of dominant follicle size beyond 28.5 mm is connected to high risk of its anovulation or persistence. It should also be taken into account that ovulation can occur at any stage of stigma formation, also without its sonographic appearance.Conclusion: The study of phenotypic features of stigma formation by means of TVS + MHAW can be useful for timing of OPU in IVF natural cycles and prediction of high risk of follicle persistence/regression at intrauterine insemination.
      PubDate: 2017-09-14
       
  • Pathogenetic therapeutic and preventive measures in women of risk group of
           isthmicocervical incompetence

    • Authors: Л. Б. Маркін, Т. Ф Татарчук, К. Л. Шатилович
      Pages: 44 - 47
      Abstract: The article considers the problem of isthmicocervical incompetence (ICI) as one of the leading factors in the genesis of premature termination of pregnancy. As noted, the frequency of this pathology in the population among pregnant women reaches 15%. The results of the study are presented, the purpose of which was to study the clinical effectiveness of the use of the drug Biolectra Magnesium Fortissimum in preconception prevention of ICI in women with undifferentiated connective tissue dysplasia on the background of a magnesium deficiency.The study involved 50 women at risk of ICI (hypomagnesemia, decrease in the index of resistance in the small arteries of cervix uteri (CU), ultrasound signs of connective tissue dysplasia). The age of women ranged from 20 to 40 years. Most subjects had clinical symptoms of magnesium deficiency: tachycardia occurred in 28%, sleep disorders in 24%, general fatigue in 20%, constipation in 18%, paresthesia in 36%, muscle spasms in 18% of cases.The mean magnesium concentration in the blood plasma of the patients was 0.74 ± 0.03 mmol/l. The conducted studies showed a significant decrease in the index of resistance in small arteries of CU in 86% of women, which indicated the presence of morphofunctional deficiency of CU. Also, in 78% of women, echographic examination revealed the presence of collagenopathy.To correct the magnesium deficiency in the pregestation period, women were prescribed the drug Biolectra Magnesium Fortissimum (Hermes Arzneimittel GmbH, Germany) for 1 effervescent tablet once a day for 10 days with a break of 2 weeks for 3–4 months. After completion of the course of treatment, in most cases there was a lack or decrease in the frequency and intensity of symptoms of magnesium deficiency symptoms. The gradient of magnesium level increase after a 3-month therapy was 0.14 ± 0.03 mmol/l. Residual phenomena of paresthesia occurred only in 10% of women, muscle cramps – in 8%. In 60% of women, there was an approximation of the blood flow resistance in the small arteries of CU (RI 0.63 ± 0.03) and in 64% of cases the ultrasonic examination of CU revealed an increase in the reflectivity of the organ, which indicating stabilization of collagen structures, changes in the morphofunctional state of CU, normalization of hemodynamic processes in the organ.Thus, the use of drug Biolectra Magnesium Fortissimum in magnesium deficiency provided an effective correction of hypomagnesemia, positively influenced the morphofunctional state of CU, which helped prevent the complication of pregnancy in 80% of cases.
      PubDate: 2017-09-14
       
  • Optimization of postoperative period after surgical interventions on the
           cervix

    • Authors: Н. В. Косей, Т. Ф. Татарчук, С. И. Регеда, Н. Н. Евтушенко
      Pages: 49 - 56
      Abstract: The article presents the results of research on optimizing postoperative period in patients who underwent surgical interventions on cervix.134 patients were examined who underwent radiowave conization of the cervix for histologically confirmed CIN-2. By simple randomization, they were divided into two groups: Group I (66 women) received 2.0 ceftriaxone intraoperatively, and also Tamistol® vaginally for 1 suppository once a day for 3 days before surgery and for 12 days in postoperative period; patients of Group II (68 women) underwent only intraoperative prophylactic administration of 2.0 ceftriaxone.The laboratory studies after the operative intervention, in particular, revealed a higher microbial load in Group II than in Group I after 21 days and 1.5 months after operation. In addition, when comparing subjective and objective clinical indices, it was noted that the course of the postoperative period in Group I was easier than in Group II.It is proved that the use of complex prophylaxis that included local application of myramistin enhanced decontamination of vagina and cervix with bacterial and viral flora, benign сourse of postoperative period, fewer complications as well as faster and more complete epithelization of cervix after intervention. Considering the high incidence of sexually transmitted diseases in population, increase of the number of multimicrobal associations and the growing resistance of microbes to antibiotics the rationality of local antiseptic therapy in the complex of purulent-septic complications prevention in case of planned surgical interventions on cervix is concluded.Local application of the drug Tamistol® showed its high effectiveness against such pathogens as Atopobium vag. and Mobiluncus mul., considered highly specific markers of bacterial vaginosis. Given the increasing resistance of these microorganisms to nitroimidazole drugs, the proven high efficacy of myramistin against these microorganisms allows us to draw conclusions about the preferred choice of the drug Tamistol® for the prevention of purulentseptic complications during surgical interventions.
      PubDate: 2017-09-14
       
  • The modern features of optimal therapy of salpingoforite

    • Authors: О. В. Булавенко, Д. Г. Коньков, О. М. Гончаренко
      Pages: 58 - 62
      Abstract: The aim of the prospective study was to investigate the clinical efficacy of Tamistol and Bifiten in the complex treatment of salpingoophoritis.Patients and methods. The study involved 152 patients of reproductive age with salpingoophoritis. All women were divided into 3 groups: I – 48 patients received traditional therapy; II – 54 patients who received complex anti-inflammatory treatment with vaginal application of a combined drug containing neomycin sulfate 35,000 IU, polymyxin B sulfate 35,000 IU and nystatin 100,000 IU; III – 50 women, each of whom in addition to traditional therapy received Tamistol and the synbiotic Bifiten. The comparative assessment of the effectiveness of treatment was conducted on the basis of regression of women’s complaints and the results of bacteriological research in dynamics.Results. The local application of suppositories Tamistol or combined drug with neomycin sulfate, polymyxin B sulfate and nystatin had a pronounced clinical effect in the treatment of salpingooophoritis. However, the use of suppositories of Tamistol and Bifiten capsules were more effective than the use of combined drug to reduce the incidence of dysbiosis (RR 2.01, 95% CI 1.14–3.53, p = 0.02 and RR 4.63, 95% CI 1.43–15.04, p = 0.01), for a higher number of lactobacilli (RR 1.99, 95% CI 1.17–3.40, p = 0.011 and RR 5.45 95% CI 1,71–17,41, p = 0,004) on the 14th and 30th day of the study.Conclusion. Use of suppositories Tamistol and capsules Bifiten was clinically highly effective in the complex therapy of salpingoophoritis. The combination of suppositories Tamistol and Bifiten capsules per os requires further investigation.
      PubDate: 2017-09-14
       
  • Modern methods of diagnosis and treatment of vaginal dysbiosis caused by
           mushrooms of the genus Candida

    • Authors: Е. Н. Носенко, Е. П. Головатюк
      Pages: 64 - 72
      Abstract: The article presents literature data on modern approaches to diagnosis and treatment of vaginal dysbiosis caused by fungi of the genus Candida and personal data on the effectiveness of vaginal dysbiosis treatment in women with recurrent miscarriage occurring in ART cycles by combined local therapy with sertaconazole and povidone-iodine.240 patients of reproductive age with habitual miscarriage of pregnancy after ART and 30 conditionally healthy fertile women were examined. The state of vaginal microbiota was studied using PCR and culture. It were carried out a species identification of the fungi of the genus Candida and their susceptibility to antimycotics.It has been established that among women with a recurrent miscarriage after cycles of ART that repeatedly receive antibacterial therapy in preparation in the ART cycles and after abortion, in the vaginal microbiota in 39.75% of cases Candida fungi are diagnosed in diagnostically significant quantities, including C. albicans registered in 75.79% of cases, and non-albicans – in 24.21%. Fungi of the genus Candida in diagnostically significant amounts in 92.63% of cases occurs against the background of aerobic, anaerobic or aerobic-anaerobic imbalance. In 87.36% of ART patients with recurrent miscarriage, the detection of fungi of the genus Candida in diagnostically significant amounts is not accompanied by clinical manifestations of the vaginal candidiasis, but proceeds according to the type of asymptomatic increased colonization by these yeasts.For the treatment of patients prescribed vaginal suppositories Zalain (sertaconazole 0.3 g) per night once, after 7 days – suppositories Betadine (povidone-iodine) at night once a day for 14 days. The culture and PCR studies after the end of treatment showed normalization of the urogenital microbiota and the absence of fungi of the genus Candida in diagnostically significant amounts in all patients.Thus, sertaconazole in combination with povidone iodine is a highly effective regimen of vaginal microbiota normalization in patients with ART with a recurrent miscarriage.
      PubDate: 2017-09-14
       
  • Optimization of treatment of cervical pathology of inflammatory genesis in
           women of reproductive age

    • Authors: Г. В. Чубей, А. Г. Корнацька
      Pages: 73 - 75
      Abstract: The article presents the results of studying the effectiveness of using the drug Depanthol in women with benign cervical diseases of inflammatory genesis.Were examined 30 women of childbearing age (from 18 to 40 years) with benign diseases of the cervix. According to laboratory indicators, the results were compared with the data of 20 healthy non-pregnant women of reproductive age who made up a control group.Methods of study included gynecological examination, advanced colposcopy, cytological examination of scrapings from the cervical canal and exocervix surface, bacterioscopic, bacteriological examination, detection of sexually transmitted infections by direct immunofluorescence method.In all women with benign diseases of the cervix of the inflammatory genesis, there are violations of the microbiocenosis of the genital tract. Most often, nonspecific vaginitis was detected bacterioscopically. In the bacteriological examination, fungi of the genus Candida, staphylococcus, in particular epidermal, streptococcus and enterococcus was predominated, in most cases in associations that included three or more microorganisms. In addition, sexually transmitted infections were often detected in the examined patients. The state of local immunity of the examined women indicated its stress, which was manifested in an increase in the concentration of immunoglobulin class G in cervical mucus and a significant decrease in lysozyme levels.Patients who had sexually transmitted infections received complex ethiotropic treatment in accordance with the identified flora and with an individual approach. Simultaneously, the partner was examined and treated. Local treatment included the administration of Depanthol suppositories twice a day for 10 days.As a result of local therapy with the drug Depanthol, the contamination of the genital tracts of women with normal microflora was improved, the parameters of sowing the opportunistic microflora and fungi of the genus Candida was normalized. Microbiological sanation was achieved in 85.2% of the examined patients. Also, the normalization of the indices of local immunity was noted. Two months after the treatment, epithelization of the cervix was noted in 76.7% of patients, which allowed recommending Depanthol for a wide application in patients with benign cervical diseases of inflammatory genesis.
      PubDate: 2017-09-14
       
  • The experience of ulipristal acetate using in patients with uterine
           leiomyoma

    • Authors: Р. А. Сафонов, И. Н. Сафонова
      Pages: 76 - 81
      Abstract: In the study of clinical experience of the use of ulipristal acetate (UPA) – a selective modulator of progesterone receptors – in women with symptomatic uterine leiomyoma, 65 women with a clinically significant tumor were treated. The drug was given to patients both as a drug monotherapy, and as a stage of complex treatment before surgery.The analysis of the effectiveness of therapy in terms of primary clinical results, the features of changes in the ultrasound pattern, as well as intraoperative features and the possibilities of restoring the reproductive function was held. Thus, with monotherapy was reduced the severity of clinical manifestations of abnormal metrorrhagia (in 63 of 65 women), was decreased the volume of nodes by 35.5 ± 9.8% on average, with a very slight decrease in their linear axial dimensions measured in perpendicular ultrasound sections (in an average of 10.13 ± 0.48%), as well as was tagged a reduction in 3D-PD indices of vascularization of the leiomyoma nodes and the degree of vascularization of nodes in ultrasound scanning in the color Doppler mapping mode. A persistent relapse-free effect of volume reduction and vascularization of the myoma node was noted during the first year of follow-up. Combined treatment in several cases had the effect of a «slippage» of the myomatous node with the transformation of the 2–3th type of growth into the 0–1 type, a significant decrease in intraoperative blood loss was noted in comparison with patients who had not received preoperative preparation of the UPA (120 ± 26 vs. 190 ± 33 ml, p <0.05), as well as facilitation of the surgical stage of node exudation provided that the pseudocapsule is correctly identified. The restoration of reproductive function in 6 patients with the possibility of urgent vaginal birth was noted.In the opinion of the authors of the article, to assess the effectiveness of preoperative preparation, it is inappropriate to do a control ultrasound study before the end of the 12-week course of the UPA. In addition, sonologists performing ultrasound monitoring of treatment should take into account the features of node measurement and specific changes in the endometrium associated with selective modulators of progesterone receptors. In general, the use of UPA opens up new opportunities and prospects for the management of patients with uterine leiomyoma in both monotherapy and multi-stage combined treatment.
      PubDate: 2017-09-14
       
  • New views on the treatment of uterine leiomyoma in women of reproductive
           age

    • Authors: А. Г. Корнацька, О. О. Ревенько, І. С. Колесніченко, М. А. Флаксемберг, Г. Ю. Обухова
      Pages: 82 - 85
      Abstract: Uterine leiomyoma is the most common reproductive system disease in women of fertile age, which takes the leading place in frequency among tumors of the female sexual sphere. It is diagnosed in 20–70% of women of reproductive age. The uterine leiomyoma is still often treated surgically, and is the most common cause of hysterectomies.The article examines the issues of increasing the effectiveness of treatment of uterine leiomyoma and its complications in women of reproductive age by using combined methods of conservative treatment. The results of examination and treatment of 55 patients aged 27–45 with different forms of leiomyoma are presented: intramural nodes (18–32.7%), intramuralsubserous (21–38.3%) and intramural-submucous (16–29.0%). The size of the dominant node varied from 4.5 to 12 cm. Clinical manifestations of leiomyoma was hyperpolimenorrhea (82.3%), lower abdominal pain (34.7%), frequent urination (15%). Also, 86% of women suffered from a decrease in hemoglobin in the blood.In respect of all patients, organ-preserving surgical treatment was planned in connection with the desire of women to giving birth to a child. Patients took ulipristal acetate in a continuous regimen of 5 mg per day and indole-3-carbinol with epigallocatechin-3-gallate 1 tablet 2 times a day for 12 weeks. Women with anemia concurrently with this basic therapy took iron preparations inside.43 (78.3%) women had amenorrhea since the beginning of treatment within a month. The mean decrease in the size of the uterus was 40.7%. After the end of treatment, 49 (89.0%) patients successfully underwent conservative myomectomy, and in 6 (11.0%) patients after the termination of treatment surgical intervention was avoided. During the year after the termination of the course of treatment 13 women became pregnant.In using the combination therapy with ulipristal acetate in combination with indole-3-carbinol and epigallocatechin-3-gallate for 3 months the hemoglobin level was normalized, and the size of the leiomyoma was decreased, which is important for the safe operation. This therapy is a method of choice for the treatment of young women, who intend to exercise their reproductive function.
      PubDate: 2017-09-14
       
  • Possibilities for therapy of a comorbidity of uterine myoma and benign
           breast dysplasias

    • Authors: В. Е. Радзинский, И. М. Ордиянц, М. Н. Масленникова, Е. А. Павлова, В. В. Карданова
      Pages: 86 - 89
      Abstract: Objective. To improve the reproductive health of women with benign breast dysplasia (BBD) and uterine myoma, by elaborating a differentiated approach to preventing and treating comorbid diseases.Subject and methods. The investigation included 175 women with concomitant genital diseases and BBD who were treated at the Gynecology Unit of the City Clinical Hospital No. 12, Moscow. The results of their examination and differentiated treatment for comorbid diseases of the uterus and breast were analyzed.Results. The altered ratio of steroid hormone levels as absolute or relative hyperestrogenemia underlies the pathogenesis of BBD in women with uterine myoma. The elaborated differentiated approach allows quality of life to be improved of 43.4% of patients with combined diseases of the mammary glands and genitals, to reduce the progression and recurrence of BBD in patients with uterine myoma from 36.7 to 15.9%.Conclusion. The findings strongly suggest that the women of this category must form a special follow-up gynecological group and their treatment must be a preventive measure against the progression and recurrence of BBD.
      PubDate: 2017-09-14
       
  • Application of organic estrogenes in women from the tubal-peritoneal
           factor of infertility in the cycle of art

    • Authors: В. В. Камінський, М. Н. Шалько, І. В. Малишева, Ю. С. Мудра
      Pages: 90 - 94
      Abstract: The article discusses the advisability of using oral estrogens in the treatment of infertility in cycles of auxiliary reproductive technologies in women with a tubal peritoneal factor of infertility. The authors present their own observations and practical experience, which are based on a meta-analysis of global trends concerning the effect of oral estrogens on the state of the endometrium in conducting controlled ovarian stimulation.Described study conduct additional inclusion in the drug supply of the ART program Proginova in a dose of 4 mg per day with the prolongation of the using until 12 weeks of pregnancy, with the purpose of pregnancy and its physiological prolongation in women with tubal peritoneal factor of infertility. The results which we have obtained showed the high effectiveness of the using preparation containing estrogens as a part of complex therapy during the cycles of auxiliary reproductive technologies. It was found that the use of estrogen preparations improved the implantation receptivity of the endometrium, achieved the necessary thickness of the endometrium, improved the pregravidary transformation of the endometrium, prolonged pregnancy, in the presence of the threat of interruption in the early periods (until 12 weeks).At appendix of oral estrogens of the standard hormone therapy in the treatment of infertility by the methods of auxiliary reproductive technologies, the number of onset of biochemical pregnancies, the number of diagnosed clinical pregnancies which were diagnosed during ultrasound, and the number of pregnancies prolonged until the 12th week of pregnancy, significantly increased on comparison with the standard treatment without application of drugs which contain estrogen. All patients had noted the ease of using oral forms of estrogen preparations, the absence of side effects and the convenience of a prescribed hormone therapy regimen in the treatment of infertility.Considering the significant positive effect from application preparation Proginova in the complex scheme of drug support of the program of auxiliary reproductive technologies the high expedience was marked in using it in ART programs as standard scheme pharmacological support of endometrial functionality and prolongation of pregnancy in a period until 12 weeks.
      PubDate: 2017-09-14
       
  • Pregnancy and polymorphisms in folate-cycle genes: what dose and
           formulation of folates to choose'

    • Authors: Н. А. Курмачёва, Е. В. Верижникова, О. М. Харитонова
      Pages: 96 - 102
      Abstract: Study objectives: To compare the course of pregnancy and perinatal outcomes of term delivery in women with polymorphisms in the folatecycle genes and a history of miscarriage, depending on what strategy was chosen to correct folate deficiency.Study design: This was a retrospective, comparative study.Materials and methods: We analyzed medical records of 114 patients (Medical Forms No. 025/у, 111/у and 113/у) with polymorphisms in the folate-cycle genes and a history of miscarriage. In Group I, 54 women received conventional treatment with folic acid (5.8 mg/day) before conception and until week 28 of pregnancy as a combination of a single supplement or a vitamin B complex with vitamin-mineral combination supplements. In Group II, 60 patients received a vitamin-mineralcombination supplement, containing 208 mg of metafolin and 200 mg of folic acid, and other B vitamins (В1, В2, В5, В6 and В12) before conception and throughout pregnancy. Also, we compared the levels of homocysteine, blood-coagulation parameters, the course of pregnancy and delivery, and the health state of newborns.Study results: Compared to patients in Group I, patients in Group II had significantly lower levels of homocysteine, fibrinogen and the markers of abnormally increased blood levels of thrombin. In the second group, the rates of some obstetrical and perinatal complications were also lower (1.5–3.9-fold, p < 0.05) than in the first group.Conclusion: In women with polymorphisms in the folate-cycle genes and a history of miscarriage, the use of vitamin-mineral-combination supplements, containing an active form of folates (metafolin), improves the course of pregnancy and perinatal outcomes of term delivery.
      PubDate: 2017-09-14
       
  • Viral hepatitis in women of reproductive age

    • Authors: И. А. Зайцев
      Pages: 104 - 110
      Abstract: A considerable number of various liver diseases that are associated with the course of pregnancy are quite common and occur at least three percent of pregnant women.This pathology plays an important role and is one of the most important reasons for the development of a wide range of different pathologies in pregnant women, in fetuses and newborns. The problem of changing functional liver tests during pregnancy acquires special sharpness and significance in connection with the not-so-recent role of liver pathology in mortality in maternal and perinatal mortality.In recent years, based on a large number of observations and statistical data, important information has been obtained on the details of the mechanism of this pathology, developed and refined diagnostic methods, as well as detailed schemes for treating liver diseases in pregnant women at different stages of pregnancy. Collected and scrupulously processed extensive data on the change in a variety of functional liver tests at various stages of pregnancy, both under normal and with complicated flow.Particular attention is paid to such pathology as preeclampsia, eclampsia, acute fatty liver disease of pregnant women, HELLP syndrome, intrahepatic cholestasis of pregnant women, uncontrollable vomiting of pregnant women, liver rupture, in the diagnosis of which one of the leading, decisive roles is assigned to the change in functional liver tests.In our review, the main emphasis was made in the direction of changing various significant indicators of functional hepatic tests in pregnant women both in physiologically developing pregnancy and in various liver diseases, both as a consequence of pregnancy and not directly related to it. The article also highlights the main mechanisms of these changes. The publication provides the latest information on the timing of full or partial normalization of a wide range of functional liver tests both after delivery and in the natural course of the disease.
      PubDate: 2017-09-14
       
 
 
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