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Publisher: Trilist Publishing   (Total: 1 journals)   [Sort by number of followers]

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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]
  • Modern approaches to surgical and postsurgical medical management of
           patients with endometriosis

    • Authors: В. В. Камінський, Т. Ф Татарчук, І. З. Гладчук, М. Мюллер
      Pages: 8 - 14
      Abstract: December 8, 2016 in Kyiv Advisory Board was held related to modern approaches to surgical and postsurgical medical management of patients with endometriosis. Endometriosis is a chronic estrogen-dependent gynecological disease which requires a life-long management plan with the goal of maximizing the use of medical treatment and avoiding repeated surgical procedures. The disease management tactics in patients with endometriosis are determined by the clinical symptoms and includes observation, medical treatment, surgical treatment (conservative, radical), using of the assisted reproductive technologies. To prevent endometriosis recurrence it is reasonable to use a combined approach – surgical methods and hormonal therapy.In resolution surgical tactics of management of patients with endometriosis is described in detail based on clinical symptoms and appropriate conditions for this intervention, according to the unified clinical protocol “Management of patients with genital endometriosis” approved by Order of Ministry of Health of Ukraine No. 319 dated April 06, 2016.Postsurgical prevention of endometriosis recurrence is an important stage of management of patients with endometriosis, as regardless of the proven efficacy of the surgical treatment, a risk of endometriosis lesions and pain recurrence is exist.As noted in the resolution, currently no clear criteria for endometriosis recurrence evaluation are available. The hormonal therapy may maintain the positive effect of the surgical treatment for a long time and may minimize the risk of pain and endometrioid lesions recurrence. For secondary prevention of endometriosis recurrence and associated pain long-term hormonal therapy is recommended (> 6 months). A surgeon plays a key role in prescription of postsurgical medical treatment: he/she determines its strategy for the first 6 months after the surgery in alignment with the outpatient physician.To treat the women with endometriosis and infertility, the surgeon should have the appropriate skills and experience. Cooperation with the centers of reproductive medicine is also mandatory. In persistent infertility (failure of long-term therapy) of non-defined origin and suspected endometriosis (presence of pain syndrome), it is reasonable to perform the laparoscopy to rule out the endometriosis as a cause of infertility and its surgical treatment. After surgery, the patients with the reproductive plans are recommended to prescribe dienogest for 3 months and in case of infiltrating endometriosis forms – at least for 6 months to minimize the inflammatory process. As its noted in resolution medical and surgical methods of endometriosis treatment should not be considered as competitive but as compatible, which increase the treatment efficacy and improve the disease prognosis.
      PubDate: 2017-04-30
       
  • Premature ovarian insufficiency: a syndrome or diagnosis

    • Authors: Т. Ф Татарчук, Н. В. Косей, Т. Н. Тутченко
      Pages: 16 - 22
      Abstract: The article presents modern views on the etiology, pathogenesis, diagnosis and management of premature ovarian insufficiency (POI) – syndrome which is heterogeneous in the etiology and pathogenesis and has a significant negative impact not only on the reproductive sphere, but also on the quality of life, the overall morbidity and mortality of women.The term “premature ovarian insufficiency” is used today by leading professional societies in the US and Europe and is recommended for use in clinical practice. In the clinical recommendations of 2016, the European Society for Human Reproductology and Embryology provides the following definition of the POI – the clinical syndrome whose main manifestation is the cessation of ovarian function before the age of 40, which is characterized by a disruption of menstrual function, an increase in gonadotropins and a decrease in the concentration of estradiol.Given the already well-formed trend in developed countries for the late realization of reproductive function, a higher frequency of POI in a group of women of late reproductive age is an actual problem of modern reproductive technology.The clinical significance of the POI goes beyond gynecology: prolonged hypoestrogenia is accompanied by a decrease in bone density, the disease also has negatively affects the incidence of cardiovascular and neurological diseases, cognitive function, sex life and the social realization of women.Hormone replacement therapy is an obligatory and essential component of correction of symptoms and prevention of long-term consequences of estrogen deficiency. With this in mind, the article discusses in detail the effects and safety issues of the application of various types and ways of hormone replacement therapy available today for the elimination of symptoms of estrogen deficiency and the prevention of its consequences in women with POI and various concomitant conditions. The pharmacological effects of natural transdermal estrogens and micronized progesterone make it possible to treat this combination as the most optimal variant of hormone replacement therapy for women with POI due to the flexible dosage regimen that allows to provide individual needs for compensation of estrogen deficiency.
      PubDate: 2017-04-30
       
  • Endometrium in focus of the gynecologist’s attention: the role of
           hysteroscopy and immunohistochemistry in the diagnosis of chronic
           endometritis, the choice of treatment

    • Authors: І. Т. Кишакевич, Н. В. Коцабин, В. В. Радченко
      Pages: 24 - 27
      Abstract: The aim of the study was to evaluate the immunohistochemical marker CD138 for the diagnosis of chronic endometritis in women with infertility and to explore the impact and effectiveness of Epigalin® (indole-3-carbinol – 200 mg, epigallocatechin-3-gallate – 45 mg) on the state of the endometrium based on established key relationships between structural and functional state of the endometrium, morphological and imunoglobulin features.Materials and methods: the study included 46 women of reproductive age with infertility, ranging in age from 20 to 45 years. All women were carried out hysteroscopy with endometrial biopsy with subsequent morphological study of the endometrium and determination CD138 expression (membrane protein used as a marker of plasma cells).Patients were randomized into two equal groups. The first group received traditional antibiotic therapy, women of the second group in combination with antibacterial therapy received Epigalin® 1 capsule twice a day for 3 months.Monitoring the effectiveness of therapeutic interventions was carried out through 3 months after treatment conducted. Repeated CD138 expression was determined in endometrial samples obtained during Pipelle biopsy of the endometrium, which was carried out on 7–10 days of ovarian menstrual cycle. An important criterion of treatment effectiveness was the positive dynamics in the implementation of reproductive function.Results: during a year the number of achieved pregnancies among women of the Epigalin® group was significantly higher than the other group number.Conclusion: the comprehensive therapy with Epigalin® of chronic endometritis in women with infertility allowes tosignificantly reduce the severity of clinical symptoms, increase reproductive function, normalize morphological function and proliferation and apoptosis processes in the endometrium.
      PubDate: 2017-04-30
       
  • Risk factors for recurrence of endometrial hyperplasia in women of late
           reproductive and premenopausal age

    • Authors: С. М. Корниенко
      Pages: 28 - 31
      Abstract: According to many researchers, hyperplastic endometrial processes are not precancerous diseases. However, recurrent endometrial hyperplastic processes, as well as their combination with genital and extragenital pathologies, significantly increase the risk of malignant transformation of the endometrium. Late reproductive and premenopausal age is associated with an increase in the frequency of endometrial hyperplastic processes, extragenital pathology and operative interventions on the internal genitalia. The limited possibilities of conservative treatment in connection with concomitant diseases and the tendency of an increase in the recurring hyperplastic processes of the uterus make the problem of studying various aspects of hyperplastic endometrial processes in women of this age period extremely urgent.The purpose of research: to identify risk factors for recurrence of endometrial hyperplasia in women of late reproductive and premenopausal age.Materials and methods. We studied the clinical and medical history and long-term results of treatment of 276 women aged 35–54 years with endometrial hyperplastic processes. All patients underwent diagnostic and therapeutic hysteroscopic procedures were carried out. In 88 (31.9%) women for 1.5 years after treatment were observed relapses of the disease. These patients accounted for Рц group, the remaining 188 women included in the group K. Data processing was performed using variation statistics method, Mann-Whitney ranking test, χ2-test and Fisher’s exact test.Results and conclusions. It should be noted the high rate of recurrence of endometrial hyperplastic processes in women of late reproductive and premenopausal age and lack of nosological specificity of recurrent endometrial hyperplastic processes. At the same time, recurrence of endometrial hyperplastic processes significantly increased the risks against the backdrop of giperpolimenorei, endometrioid disease, especially, adenomyosis and ovarian cysts. The greatest chances of recurrence were associated with the presence of patients extragenital diseases: gastrointestinal disorders, iron deficiency anemia, thyroid and breast cancer, vegetative-vascular dystonia. Within the framework of all investigated factors, the chances of recurrence of endometrial hyperplastic processes are most significant increased at the vegetative-vascular dystonia, and the pathology of the lacteal and thyroid gland.
      PubDate: 2017-04-30
       
  • Looking at the problem of cytomegalovirus and Epstein-Barr viral infection
           in gynecology and possible solutions

    • Authors: Л. С. Осипова, А. А. Суханова, Е. И. Соколова
      Pages: 32 - 39
      Abstract: In recent years, there has been an increase in the number of patients suffering from chronic recurrent herpes-viral infections, which in many cases are accompanied by a pronounced disturbance in overall well-being and a number of therapeutic complaints. In particular, on transplantology and gynecology often have diseases and syndromes caused by cytomegalovirus (type V herpes viruses) and Epstein-Barr virus (type IV herpes viruses). The article presents the results of the effectiveness and experience of using an antiviral drug with the immunomodulatory action of Groprinosin® (inosine pranobex) in the treatment of chronic persistent conditions caused by cytomegalovirus infection and infection of the Epstein-Barr virus.Patients with verified cytomegalovirus infection and Epstein-Barr virus infection were examined. Group I included 56 women with active cytomegalovirus infection; group II – 49 women with active Epstein-Barr virus infection. The control group consisted of 30 healthy women.All patients received in complex therapy Groprinosin® 50 mg per kg of body weight per day for 2 weeks, then 2 tablets (1000 mg) once a day, regardless of body weight for 2 weeks (3 such courses during the 3 months). The daily dose of Groprinosin® was divided into 3–4 doses.After 3 months, the cytomegalovirus DNA was detected in spittle of 3 (5.3%) patients of group I, Epstein-Barr virus DNA – in 2 (4.0%) patients of group II. After treatment in patients receiving complex therapy Grosprinosin®, the quantitative indices of T-lymphocyte subpopulations were restored and their imbalance was eliminated (the immunoregulatory index was normalized), the same dynamics was also observed with regard to the number of natural killers.Based on the conducted studies, it was found that the inclusion of Grosprinosin® in the complex therapy of cytomegalovirus infection and infection with the Epstein-Barr virus promotes an increase in the immunological reactivity of the organism, allowing to significantly improve the clinical course of the disease. Grosrinosin® is well tolerated by patients and can be recommended for the treatment of both of these infections.
      PubDate: 2017-04-30
       
  • The new view on treatment of the infections of urogenital system of
           pregnant women with diabetes

    • Authors: Т. В. Авраменко, А. В. Грибанов, И. В. Кривущенко
      Pages: 44 - 52
      Abstract: The article discusses the application and effectiveness of drug Aflazin® manufactured by Valartin Pharma Ltd. as an antimicrobial therapy in pregnant women with diabetes mellitus in the II-III trimesters with uncomplicated urinary tract infection.In the course of the study, 91 women aged 18–40 years were examined. Patients were randomized into 2 groups: 45 women entered group I (main), and group II (comparisons) – 46 pregnant women. All women received basic antibiotic therapy used in the clinic for the treatment of chronic nonspecific urinary tract infections. Additionally, pregnant women from the comparison group received Aflazin® 1 capsule 2 times a day for 15 days.Characteristics of the clinical course of the disease in pregnant women of both groups were homogeneous. The main signs of uncomplicated urinary tract infection were frequent painful urination in small portions, pain in the lower abdomen and in the lumbar region, an increase in body temperature. In 80% of cases, when studying the bacterial culture of the urine of pregnant women, microorganisms were detected in various associations.After using the drug Aflazin®, changes in the immunological reactivity of the organism were revealed due to a decrease in the level of CD4+-helpers and an increase in the percentage of phagocytosis. There was a change in the microbial spectrum of the organism towards the disappearance of the pathological flora in the urine. In the course of the study, a positive dynamics of the subjective and objective state of the examined women was obtained, a good tolerability and safety of the drug was noted.Complex therapy, supplemented with Aflazin®, had a significant positive effect on the overall condition of pregnant women. Efficacy of treatment as sufficient or high was noted in 45 (97.8%) cases from 46 in the comparison group and in 20 (44.4%) cases from 45 in the main group. The results obtained make it possible to recommend Aflazin® for the complex treatment of nonspecific urinary tract infections in women with diabetes mellitus in the II and III trimesters of pregnancy.
      PubDate: 2017-04-30
       
  • Therapeutic options for women with infertility before IVF

    • Authors: Н. О. Данкович, О. М. Бабенко
      Pages: 53 - 56
      Abstract: The number of infertile couples in Ukraine reaches 20%. Elevated prolactin level is significant reason of fertility decline.The aim of the study was to study the effectiveness of the Agnus Castus extract in infertil women with functional hyperprolactinemia who are preparing for IVF. This observational noninterventional cohort study included 30 women who applied for infertility treatment. All women were prescribed a drug that contained a standardized extract of Agnus Castus Ze 440, a tablet of which contains 20 mg of active ingredient, 1 tablet once a day for 3 months.In the course of the study there was a significant reduction in the severity of complaints as a part of premenstrual syndrome, according to the patients assessment using a visual analogue scale. So, after a month of treatment, half as much patients had irritability and mood swings, 1.5 times less often had headache, breast pain, attacks of anger, and almost 3 times – bloating.Such positive dynamics persisted with further therapy: breast pain and bloating almost disappeared (scores of 1.33 ± 0.10 points and 1.18 ± 0.05 points, p < 0.05); other complaints were low intensity (scores of 2–3 points). The level of prolactin in examined women was 47.12 ± 5.34 ng/ml before the start of treatment, and after completion of the treatment it decreased more than two times – 19.08 ± 3.47 ng/ml (p < 0.05).The authors concluded that the use of standardized extract of the Agnus Castus Ze 440 (Prefemin) in women with infertility and functional hyperprolactinemia was highly effective and led to normalization of prolactin level in 76.66% of cases and reduction of PMS clinical manifestations in majority of patients. Thus, studied drug can be considered as an effective therapeutic option in patients before IVF in order to reduce the pharmacological burden and improve the results of infertility treatment.
      PubDate: 2017-04-30
       
  • Folic acid supplementation and pregnancy: more than just neural tube
           defect prevention

    • Authors: James A. Greenberg, Stacey J. Bell, Yong Guan, Yan-Hong Yu
      Pages: 57 - 63
      Abstract: Folate (vitamin B9) is an essential nutrient that is required for DNA replication and as a substrate for a range of enzymatic reactions involved in amino acid synthesis and vitamin metabolism. Demands for folate increase during pregnancy because it is also required for growth and development of the fetus. Folate deficiency has been associated with abnormalities in both mothers (anemia, peripheral neuropathy) and fetuses (congenital abnormalities).This article reviews the metabolism of folic acid, the appropriate use of folic acid supplementation in pregnancy, and the potential benefits of folic acid, as well as the possible supplementation of L-methylfolate for the prevention of pregnancy-related complications other than neural tube defects.The term folate is typically used as a generic name for the group of chemically related compounds based on the folic acid structure. Folate, or vitamin B9, is thought of as one of the 13 essential vitamins. It cannot be synthesized de novo by the body, and must be obtained either from diet or supplementation. Folic acid is a synthetic dietary supplement that is present in artificially enriched foods and pharmaceutical vitamins. Neither folate nor folic acid is metabolically active. Both must be reduced to participate in cellular metabolism. L-5-Methyltetrahydrofolate (L-methylfolate) is the predominant micronutrient form of folate that circulates in plasma and that is involved in biologic processes.Periconceptional folic acid supplementation protects against fetal structural anomalies, including neural tube and congenital heart defects. Recent data suggest that it may also protect against preterm birth. Although additional studies are needed to better define the precise timing, dosing, and formulation, existing data suggest that dietary folic acid supplementation is a good idea for all reproductive-aged women.
      PubDate: 2017-04-30
       
  • Is it necessary to treat the mild preeclampsia'

    • Authors: А. Х. Каримов, Г. А. Ахмедова
      Pages: 64 - 66
      Abstract: Preeclampsia and eclampsia are the most common causes of gestational complications for both the mother and the fetus. As the results of a confidential audit of maternal deaths from preeclampsia in regions of Russia in 2016 showed, the main causes of maternal deaths from preeclampsia/eclampsia are the lack of prediction of preeclampsia; belated diagnosis of mild preeclampsia and underestimation of its severity; insufficient and untimely examination; belated delivery; cessation of magnesia therapy during and after delivery. The aim of the study was to research the need for the treatment of mild preeclampsia, which, according to the clinical protocols approved by the Ministry of Health of the Republic of Uzbekistan, should not be treated, but it is necessary to observing for arterial pressure and proteinuria.Under observation were 68 women in the third trimester of pregnancy, admitted to the obstetrics department of the 2nd clinic of the Tashkent Medical Academy with a diagnosis of mild preeclampsia. Women were divided into two groups: 1 (comparison group) – 30 pregnant women with mild preeclampsia, administered according to clinical protocols with monitoring of arterial pressure and proteinuria; 2 (main group) – 38 pregnant women with mild preeclampsia who received L-arginine (Tivortin®) in combination with a complex of antioxidant vitamins.In the study, 18 women of the comparison group experienced progression of pre-eclampsia to severe, and after a loading dose of magnesium therapy these patients were delivered by induction of labor or a cesarean section. In patients of the main group who were injected with Tivortin® and a complex of antioxidant vitamins, the progression of preeclampsia was not observed and the pregnancy was prolonged until the viable period of the fetus.Thus, the authors of the study conclude that pregnant women with mild preeclampsia with a high risk of developing severe preeclampsia and eclampsia must be hospitalized for inpatient examination and treatment by introducing an amino acid (Tivortin®) and a complex of antioxidant vitamins.
      PubDate: 2017-04-30
       
  • Problematic issues of diagnosis of trophoblastic disease

    • Authors: Н. Ю. Педаченко, О. І. Мухомор, К. Л. Аветисьян, Ю. С. Денисенко
      Pages: 68 - 76
      Abstract: The article investigates the difficulties of diagnosis of trophoblastic disease in practice. Till nowadays there is no general strategy in the detection and treatment of gestational trophoblastic disease, as there is no clear status. The diagnosis of this pathology is multifactorial in nature, which also presents some difficulties in the timely detection of gestational trophoblastic disease. This shown that the occurrence of this disease depends on many factors, including the important role of pathogenetic predisposition.In the current study the features of diferrential diagnosis of trophoblastic disease in the early stages of development by ultrasonography and hystologycal analysis were investigated. It was proved that these studies play an important role in the differentiation of uterine molar pregnancy. A clinical case is presented, in which disagreements in diagnoses of a pregnant patient are noted. Also there is a need to respect modern principles of medical ethics and deontology (another device, “other eye” of researcher).As the authors of the article notes, the interpretation of cases with pathology of small pregnancy terms should implemented by doctors of diagnosts together with gynecologists, who have sufficient experience and special training on the problems of trophoblastic disease. In this case, the ultrasound data in the dynamics and the results of clinical and laboratory studies should be taken into account in the complex. Histological studies should be carried out by doctors in specialized institutions (oncological centers, scientific institutions of the 4th level). This problem continues to be relevant, given the high risk of transformation of the physiological conditions of pregnancy into oncopathology, and radical decisions in such cases should be taken by the consilium.With the increase in the number of pregnant women after infertility treatment, including methods of assisted reproduction, such cases can happen more often for different reasons.Therefore doctors who are entrusted to watch and treat such patients should always take into account the significant moral, psychological and possibly additional legal aspects, the occurrence of which can often be foreseen and prevented.
      PubDate: 2017-04-30
       
  • Cystic changes in the mammary gland structure in different age periods

    • Authors: М. Л. Травина, А. Г. Попов, С. А. Попов, Е. В. Куликова
      Pages: 77 - 83
      Abstract: The article is devoted to problems of diagnosis of cystic disease of breast at different ages including children and teens. Analyzed various options for classification of cystic changes.The main method of detecting liquid formation is breast ultrasound, then, as a final verification is possible after thorough laboratory studies education (cytological, biochemical and histological method).Therapeutic and diagnostic puncture cysts do not affect the continued operation of the glandular tissue and can be used at any age. Active sanitation of cysts in children due to the high probability of occurrence of inflammation on the available background cystic cavity. In the adult diagnostic and treatment interventions have a diagnostic character and for reducing local pain symptoms associated with overexertion cysts.Analysis of the results carried out on the basis of examination and treatment of 22 381 patients aged 8 to 72 years, who applied to receive a specialized mammography department of the Federal State Autonomous Institution “National Health Research and Practical Center for Children” of the Ministry of Health of the Russian Federation for the period from 2008 to 2015. According to the results of instrumental studies, cystic changes were detected in 12.1% of 6 126 examined children and adolescents aged from 8 to 17 years, as well as in 49% of 16 255 examined patients over the age of 18.The authors summarize that the current International Classification of Diseases of the 10th revision does not reflect the structural features of the revealed cystic breast pathology for determining forms with increased oncological alertness. At present, for the formation of groups of oncological alertness, the most approximate to the work of the clinician is the classification of cysts according to Berg, which more closely examines the internal structure of the revealed cystic formations and determines indications not only for cytological, but for histological examination in groups whose types of cysts have high risk of malignancy.
      PubDate: 2017-04-30
       
  • Radiofrequency intervention methods in the treatment of pelvic pain

    • Authors: К. С. Новакович, Б. Б. Павлов
      Pages: 84 - 87
      Abstract: The article illuminates a general problem of a pelvic pain. This problem is resolving not only by gynecologists, proctologist, general surgeons, etc., but also neurosurgeons. Neurosurgeons have an experience of working on neural structures, responsible for the innervation of the pelvic organs, and also have the equipment that gives a possibility to perform a series of interventions.The complexity of diagnosis and treatment is caused by the proximity of anatomical and physiological kinship, blood supply and innervation of the pelvic organs.Hereby we give a clinical case to case: the patient, who started a treatment in clinic of Pain Medicine Center (Kyiv) after unsuccessful and prolonged attempt of conservative treatment. Main complains were about the pain in the tailbone, under the buttocks and lower back. The patient was diagnosed chronic perineal pain, protrusion of the disc L3-L4, severe arthropathy of facet joints, spinal stenosis at L3-L4. Chronic perineal pain was not associated with the pathology of internal organs, and the protrusion stenosis caused less pronounced as compared to perineal, and lumbar pain.This clinical case needed staged treatment which performed by epidural blockades, closures and radicular finally, RF techniques. Destruction or neyrolizys used to treat osteoarthritis facet joints, as well as perineal pain. To exclude the motor unit (with radiculopathy) used pulsed radiofrequency. Methods are self-sufficient, but it is complementary to be effective in the treatment of pelvic pain, in this clinical case having not one but several reasons. A sign that the treatment has been completed successfully – a positive therapeutic effect in a sustained and prolonged absence of pain after the last procedure.As the authors of the article notes, the success of the treatment of pelvic pain lies precisely in such a consistent approach from less complex steroid blockades to destructive radio-frequency procedures, taking into account the features of the course of the disease in each individual case.
      PubDate: 2017-04-30
       
  • Noninvasive prenatal testing in the general obstetric population: clinical
           performance and counseling considerations in over 85000 cases

    • Authors: P. A. Taneja, H. L. Snyder, E. de Feo, K. M. Kruglyak
      Pages: 89 - 94
      Abstract: The article contains the results of the research, which set two main goals. The first is the determination of the actual indicators of the effectiveness of noninvasive prenatal studies and the development of counseling tools about the predictability of a positive outcome, taking into account certain clinical indicators and the a priori age risk of the mother. The second is the assessment of changes in the clinical and demographic population after the introduction of testing.Objective: The primary goal of this study was to provide clinically relevant information for appropriate patient counseling.Method: Demographics and test metrics were reviewed for 86 658 clinical cases. Outcome information was requested for samples reported as aneuploidy detected or suspected for chromosomes 21, 18, or 13; voluntary outcome reporting was encouraged for all discordant outcomes.Results: Of 86 658 cases, 85 298 (98.4%) met inclusion criteria for result reporting. Of the 1360 (1.6%) cancellations, only 101 (0.1%) were for technical reasons. Average time to result was 3.3 business days. Aneuploidy was detected or suspected in 2142 (2.5%) samples. For aneuploidy detected cases with known clinical outcomes, the overall positive predictive value was 83.5% (608/728); observed positive predictive values for trisomies 21, 18, and 13 ranged from 50.0 to 92.8%. As individual positive predictive values are determined by a patient’s prior risk, we developed a chart for counseling patients on positive predictive value based on maternal age.Conclusion: This large-scale report reinforces that noninvasive prenatal testing is a highly accurate screen for fetal aneuploidy in the general obstetric population. Test improvements have facilitated a reduction in failure rates, time to result, and borderline results/unclassifiable results. We have developed a positive predictive value counseling tool to ensure appropriate patient education, counseling, and clinical utilization.Funding sources: This study was funded by Illumina.Conflicts of interest:
      Authors of article are employees of and hold equity in Illumina.
      PubDate: 2017-04-30
       
  • Possibilities of using melatonin in gynecology

    • Authors: Н. В. Яроцкая, Е. В. Занько
      Pages: 96 - 101
      Abstract: For the modern gynecologist, the problem of human aging acquires a special urgency – the tasks of preserving the reproductive potential of a woman, alleviating the symptoms of perimenopause come to the fore. Clinical manifestations of climacteric syndrome are very diverse and polysymptomatic and can vary from the presence of several symptoms to the development of the entire symptom complex. In the article the modern strategies of conducting women during menopausal transition and postmenopause are considered: hormone replacement therapy as the main method of correction and prevention of climacteric disorders, as well as auxiliary methods – phytoestrogens, anticonvulsants, antidepressants, agents acting on the autonomic nervous system, multivitamin complexes, plant extracts that are used more or less successfully in clinical practice.Melatonin preparations, analogues of one of the main endogenous adaptogens, are of particular interest in this series. This review describes the main effects of melatonin, its place in the complex treatment of the proliferative processes of the reproductive system, in particular, in the treatment of premenstrual syndrome, dysphoria, correction of sleep disorders in the perimenopause, its special role in the maturation of the follicle and ovulation. Melatonin is a universal natural adaptogen with a sleep effect, which is recommended by the National Consensus on the management of patients in menopause as a preparation of additional non-hormonal therapy. In the treatment of climacteric syndrome, it can be used at a dose of 1.5 mg 30 minutes before sleep for three months. It can be recommended as a monotherapy in the mild course of menopause and the prevalence of sleep disorders. If symptoms are more pronounced, melatonin should be combined with hormone replacement therapy.Synthetic analogue of melatonin is represented in Ukraine by drug Vita-Melatonin produced by PJSC “Kiev Vitamin Plant”. The drug allows to perform the task of increasing the effectiveness of therapy for various gynecological diseases. Not being selectively tropic to the reproductive system, melatonin promotes adaptation, improvement of the general condition and well-being of women in the climacteric period.
      PubDate: 2017-04-30
       
 
 
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