No 2 (2016)

The study presents peculiarities of the organization of obstetric care in regions of the Russian Federation. The dependence of the maternal mortality and geographical, demographic, economic, medical, organizational factors in the regions was analyzed. The main determinants associated with maternal mortality rate were defined. The power of influence of the organizational, demographic and economic factors on the maternal mortality rate was determined. The clinical and anamnestic risk of the maternal mortality was evaluated. The clinical features of pregnancy and childbirth, forming maternal mortality in different regions, were identified. The complex of priority measures to reduce maternal mortality in the regions was developed and implemented.

The paper presents the assessment of neonatal and maternal outcomes of extremely early preterm births based on retrospective analyses of 74 cases.

Our objective was to improve health of women and children by appropriate breastfeeding practices and developing в implementing to practice an algorithm of prophylactics and correction of breastfeeding complications.

We investigated the vaginal microbiome of 67 patients with threatened pregnancy using bacterioscopic method and qPCR of vaginal swabs, vaginal pH measurement, and FISH to evaluate desquamated epithelial cells of vagina in urine sediments. Vaginal dysbiosis of women with miscarriage was detected by evaluation of vaginal pH, vaginal swabs bacterioscopy, qPCR in 59,7%, 62,7% and 52,7% of women respectively. Gardnerella vaginalis associated vaginal dysbiosis was determined by qPCR and FISH in 14,9% of women. Enterobacteriaceae in urine sediments were highly presented in women with vaginal dysbiosis (54,8%) and pelvic and/or abdominal cavity inflammatory diseases (46,2%).

Genital prolapse (GP) issue is important due to high prevalence, early onset and high rates of recidivation. The basic principle of surgical treatment of GP recidivation is an individual method selection for a specific patient. This paper presents individually selected methods of surgical correction for GP recidivation treatment. Timely selected surgical correction method of the prolapse recidivation is effective, reliable and affordable way to improve the quality of women's live.

Analysis of the sexual function revealed that dyspareunia and decrease the frequency of orgasm as sexual dysfunction symptoms significantly more frequently observed in patients with pelvic organ prolapse. That, of course, reduces the quality of life of women with early forms of pelvic organ prolapse.

The article presents comparative research data to improve the reproductive health of women with uterine fibroids with antiprogestins, selective progesterone receptor modulators (SPRM) and gonadotropin-releasing hormone (GnRH), depending on the size, location and clinical manifestations of leiomyoma. To evaluate the effectiveness of therapy was carried out clinical and statistical analysis of the survey results in patients with uterine myoma patients and analyzed the results of laboratory and instrumental methods of examination in dynamics during treatment and for 6 months after graduation.

The aim of this article is to describe an interesting case of metroplasty exclusively transvaginally in utero-peritoneal fistula after laparotomic myomectomy in nulliparous patient with scar dehiscence. A 32 year old patient with primary infertility was admitted with a defect, suspected by ultrasound (US) examination of pelvic organs and confirmed by hysterosalpingography (HSG) 17 months after laparotomic myomectomy.

Preterm labour is one of the most important issues of protection of maternal and child health, since it determines the level of perinatal morbidity and mortality. Despite the variety of tocolytic therapy, during its using polypragmasy is observed. To prevent or to stop preterm labor is not easy, and perhaps it is possible to prolong the pregnancy for only 2-7 days, and rarely to the calendar date. One of the most controversial issues is the method of delivery before 28 weeks of gestation. On the one hand the survival of these children is low (≈13%), on another - cesarean section is more sparing method of delivery for preterm infants. The most important parameter for evaluating the effectiveness of the obstetric care is evaluating of the long-term outcomes of the development of children.

Endometrioid disease (ED) is multifactorial nature of etiopathogenesis. Since the control of hemostasis in human tissue provided by the immune system, it is clear that the basis of violations of the timely elimination of the altered cells are the body's immunological disorders. Consequently, the basis of endometriosis should lie immune disorders. The article is devoted to the currently existing problems and controversial issues in relation to the pathogenesis of external genital endometriosis. The review presents the national and international research, as well as its own approach to the problem, the prospects and possible solutions.

Dystrophic processes of a vulva were and remain a problem of both practical and theoretical medicine. Despite considerable achievements on the basis of highlighted fundamental medicine questions of an etiopatogenesis, it continues to remain not fully elucidated. It is supposed that more thorough investigation skin aging processes can conceptually change our pathological understanding, in this case dystrophic changes of skin of a vulva and vagina. Correction methods remain unresolved, although there is obvious progress in this field.

This article deals with the problem of choosing the optimal technique of caesarean section, which effects on early and late postoperative complications and uterine scar in the future. The frequency of complications in reoperation far exceeds the risks of the first caesarean section. On the formation of a full scar is influenced by many factors, including the method of performing a caesarean section. The solution to the problem of repeated cesarean section can serve not only the frequency of the first caesarean section, but the possibility of delivery in women with scar (if opulence on the uterus through the birth canal.

This article is about main modern aspects of pathogenesis of myoma, including epigenetics. The authors made an attempt to demonstrate the most investigated epigenetic mechanisms, perspectives of their researching and possible application in practice.

Modern endometrium hyperplasia molecular-based diagnosis methods described in the article.

Nowadays in the world a great number of different questionnaires and forms for estimation of the quality of life of patients, including patients with morbid obesity, have been worked out and used. For the estimation of the quality of life we use three forms: SF-36, GIQLI and the original form for the estimation of the index of quality of life, worked out by us especially for patients with morbid obesity. The main group consisted of 26 patients with morbid obesity, the average age of which was 36,7 ± 0,3 years. The average weight was 125,1 ± 24,5 kgs (from 93 to 160 kgs), the average BMI was 42,8 ± 8,1 kg/m2. The control group consisted of 26 healthy persons without any comorbidities and morbid obesity. There are true differences between the two groups in all the blocks of questions which shows a lower level of quality of life of the patients with morbid obesity than the healthy patients. The analysis of the index of the quality of life gave similar results. The analysis of the three forms truly proves the difference in quality of life between the patients with morbid obesity and the healthy ones. These scores are different as for the total amount of points and the particular blocks of questions. Studying the correlation between BMI and the scores of the quality of life demonstrated that it doesn’t exist due to GIQLI. Due to the results of studying the answers in the form SF-36 there is mutual connection between the scores of physical health and the body mass of the patients. There is such a connection in the form “IQL” in the block of disease-specific questions.

In the present review of the literature discusses treatment options for uterine fibroids in women of reproductive age based on current possibilities of pathogenetic therapy.