Obstetrics and Gynecology

The aim of the study was to improve management of the postoperative period in patients with genital prolapse after surgery. Methods. Survey of 57 patients, which, depending on the characteristics of the postoperative period were divided into 2 groups: 22 patients received conventional treatment methods vagina seams, in complex treatment of 35 patients was included depantol. The effectiveness of inclusion depantol was control by clinical and laboratory (analysis of blood, vaginal discharge) evidence. Results. Clinical and laboratory evidence of the effectiveness of inclusion depantol, which has antiseptic and stimulating regenerative processes, in the complex of therapeutic measures, reflected in the absence of infectious complications in patients of the main group and reducing lengths of stay in hospital. Conclusions. A higher efficiency of the new method is proved

Purpose: to study efficiency of various methods of prevention of perinatal complications in mother and child. Material and methods. In three risk groups preventive treatment of intrauterine infected fetus (IUIF), gestosis, noncarrying of pregnancy and fetoplacental insufficiency has been carried out. In group I consisted of 71 pregnant women preventive treatment has included medication with application of antioxidants; stimulators of processes of carboxylation in cycle Krebs; endogenic synthesis prostaglandins, prostacyclin; drugs improving processes of microcirculation, stabilizing function of endothelium ofvessels, an exchange of homocysteine. In group II consisted of 67 pregnant women prevention of IUIF and complications has been carried out by means of physical exercises in combination with aqua aerobics. In group III consisted of 100 women prevention of IUIF has been standard. In the control group IV consisted of 70 women pregnancy has not been complicated. Parameters of oxidant and antioxidant systems, central hemodynamics, determined in this group have been determined as normal for comparison. Results. In relation to group III medicamen-tous treatment in group I, regular aqua aerobics in group II have allowed to lower frequency of IUIF, perinatal mother complications, perinatal diseases, death rates in newborns and morbidity in children of early age. Conclusion. For the prevention of IUIF, mother and child perinatal complications, morbidity in children of early age it has been proposed to use medication and regular aqua aerobics which provides nonmedicamentous pregnancy course

The research goal is to study the immune effects in patients with external genital endometriosis. 126 patients with external genital endometriosis ages 22-44 years have been examined. CD3+, CD4+, CD8+, CD16+, CD19+, CD25+, immunoglobulin A, M, G are defined in peripheral blood and peritoneal liquid. Method of cytoflowmetry and radial immunodiffusion by Manchini has been used. Statistical processing of results has been spent by means of a package of the statistical program «Statgraphics», STSC (USA). Reliability of variability has been estimated by means of calculation of nonparametric criterion by Uilkokson — Mann — Uitni. Depression of cellular and increase of humoral immunity (IgG and IgA) in peritoneal liquid have been revealed. Degree of expressiveness of immunity has been depended on presence of inflammatory diseases, duration of disease, localization of the pathology center. In peritoneal liquid the total amount of T-lymphocytes, CD4+ cells and CD8+ lymphocytes has been increased in patients with of external genital endometriosis of lll-IV degree. The immunoregulatory index has been also increased. These results have confirmed the presence of inflammatory process in peritoneal cavity

The research goal was to study the influence of extremely high temperatures on the hemostasis indices in patients with uncomplicated pregnancies with the concomitant limitation of liquid intake. The research results of hemostasis of pregnant women being hospitalized during the period of spring and summer in 2010 have been analyzed. The differences in the level of hypercoagulation changes of hemostasis in summer and spring have been found to be insignificant. In the platelet link hemostasis in summer of 2010, as compared to the spring, the increase of platelet aggregation and amount has been observed, with the exception of the third trimester, which is marked by the decrease of platelet amount. Hot seasons and liquid intake limitations make additional demands on hemostasis adaptive capacity, increasing the risk of thrombohemorrhagic complications

The literature on principal causes of early abortions and ways of treatment in the first trimester was studied. Reproductive losses in the first trimester were found out to be the most active because of 5 main groups of reasons. In each group the therapeutic way of abortion was considered

Research objective. Study of condition of hemostasis system at patients with hysteromyoma complicated by bleeding; comparative estimation of hemostasis indicators at patients with uterine arteries embolization (the basic group n=48) and abdominal hysterectomy (comparison group n=65). Materials and methods. Complex study of the basic hemogram parameters and hemostasis at 162 patients with hysteromyoma and 30 patients without marked genital pathology (the II control group) was carried out. 48 patients formed the main group which was subjected to uterine arteries embolization for bleeding break; 65 patients (the comparative group) were surgically operated upon abdominal hysterectomy; 49 patients with hysteromyoma had no bleedings and formed the control group. Research of hemostasis system was carried out by means of test-tube method, and also by plotting set for express-diagnostics, analysis of thrombocyte unit of hemostasis system was realized with 2-channel analyzer of thrombocyte aggregation «Biola» — LA 230. Results. Presented analysis of hemostasiogram parameters allows to state development of chronic DIC-syndrome in women with hysteromyoma. Reliable shortening of coagulation index, decrease of thrombocyte aggregation function in comparison to the control group data were revealed. Conclusion. Development of hyper coagulation with increase of paracoagulative products with simultaneous activation of fibrinolysis processes in all the patients with hysteromyoma was revealed. Minimal effect of embolization of uterine arteries to hemostasis system in patients with hysteromyoma was marked. And they were intensified after surgical treatment, which is the evidence of definite advantages of this method unlike of hysterectomy

Objective of the present article is to define optimal tactics and volume of surgical intervention in patients with hysteromyoma during labor process. Evaluation of possibilities and prospects of conservative methods of myomectomy have been determined. 1000 case histories dated 2009 were analyzed. Patients aged from 22 to 43 were under study. During the research it was revealed that hysteromyoma was mostly prevailed in women aged 30 and older (75%). 5% of them were primipara, 44% — bipara. 57% of pregnant patients were delivered by means of cesarean method. Widening of surgical intervention required 29% of 100 observed patients. Conservative myomectomy was conducted for 27 patients (87%), supracervical hysterectomy — for 2 women (6,4%). Natural delivery by vaginal route was marked in 43% of pregnant women with hysteromyoma; it was not a problem for birth and was first diagnosed in the early postnatal period by means of ultrasonic diagnostics. During analysis of the received data attention should be paid to expediency and promising of delivery of patients by means of cesarean method with following conservative myomectomy; it promotes to preserve childbearing function, their quality of life and consequently improves the demographic situation

The review considers the current understanding of mechanisms that regulate uterine contractions and the nemo-dynamic changes in the cervix uteri occurring prior to and during delivery. Disorders in hemodynamic transformation of cervix uteri are the most significant causes of delivery anomalies. The criteria for ultrasound diagnostics of the degree of maturity of cervix uteri have been analyzed. Cervix blood flow parameters have been taken into account. The further research perspectives in this field of scientific problems have been stated

The article presents the results of monitoring of iodine intake and thyroid status in pregnant women in Saratov region according to the two cross-sectional studies in 1999 and 2008. The study involved 229 pregnant women. It has been established that there is a decrease in frequency of endemic goiter in pregnant women from 52,8 to 23,6% and increase in median urinary ioduria from 33,0 to 115,5 ug/l. However, iodine intake in pregnancy remains insufficient, as currently the median urinary ioduria is 150-249 ug/l (WHO, 2007). The frequency of maternal hypothyroxinemia, the most significant iodine deficiency disorders in pregnant women, has not changed in a 10-year period (1999 - 46,3%; in 2008 - 55,7%; p>0,1). The research has not obtained significant differences in the frequency of interrelated with pregnancy and delivery complications within two groups of patients

The article presents modern data concerning mechanisms of uterine bleedings in undeveloped pregnancy, hystero-myoma, and cervical carcinoma. Hemostasis system malfunctions appeared in case of dead foetus in uterus have been considered in the work. They are manifested by consumption coagulopathy and haemorrhagic complications. Uterine bleedings in case of hysteromyoma are caused by dilation of arterial vessels and deprivation of their contractile function and malfunction myometrium contraction. Complications that occur in oncological uterine bleedings arrest have been described. They are caused by individual uterine blood supply and developed network of collateral anastomoses between branches of internal iliac arteries