V.F.Snegirev Archives of Obstetrics and Gynecology

Peer-review medical journal

Editor-in-chief

About

The goal of the journal is to provide clinicians with practical information on new methods to diagnose and treat diseases of the female reproductive system as well as on the possible complications of extragenital disorders and their impact on the reproductive system.

The target audience of the journal includes not only obstetricians and gynecologists, but also endocrinologists, general practitioners, urologists, oncologists, anesthesiologists, intensive care specialists, neonatologists, pediatricians, fetal surgeons, and pharmacologists.
The journal discusses achievements in obstetrics and gynecology in Russia and the rest of the world, clinical cases, issues of terminology, diagnostics, patient management techniques, and methods of teaching obstetrics and gynecology. The journal especially focuses on the diverse effects of drugs on the female reproductive system (and other systems), the fetus, and the further development of the infant.

The journal features articles and lectures on relevant topics in obstetrics, gynecology, and allied medical fields, abstracts of important publications from other journals, and reviews of monographs. The journal also disseminates information on meetings, conferences, and symposia held in Russia and the rest of the world.

Types of accepted articles:

  • systematic reviews and meta-analysis;
  • results of original research;
  • plain-text reviews;
  • clinical case reports and series of clinical cases;
  • editorials;
  • datasets;
  • letters to the editor;
  • short communications.  

Publication & distribution

  • in English and Russian
  • Issues quarterly, 4 issues per year
  • Continuously publication in Online First mode
  • No APC
  • Hybrid Access: subscription and OA; Oppen Access articles distribute under the CC BY-NC-ND 4.0 License

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Current Issue

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Vol 9, No 4 (2022)

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LITERATURE REVIEWS

Hemostatic system in patients with endometrial hyperplasia and the risk of venous thrombosis: А literature review
Ozolinya L.A., Anikeeva A.A.
Abstract

While treating patients with endometrial hyperplasia, the physician may face both bleeding and thrombotic complications, particularly, during hormonal or surgical treatment, which significantly increases the risk of these complications. In addition, thrombotic complications in gynecological patients may result from congenital or acquired thrombophilia, blood flow disorders (blood stasis), and vascular wall damage, that is, the classic Virchow triad.

This study aimed to review the recent scientific literature on the peculiarities of the blood coagulation system in patients with endometrial hyperplasia.

The review reflects the results of studies conducted by Russian and foreign authors on the status of the blood coagulation system in patients with endometrial hyperplasia. The features of vascular, thrombocytic, plasma (procoagulant and anticoagulant), and fibrinolytic elements of hemostasis in these patients are considered. The data from the literature on the state of hemostasis before treatment and following hormone therapy and surgical treatment are presented. Moreover, the data of some studies on the genetic features of the hemostatic system in patients with endometrial hyperplasia are summarized. An analysis of the literature indicates the need for a careful choice of drugs and methods of treatment of these patients to avoid venous thromboembolic complications.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):193-201
pages 193-201 views

Original articles

Diagnostic significance of autoantibody combination in fetal growth restriction with early and late manifestation
Yakubova D.I., Ignatko I.V., Megrabyan A.D., Silaeva T.M., Bogomazova I.M.
Abstract

BACKGROUND: Fetal growth restriction (FGR) is one of the current problems in modern obstetrics and perinatology, which is associated with a large number of adverse perinatal outcomes.

AIM: This study aimed to assess the diagnostic significance of the combination of autoantibodies (AAB) in the early and late FGR manifestation.

MATERIALS AND METHODS: The study involved 117 pregnant women, classified into Group 1 (90 women with FGR) and Group 2 (27 women with a physiological course of pregnancy). Pregnant women with FGR were divided into two subgroups depending on the time of manifestation, i.e. FGR subgroups with early and late manifestation (45 patients each), respectively. Upon hospital admission, all patients of the study groups had blood sampling to determine autoimmune AABs using the ELI-P-test.

RESULTS: An isolated increase in AABs to human chorionic gonadotropin (hCG) antigen, TrM (AAB markers of changes in vascular and hemostasis system), S100 protein, antineutrophil cytoplasm antibodies (ANCA), and KiMS (AABs to the cytoplasmic antigen of glomerular kidney cells) were observed in the early FGR manifestation when comparing the abnormal AAB spectrum in the early and late FGR manifestation, while a statistically significant isolated increase in the level of AABs to DNA and insulin was found in the late FGR manifestation.

CONCLUSIONS: The study revealed the diagnostic significance of AAB combinations, as well as the combinations of increased AAB levels to hCG, S100, ANCA, and KiMS and an increase in AABs to DNA, collagen, and S100 protein in the early and late FGR manifestation, respectively.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):203-211
pages 203-211 views
Clinical and morphological features of endometrial pathologies during the perimenopausal period
Aliyeva F.T., Bryunin D.V., Paramonova N.B., Bakhvalova A.A., Dzhibladze T.A., Zuev V.M., Aliyeva F.T.
Abstract

BACKGROUND: Disorders leading to pathological (most commonly, hyperplastic) processes in the endometrium often occur during the perimenopausal period, in addition to the natural changes associated with a physiological decrease in the function of hormone-producing and hormone-dependent organs.

AIM: This study aimed to investigate the clinical and morphological features of endometrial pathological processes during the perimenopausal period.

MATERIALS AND METHODS: We examined 73 perimenopausal women with various endometrial pathologies. The mean age of the examined patients was 47.8±0.3 (45–51) years. All patients with perimenopausal endometrial pathologies underwent clinical, functional, endoscopic, and morphological examination.

RESULTS: Endometrial polyps, endometrial hyperplasia, chronic endometritis, and endometrial adenocarcinoma were present in 54.8%, 30.1%, 12.4%, and 2.7% of perimenopausal patients examined, respectively.

The most common clinical manifestations of endometrial pathologies in the perimenopause were polymenorrhea, acyclic menorrhagia, and menorrhagia in 42.4%, 39.7%, and 27.4% of patients, respectively. Moreover, a glandular fibrous endometrial polyp was diagnosed in 61.3% of patients with polymenorrhea and 50% of patients with acyclic bloody discharge and menorrhagia.

CONCLUSIONS: The revealed variety of clinical signs, including their absence in some cases, as well as the diversity of hysteroscopic and morphological endometrial pathologies in perimenopausal women, up to the detection of endometrial cancer, confirmed the need for both ultrasound screening and mandatory hysteroscopy with separate diagnostic endometrial curettage in echo signs of intrauterine pathologies for timely diagnosis and adequate treatment.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):213-219
pages 213-219 views
Experience of reconstructive plastic robot-assisted surgery in patients with isthmocele after cesarean section
Bryunin D.V., Mikhaelyan N.S., Bakhvalova A.A., Khokhlova I.D., Dzhibladze T.A., Gadaeva I.V., Chushkov Y.V., Svidinskaya E.A., Asambaeva A., Ishchenko A.I.
Abstract

BACKGROUND: According to several Russian researchers, the number of cesarean deliveries in different regions of Russia varies from 15.2% to 42%. The incidence of complications — inconsistency of the uterine scar (isthmocele) after surgery is 10%–15%.

AIM: This study aimed to assess the efficiency and safety of robot-assisted surgery in the correction of isthmoceles after cesarean section in patients of reproductive age.

MATERIALS AND METHODS: The study involved seven patients aged 27–34 years with signs of isthmoceles after urgent or elective cesarean section 12 months to 6 years prior to hospitalization. A comprehensive dynamic examination (echography, magnetic resonance imaging, and office hysteroscopy), surgical treatment with the da Vinci Si robotic complex, and outpatient monitoring in the early and long-term period (1, 6, 12, 24, and 36 months) were performed.

RESULTS: The patients were satisfied with the results of surgical treatment during outpatient monitoring due to the improved quality of life resulting from the reduction of pathological symptoms. The control echography (1, 6, and 12 months later) showed normal myometrial thickness (9–11 mm) and adequate blood flow in the metroplasty area in all patients. The “niche” was not visualized during office hysteroscopy 6-months after the metroplasty. Three patients became pregnant 16–20 months after the reconstructive uteroplasty and ended with a timely operative delivery. Two patients were followed up for their pregnancies at 12 and 29 weeks of gestation, while two women continued taking oral contraceptives and planned their next pregnancy at least a year later.

CONCLUSIONS: The use of the da Vinci Si robotic system for surgical correction of isthmoceles provides volumetric three-dimensional visualization of anatomical structures, reduces the duration of surgery and intraoperative blood loss, minimizes the number of intraoperative and postoperative complications, and contributes to accelerated postoperative rehabilitation of patients.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):221-229
pages 221-229 views
Morphological features of the endometrium in patients with atrophic chronic endometritis and impaired hemodynamics
Gazizova G.K., Yashchuk A.G., Maslennikov A.V., Dautova L.A., Battalova G.Y.
Abstract

BACKGROUND: Chronic endometritis is a clinical and morphological syndrome in which, due to persistent endometrial damage to the endometrium by an infectious agent, multiple secondary morphofunctional changes occur that impair cyclic transformation and receptivity of the uterine mucosa.

AIM: This study aimed to reveal morphological features of the endometrium in patients with atrophic chronic endometritis and impaired hemodynamics in the endometrium.

MATERIALS AND METHODS: The study involved 86 female patients divided into two groups. Group 1 comprised 44 patients with chronic endometritis and impaired endometrial hemodynamics. Group 2 included 42 patients with chronic endometritis without impaired microcirculation in the endometrium. The patients underwent endometrial pipelle biopsy for histological and immunohistochemical examination to determine the expression of VEGF, TGF-β and CD138 during the proliferative phase of the menstrual cycle.

RESULTS: Histological examination revealed vascular sclerosis, plasma cells, inflammatory infiltrates, stromal fibrosis, granulomas, and hemorrhagic foci in patients with atrophic chronic endometritis and impaired hemodynamics.

CONCLUSIONS: While examining the morphological picture of atrophic chronic endometritis with impaired hemodynamics, the formation of scar tissue was noted resulting in impaired blood circulation, which leads to focal hemorrhages in the uterine mucosa. According to immunohistochemical analysis, patients with impaired endometrial hemodynamics showed a statistically significant decrease in VEGF and an increase in TGF-β expression, which indicates the severity of fibrosis.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):231-237
pages 231-237 views
Long-term effect of antiviral therapy for grade II cervical intraepithelial neoplasia
Vinogradova O.P., Andreeva N.A., Epifanova O.V., Artemova O.I.
Abstract

BACKGROUND: The production of many molecular markers at different grades of cervical intraepithelial neoplasia is currently being studied to predict the outcome of the disease and build an individual prognosis. However, no clear criteria for the course of neoplasia are available at this time.

AIM: This study aimed to assess the efficiency of the antiviral immunomodulator Allokin-alpha (Alloferon) in the treatment of cervical intraepithelial neoplasia of moderate severity from the perspective of long-term follow-up.

DESIGN: Prospective study.

MATERIALS AND METHODS: We examined 86 women of reproductive age with grade II cervical intraepithelial neoplasia (CIN II) associated with human papillomavirus (HPV). In the CIN II group, all patients underwent excision of the affected area. According to the study design, 43 women were followed up after excision (Group 1a), while 43 participants were treated surgically and used the study drug (Group 1b). By cytological and colposcopic examination, the efficiency of the chosen therapy was assessed after 3, 12, and 18 months. However, the main criteria for the efficiency of treatment were the absence of HPV or a decrease in the viral load below significant values and the absence of recurrence of the pathological process.

RESULTS: The combination of excision and the use of Allokin-alpha (Alloferon) showed significant advantages over monosurgical treatment.

CONCLUSIONS: The data obtained indicate high HPV elimination and reduced probability of recurrence after excisional treatment in patients with CIN II when using Allokin-alpha (Alloferon).

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):239-246
pages 239-246 views

CLINICAL CASE

Experience of using extracorporeal membrane oxygenation for total abruption of a normally located placenta in severe preeclampsia
Lazareva A.Y., Fatkullina I.B., Yashchuk A.G., Zolotukhin K.N.
Abstract

INTRODUCTION: Premature abruption of a normally located placenta is a sudden and challenging problem to manage, and is a leading cause of maternal and perinatal mortality. Here, we reviewed the case of a pregnant woman with multiple organ failure and premature placental abruption involving the successful use of extracorporeal membrane oxygenation (ECMO) in the treatment of respiratory distress syndrome.

AIM: We aimed at assessing the feasibility of using ECMO in the treatment of severe lung damage in a patient with multiple organ failure.

CLINICAL CASE: We reviewed the clinical findings of the course of multiple organ failure and lung damage in a puerpera with severe preeclampsia. Moreover, we analyzed her life history, diseases, and diagnostic and treatment methods were analyzed.

The described clinical case shows the possibility of the successful use of ECMO in patients with severe lung damage and respiratory distress syndrome in multiple organ failure resulting from severe obstetric complications. Currently, this is the first case involving ECMO in the treatment of the consequences of acute total abruption of a normally located placenta with favorable outcomes in the Republic of Bashkortostan.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2022;9(4):247-254
pages 247-254 views


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