Vol 2, No 4 (2015)

This lecture presents the management of pregnancy and labor in cardiovascular patients. Classification of congenital cardiovascular diseases is presented, the changes in cardiovascular system developing in pregnancy and labor are described. The authors emphasize that hospitalization is recommended for this patient population before 12 weeks, in order to diagnose the heart disease, rule out the rheumatic process, and decide whether pregnancy can be prolonged. Repeated hospitalization is recommended at weeks 28-32, for further examinations and treatment, and then 2-3 weeks before planned delivery, in order to prepare the patient to labor, determine the labor management plan and mode of delivery in an inpatient setting. Complex clinical and laboratory studies should be carried out in all pregnant patients with heart diseases. Women with congenital heart disease and their babies should be examined with the use of genetic methods. The management of pregnancy and labor in patients with mitral and aortic valvular diseases, with a history of cardiosurgery, with rheumatic heart disease is described. Differences in drug therapy of patients with various diseases are emphasized. The authors emphasize that the outcome of labor largely depends on proper preparation to labor, correct choice of the mode of delivery, timely therapy and anesthesiological care in labor, and qualification of the physician.

Theories of emergence and the pathogenesis of Stein-Loewenthal’s syndrome, or the polycystic ovaries syndrome (PCOS), are discussed, its diagnosis and clinical morphological manifestations are presented. Methods for conservative and surgical treatment are presented, with special emphasis on surgical treatment of infertility caused by the syndrome (laparoscopic laser drilling of the ovaries with subsequent extracorporeal fertilization).

For full implantation is important not only morphological condition of endometrium, proliferative activity, the readiness of the receptor apparatus, but also immunological features of the mucosa. To evaluate the endometrium in women with infertility and endometrial hyperplasia uses a variety of immunohistochemical markers.

In the course of the work we have seen that it is the combined use of clinical data, morphological studies and molecular techniques are the most justified to identify the earliest prognostic markers of endometrial cancer pathology and thus implement an effective treatment of patients with endometrial hyperplasia in premenopausal women.

While examination of 26 patients of reproductive age who are receiving glucocorticoid therapy due to the systemic diseases noticable changes of vaginal biocenosis have been diagnosed. The patients of this cohort require local probiotics therapy.

The determination of the long-term changes of ovarian reserve state after organ-sparing pelvic surgery in women of reproductive age is one of the most challenging issues of modern gynaecology.

The progression of obesity increases the production of lipid peroxidation products in patients who developed MS. Antioxidant system has its adaptive capacity.

This article represents the results of perinatal outcomes of postterm pregnancies delayed delivaries depending on the method of delivery. Antenatal and postnatal features and fetus and newborn indicators are reviewed and analyzed. Various historical views of doctors on the problem of postterm pregnancy and the results of international studies are presented.

In this study, we wanted to show the influence of somatic pathology in women for pregnancy and childbirth, patterns of disease at different ages and in different regions of the Russian Federation, as well as the occurrence of complications in women with extragenital pathology rural and urban areas.

The minimally invasive diagnostic method of ovarian aromatase activity with the test with aromatase inhibitor letrosol is developed in the study. Aromatase activity is not considerably effect on combined treatment of endometriosis with gonadotrophin-releasing hormone agonist, but its increase can serve as pathogenetic ground for administration of aromatase inhibitors in this disease.

A prospective survey of 816pregnant women, pregnancy and childbirth was performed in order to develop modern approaches to screening and management of pregnant women with critical fetal distress. We have used the new technologies for assessment of mother and fetus, and rational choice of timing and method of delivery. Differentiated approach to obstetric care and choice of tactics depending on the severity of placental insufficiency allowed 2.6 times lower frequency of children born with malnutrition, 1.5 times - in a state of moderate and severe asphyxia, 1.75 times - the need for resuscitation, 1.8 times - the frequency of hypoxic-ischemic lesion of the central nervous system, 2.6 times - perinatal losses during this pregnancy complications.

Conducted a randomized, double-blind, controlled clinical trial of gynecological patients of reproductive age with chronic endometritis, with an estimation of informative comprehensive screening diagnostics of functional state of the reproductive system. Identify highly informative technique, which allowed her to recommend screening assessment offunctional abnormalities in chronic salpingoophoritis.

Conducted a randomized controlled clinical study of 60 healthy women aged 25 to 45 years. The experimental group of women in a period of not less than 3 years, took low-dose COCs. In the experimental and control groups were evaluated vascular endothelial FMD of the brachial artery and measuring the thickness of the intima-media thickness of the carotid artery. The result of this study revealed the negative impact of long-term intake of low-dose COCs on the vascular endothelium.

The results of the use of proteolytic enzyme longidaza in the combined treatment of pelvic endometriosis are presented in this study. The use of this drug leads to reduction of pain syndrome and adhesions, suppresses neoangiogenesis, decreases inflammatory reaction and development of fibroid tissue.