Vol 6, No 4 (2019)

Prenatal diagnosis is one of the priority areas of modern obstetrics. Improving diagnostic capabilities, the introduction of new methods gradually led to the fact that the first trimester of pregnancy became a full-fledged diagnostic stage in assessing the condition of the fetus, identifying genetic problems and a significant number of malformations. Understanding the value of the proposed methods, the sequence of their use, the accuracy of the results are extremely important for the choice of management for a particular pregnancy.

Anti-Müllerian hormone is one of the most significant factors regulating woman’s reproductive function, which inhibits endogenous production of estrogens, induces cell cycle arrest, apoptosis and autophagy in human endometrial stromal cells. Disturbance of Anti-Müllerian hormone expression could be an important link to pathogenesis of endometriosis.

Introduction. One of the most common drugs for maintaining pregnancy is exogenous progesterone. With the expansion of the indications for its use during pregnancy, the number of complications associated with it may increase. Material and methods. The article presents the results of a prospective study of medical records of pregnant women, which were observed in the V.F. Snegirev Obstetrics and Gynecology Clinic in 2017 and received exogenous progesterone therapy. Results. The dynamics of changes in the studied biochemical parameters was multidirectional in the main and control groups. According to pregnancy outcomes, statistically significant differences between the groups were not found. Conclusions. Critical abnormalities of the main biochemical parameters in pregnant women of the main group were not detected. Preparations of the gestagen series in appropriate dosages do not significantly affect the main indicators of the hepatobiliary system and pregnancy outcomes, so their use is permissible under the control of laboratory parameters.

The article aims to assess the possibility of ultrasound scanning and dopplerstudy in the assessment of the condition of the ovaries and endometrial in patients after long intake of COC, predicting the restoration of reproductive function after the abolition of hormonal contraception. Material and methods. In 2018-2019, 37 women were examined after the abolition of oral contraceptives, which they took for a long period of time. At the time of the examination, all the patients stopped taking COC at least 2 months ago due to the fact that they were planning a pregnancy. UW the study was conducted on the apparat Voluson E8 Expert (General Electric), improving the quality of diagnostics used Automatic assessment of follicle condition based on ultrasonic echography (Sono AVCTM follicle) and tomographic ultrasound (TUI). Results. According to the study significant changes recorded 17 patients whose menstrual cycle did not recover within the first 6 months after the cancellation of COC. In a group of 20 patients with a regular menstrual cycle, the results of the study were within normal limits, pregnancy within 6 months occurred on their own in 8 of them. Conclusion. The possibilities of 3 dimensional reconstruction and programs for evaluating the follicular apparatus significantly improve the quality of ultrasound diagnostics, give more information about the presence of small follicles, blood flow in the ovarian tissue, the structure of the cortical apparatus substances and stroma, whichis the ability of a clinician to obtain a complete understanding of the condition of the ovaries and endometrial and predicting a good health of patients. The article may be of interest to obstetricians-gynecologists, ultrasound specialists, endocrinologists, reproductive specialists.

Swyer syndrome (46,XY complete gonadal dysgenesis) is a rare chromosomal pathology. This pathology occurs with a frequency of 1 in 80,000. In genetic analysis, mutations are most often found in the following genes: the SRY gene, the NR5A1 gene, the SOX9 gene, the MAP3K1 gene. Patients with this disease develop phenotypically as women, but due to the absence of gonads and eggs, independent pregnancy is impossible. This article describes a clinical case of a successful onset, course of pregnancy and delivery in a woman with Swyer syndrome using assisted reproductive technology.