Vol 7, No 3 (2020)

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Full Issue


Influence of ADRB2 gene polymorphism on the development of preterm birth in women of different ethnic groups

Proklova G.F., Chilova R.A., Sokova E.A., Kazakov R.E.


Preterm birth remains an acute medical and socio-economic problem. The successful course of pregnancy and its completion by timely delivery is directly dependent on an adequate balance of immune interactions between the mother and the fetus throughout the pregnancy, respectively, any failure of this system can lead to catastrophic consequences. The level of cytokine expression is genetically determined. Polymorphism of a gene affects the level of cytokines in its expression and functionality. Thus, polymorphism of cytokine genes can have an effect on the development of various pregnancy complications leading to its premature termination.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):116-119
pages 116-119 views

Chronic endometritis and its impact on female reproductive function

Silkina M.O., Sosnova E.A.


Chronic endometritis is a local inflammatory disease characterized by the presence of plasma cells in endometrial stroma regardless of menstrual cycle phase. This diagnosis can be confirmed based only on morphological examination of endometrial biopsy what makes this diagnosis difficult to prove in clinically healthy patients who can not get pregnant or carry a child. According to statistics of the past five years, more than 30% women of reproductive age having repeated implantation failures in IVF cycles and recurrent miscarriages are diagnosed with chronic endometritis. Since this pathology is related to long persistence of microbial associations in uterine cavity, the gold standard of treatment is antibacterial therapy. It is elucidated that during a year after antibiotic treatment the rate of spontaneous pregnancy is increased in more than 60% women compared with women who do not receive treatment regarding chronic endometritis.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):120-123
pages 120-123 views

Original articles

Delivery modes in intrauterine fetal death

Kastor M.V., Volkov V.G.


This study aimed to analyze the mode of delivery intrauterine death and analysis of factors that determine the choice. We analyzed 96 cases of intrauterine death in a singleton pregnancy during the 2016–2018. Two groups were formed: the 1st group (n = 32) of cesarean delivery, the 2nd group (n = 64) with vaginal delivery. The stillbirth rate for the region was 6.2% [95% CI 4.88–8.84], for the Russian Federation — 5.82% [95% CI 5.17–7.39]. The proportion of cesarean sections in intrauterine death is higher than in live births (33.3% and 31.8% respectively). When analyzing the timing of delivery, it was found that the characteristic peaks occur at 25–27 weeks (25.0% of all births) and 37–39 weeks (35.0%). Obstetric risk factors for cesarean section: placental abruption: OR — 9.64 [95% CI 3.25–28.63]; p = 0.000; uterine scar after cesarean section: OR — 7.51 [95% CI 2.52–22.39]; p = 0.000; preeclampsia: OR — 4.17 [95% CI 1.12–15.47]; p = 0.023. Non-obstetric risk factors: parity of 3 or more births: HR — 7.24 [95% CI 1.36–38.40]; p = 0.009; overweight: HR — 3.37 [95% CI 1.22–9.33]; p = 0.016; the history of the pelvic inflammatory disease: HR — 2.78 [95% CI 1.12–15.47]; p = 0.023. The presence of intrauterine growth retardation reduces the frequency of surgery: HR — 0.56 [95% CI 0.22–1.43]; p = 0.221. There is an urgent need to develop and implement in clinical practice appropriate national clinical guidelines for the management of childbirth with intrauterine death, including all aspects of this category of care. It is necessary to further study the role of the crisis stages of gestation, which are characterized by the manifestation of intrauterine death (the end of the second and third trimesters).

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):124-130
pages 124-130 views

Changing the level of some serum proteins in patients with breast cancer on the background of treatment therapy

Kachanov I.V., Sinchikhin S.P., Kuznetsov I.A., Stepanyan L.V.


The purpose of the study was to assess changes in the level of lactoferrin and ferritin in perimenopausal patients receiving trekrezan during the course of basic chemotherapy for breast cancer.

Material and methods. To study the concentration of serum lactoferritin and ferritin in breast cancer, the object of the study was patients aged 45 to 55 years, the average age was 50.7 ± 2.6 years. All patients of the main group (n =49) used basic chemotherapy in combination with trekrezan (hydroxyethylammonium methylphenoxyacetate) at a dose of 600 mg/day for 4 weeks. Comparison group patients (n = 45) received only chemotherapy. All patients (before and after a course of chemotherapy) in the blood were determined by biochemical and general indicators of blood.

The results of the study. It was established that the use of trekrezan in addition to basic chemotherapy, contributed to an increase in the concentration of lactoferrin in patients of the main group — from 396.32 ± 24.82 to 4069.32 ± 114.06 ng/ml and ferritin — from 26,2 ± 1.8 ng/ml to 439.47 ± 16.3 ng/ml, in comparison with patients of the other group. At the same time, the indicators of total protein, urea, hemoglobin, red blood cells, white blood cells and blood lymphocytes normalized in the blood in the main group of patients.

Conclusion. Against the background of the use of trekrezan, normalization of the indicators of lactoferrin and ferritin in patients of the perimenopausal period receiving chemotherapy for breast cancer is observed, which indicates a positive effect of this drug on the patient’s immune status.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):131-133
pages 131-133 views

The influence of drug abuse on the pregnancy and perinatal terminations

Fatkullina I.B., Sadykova L.A., Fatkullina Y.N., Lazareva A.Y., Parfiryev Y.M.


The article discusses the results of researches about existence of narcotic drugs in biological environment of women.

The purpose — to explore the influence of drug addiction on the pregnancy and perinatal terminations.

Material and methods. The group of 57 pregnant women was screened by gas chromatography method with a mass-selective detection on the base of the Maternity Hospital № 3, Ufa.

Results. In process of research it was relieved, that drug abuse leads to increasing of infection disease, share of prematurity, Caesarean section, pneumopathies and antenatal death of fetus.

Conclusion. Narcotic substances have an adverse influence on pregnancy and perinatal terminations.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):134-137
pages 134-137 views

The possibility of prediction of early neonatal death

Bezhenar V.F., Ivanova L.A., Drygin A.N.


The most important tasks facing obstetricians-gynecologists and neonatologists include reducing early neonatal mortality. One of the ways to solve the problem is to predict early neonatal death in the first day after birth.

In order to identify possible predictors of early neonatal death, a retrospective study was conducted that included 99 women whose children died in the first 168 hours after birth (main group) and 357 women without early neonatal losses (control group).

In the first 2–3 days after birth, the delivery period, the features of the birth act, the condition of the mother and newborn baby, including the data of a clinical blood test, morphometric and histological examination of the placenta, were determined and described for the both groups.

Based on the analysis of these data, the following statistically significant differences were revealed for puerperas and newborns of the main group: premature birth; delivery in the pelvic presentation; malnutrition of the fetus/newborn; shorter duration of the first stage of labor, a longer duration of the second and third periods of labor; higher frequency of perineal dissection, manual examination of the uterine cavity, blood transfusion for puerperas; smaller mass and growth of newborns, lower Apgar score on the 1st and 5th minute; leukocytosis and thrombocytopenia in a blood test in puerperas, a lower level of hemoglobin, erythrocytes and platelets and an higherlevel of the glucose of venous blood in newborns; the following structural features of the placenta: hematogenous viral and ascending bacterial infection and their combination, acute placental and umbilical cord failure, sub- and decompensated chronic placental insufficiency.

These indicators may be predictors of early neonatal death.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):138-146
pages 138-146 views

Maternal factors of preconceptual and early gestation periods in women with high prenatal diagnostic risks

Samchuk P.M., Azoyeva E.L., Ishchenko A.I.


Objective — evaluate maternal factors in preconception and early gestation periods in women with a high risk of prenatal diagnosis.

Methods and patients. Features of the development of preconception and early gestation periods were studied, including the first prenatal screening (PS), in 443 women with singleton pregnancy. Women were divided into 2 clinical groups: group 1 (n = 235) with a high risk (HR) of complications; subgroups: 1A (n = 69) — fetal chromosomal abnormalities (after exclusion confirmed cases); 1B (n = 66) — the development of preeclampsia; 1C (n = 48) — fetal growth restriction; 1D (n = 52) — preterm birth (PB). 2nd control group (n = 208) — women with low risk of complications.

Results. A high PS risk in the 1st group, especially in subgroups 1A, 1B, were in patients with hypertonic disease of 1-2 degrees (p < 0.05). Chronic kidney disease was leading in 1A, 1C (p < 0.05). Varicose veins of the lower extremities in the 1st group prevailed in the 1A, 1B, 1C (p < 0.05). A history of ovarian tumors and uterine myoma during pregnancy prevailed in 1A, 1B, cycle dysfunction in 1B, 1D (p < 0.05). GR was observed in nulliparous women with a history of miscarriages in 1B, 1C, 1D and artificial abortions in 1A (p < 0.05). PB in the anamnesis were significantly increased in the 1st gr. (p < 0.001). In the 1st trimester, the threatened miscarriage, bleeding and progesterone were frequent in the 1st group (p < 0.05).

Conclusion. Based on the obtain results a high risk of PS calculated according to the Astraia program using standard markers was noted in patients with somatic pathology, ovarian tumors, miscarriages, medical abortions and PB in the anamnesis, myoma during pregnancy, threatened miscarriage, bleeding, progesterone intake during 1st trimester. These factors should be considered when preparing for pregnancy.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):147-152
pages 147-152 views

Cytokine status and availability of vitamin d in women with miscarriage of infectious genesis

Savchenko T.N., Ozolinya L.A., Dergacheva I.A., Polovinkina E.N., Safonina M.S.


In recent years, there have been reports of the role of vitamin D deficiency in the development of inflammatory processes of various localization associated with the prolonged persistence of infectious agents and its effect on the implementation of the immune response.

The objective — to assess the condition of cytokine status and the availability of vitamin D in pregnant women with miscarriage and urogenital infection to improve prognostications and prevention of complications in obstetrics.

Material and methods. We examined 106 pregnant women in the I–II trimester of pregnancy: 76 pregnant women with miscarriage (the main group) and 30 women with a physiological pregnancy progression (the control group) with the determination of their serum vitamin D level by high-performance liquid chromatography (HPLC), diagnostics of urogenital infection and immunity indicators with the determination of serum cytokines.

Results and discussion. According to the results of the study, it was found that the level of vitamin D in the blood below 20 ng/ml is more often accompanied by miscarriage. Correlation analysis confirmed the presence of a relationship between cytokine production and the level of vitamin D in the blood of pregnant women.

Conclusion. Normalization of vitamin D levels in the blood can help to reduce the risk of miscarriage.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):153-157
pages 153-157 views

Polymorphism of genes affecting remodeling of connective tissue, in patients with infertility

Filipenkova T.E., Shcherbakova L.N., Balatskiy A.V., Samokhodskaya L.M., Alekseyenkova M.V., Panina O.B.


The aim of the study was to evaluate the association of gene polymorphism of matrix metalloproteinase 2 (MMP2), MMP3, MMP9, urokinase plasminogen activator (PLAU) and transforming growth factor β1 (TGF-β1) with the occurrence of infertility.

Material and methods. 84 women planning pregnancy were examined. Of these, 47 did not become pregnant in six months (the first group), 37 had a pregnancy, and lasted more than 22 weeks (second group). The single-nucleotide polymorphisms (SNPs) of rs2285052 and rs243865 of the MMP2 gene, rs3025058 of the MMP3 gene, rs17576 and rs3918242 of the MMP9 gene, rs4065 and rs2227564 of the PLAU gene, rs1800469 of the TGF gene were analyzed in all patients. Statistical analysis of genetic associations was carried out using the SNPStats program.

Results. Patients with the A allele rs2285052 and the T allele rs243865 of the MMP2 gene had an increased risk of infertility (for rs2285052 in the group of patients without pregnancy, СС 27.7%, AС 51.1%, AA 21.3%; in the pregnant group СС 54%, AС 40.5%, AA 5.4%; for rs 243865 in the group of patients without pregnancy СС 57.5%, CT 40.4%, TT 2.1%; in the pregnant group СС 81.1%, CT 18, 9%, TT 0%). With the log-additive variant of inheritance, the OR (95% CI) was 0.38 (0.19–0.77) (p = 0.0043) for rs2285052 and 0.32 (0.12–0.84) (p = 0.015) for rs243865.

No statistically significant differences were found between the main group and the comparison group in allele frequencies rs3025058 of the MMP3 gene, rs17576 and rs3918242 of the MMP9 gene, rs4065 and rs2227564 of the PLAU gene, rs1800469 of the TGF-β1 gene.

Conclusions. In the studied sample of patients SNPs rs2285052 and rs243865 of the MMP2 gene were associated with a risk of infertility: the presence of the A allele rs2285052 and the T allele rs243865 of the MMP2 gene were associated with an increased risk of infertility.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):158-164
pages 158-164 views

Clinical case reports

Difficulties in the diagnosis of feto-maternal bleeding in the antenatal period

Ishchenko A.I., Murashko A.V., Seredina T.A., Minakova A.D.


Feto-maternal hemorrhage (FMH) is a rare, potentially dangerous event characterized by the passage of fetal blood into the maternal circulation, complicating pregnancy or childbirth. Diagnosis of this condition is based on objective signs: cardiotocography, fetal ultrasound, fetal Doppler, Kleihauer–Betke test (KB) and subjective: assessment of fetal movement activity. If a pregnant woman complains of decreased fetal movement, an experienced doctor should not forget to exclude this dangerous condition. Massive FMH is associated with high perinatal morbidity and fetal mortality.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2020;7(3):165-168
pages 165-168 views

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