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Vol 8, No 1 (2021)

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Restricted Access Access granted
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Literature reviews
Contraceptive history and risk of cancer of the female reproductive organs: the realities of today (literature review)
Klyukina L.A., Sosnova E.A., Ishchenko A.A.
Abstract

In modern conditions, an increasing number of women resort to the use of hormonal contraception drugs, and their number is constantly increasing, but systematic studies on the possible role of hormonal contraceptives as independent triggers or cofactors of the development of oncological diseases of the reproductive system are currently few, which does not allow us to draw objective conclusions. In this paper, we analyzed global data on the risks and frequency of detected oncopathology of the reproductive organs, taking into account the contraceptive history of women.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):4–11
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Recurrent pregnancy loss in the modern world (literature review)
Unanyan A.L., Pivazyan L.G., Zakaryan A.A., Poimanova O.F., Bondarenko E.N., Ishchenko A.I.
Abstract

Recurrent pregnancy loss (RPL) is the loss of two or more pregnancies of reproductive women. This problem affects approximately 1‒2% of couples and has not the tendency to decrease. Several etiology factors of RPL have been described so far. The objective of this review is to evaluate the impact of different risk factors on the outcome of RPL.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):12-19
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Caesarean section ‒ global trends (literature review)
Lebedenko E.Y., Mikhel’son A.F., Bespalaya A.V., Sablina N.V., Rymashevskii M.A.
Abstract

Caesarean section (CS) is the most commonly performed surgical operation in the world. Since its introduction in obstetric practice, caesarean section rates have continuously increased in both developed and developing countries. A substantial proportion of this increment was due to unnecessary operations attributable to nonevidencebased indications, professional convenience, maternal request, and overmedicalisation of childbirth. The review examines current data on operative abdominal delivery in the world.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):20-25
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Therapeutic effects of lignans in women in perimenopausal and postmenopausal periods (review of literature)
Ozolinya L.A., Litvinova V.V.
Abstract

Today, there is a tendency towards an increase of the number of the female population that has crossed the line of menopause, which makes it more urgent to improve the quality of life of women and to develop safe methods for the prevention and treatment of climacteric syndrome (CS), which is an integral medical, social and economic problems. In view of the presence of contraindications for use and defined risks of complications with the use of hormone menopausal therapy (HRT), it is necessary to develop alternative methods for the prevention and treatment of perimenopausal symptoms. This literary review of domestic and foreign sources demonstrates information about the role of the plant lignan 7-hydroxymatairezinol (7-HMR) in maintaining the physical and psychoemotional health of women in the period of peri- and postmenopause. As a result of the analysis of the therapeutic effects of the 7-HMR molecule, the ability to relieve the main symptoms of CS (neurovegetative presentations and emotional disorders), to improve the general state of health and metabolic profile of perimenopausal women was revealed. High safety and low incidence of side effects were noted, as well as a positive effect on the dynamics of body weight. The presence of a stable anti-inflammatory and antioxidant activity 7-HMR makes it possible to recommend this lignan to women in the climacteric period as an effective drug for the prevention of the formation of immune deficiency, which contributes to the development of oncological and autoimmune diseases. The proven antitumor activity confirms the promise of using the 7-HMR for the implementation of oncopreventive measures in women of peri- and postmenopausal age.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):26-34
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Original papers
Assessment of reproductive potential in patients after myomectomy
Van Y., Romadanova Y.A., Bakhvalova A.A., Fedina E.V., Zinov’yev A.A., Shabanova D.D., Bryunin D.V.
Abstract

The aim of the study is to assess the restoration of anatomical and functional integrity of the uterus and identify changes in hormonal profile in women after laparoscopic and abdominal myomectomy.

Material and methods. 58 patients aged 36,2 ± 5,9 years old with uterine myoma underwent myomectomy: 31 patients underwent laparoscopic myomectomy and 27 patients underwent abdominal myomectomy.

The selection of surgical approach didn´t depend on the size, the number and localization of uterine myomas and the patient´s concomitant pathology.

The hormonal profile of the patients including AMH level was assessed befor myomectomy and in the 6 months after the operation. Postoperative assessment was performed on day 5th–8th after surgery and in 1 and 6 months after myomectomy.

Results. No significant differences were found in the processes of reparation of the uterus and in hormonal profile of the patients after laparoscopic or abdominal myomectomy. The time required for the patients´ reabilitation and for the restoration of the ovarian function and uterine morphological structure was similar in both groups.

Conclusion. The hormonal profile of the patients and the anatomical and functional restoration of myometrium after myomectomy doesn´t depend on the surgical approach if myomectomy is performed by an experienced surgeon after the correct assessment of the clinical situation.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):35-39
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Early prediction of placental insufficiency in obese women
Datsenko N.S., Marinkin I.O., Sokolova T.M., Kiseleva T.V., Yakimova A.V.
Abstract

Obesity is one of the most important problems in modern health care. The high prevalence of this pathology also affects women of reproductive age, which leads to an increase in the prevalence of obesity in pregnant women.

Purpose of the work ‒ analysis of the effect of adipokine indicators on predicting the development of placental insufficiency in obese women.

Materials and methods. 225 women were examined who were subdivided by such a parameter as obesity into 4 groups: 3 main and 1 control. The control group consisted of 55 pregnant women with an initially normal BMI value (18.5‒24.9 kg/m2). Group 1st included 109 pregnant women with grade I obesity (BMI 31.88 ± 1.4 kg/m2), group 2nd ‒ 34 pregnant women with grade II obesity (BMI 36.6 ± 1.1 kg/m2), group 3rd ‒ 31 pregnant women with grade III obesity (BMI 42.2 ± 1.9 kg/m2).

We studied the data of the anamnesis of pregnant women (somatic and obstetric-gynecological), indicators of adiponectin and omentin, peculiarities of the course of pregnancy and childbirth (data of cardiotocography (CTG), ultrasound markers of disturbances in the formation and functioning of the fetoplacental complex), indicators of labor activity, parameters of newborns (mass-growth, state on the Apgar scale, ponderal index, fetal-placental ratio) and the course of the postpartum period.

When conducting statistical analysis in the case of comparing two dependent (paired) samples of parameters, the paired Student’s t-test was used.

The results were considered statistically significant if the р was less than 0.05. With this indicator, the value of the probability of difference between the compared categories was more than 95%.

Results. The possibility of predicting the development of placental insufficiency depending on the concentrations of omentin and adiponectin was confirmed. The development of placental insufficiency is most likely with omentin values in the range of 177.6‒191.2 μg/ml and adiponectin in the range of 16.0‒22.5 μg/ml.

Conclusion. Determination of adipokine levels at 8‒9 weeks gestation may be practically significant in predicting the development of placental insufficiency in obese women.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):40-47
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The role of cholecalciferol in the pathogenesis of polycystic ovary syndrome
Safi A.T., Ospanova A.B., Kalinchenko S.Y., Orazov M.R.
Abstract

Objective — to evaluate and compare clinical, anamnestic and laboratory data of patients with polycystic ovary syndrome (PCOS) and without syndrome, including the level of vitamin 25(OH) D3.

Material and methods. In this work, 81 patients were examined, who, at the 1st stage of the study, were divided into two groups depending on the presence or absence of signs of PCOS. The main group included 51 patients with signs of PCOS. The control group included 30 healthy women without signs of PCOS, matched by sex and age with the main group. The main and control groups were compared by clinical and anamnestic data, including birth weight, by the presence of complications of pregnancy and childbirth in their mothers during their gestation, by the level of vitamin D. PCOS was verified on the basis of diagnostic criteria Rotterdam (2003) and International guidelines on PCOS (2018). Vitamin 25(OH)D3 was determined by mass spectrometry (ng/ml).

At the 2nd stage of the study, the main group with PCOS was divided into 2 subgroups depending on the waist circumference (WT). Subsequently, the subgroups were compared with each other in the same parameters as at stage 1, as well as in the level of insulin, low-density lipoprotein (LDL), triglycerides (TG), anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH) and luteinizing hormone (LH). To reflect the statistical results, the parametric parameters of the Student’s t-test were applied for two independent samples with equal or different variance. For nominal data — Pearson’s Chi-test, when the means are not calculated and a test is carried out for the presence of a relationship between nominal variables.

Results. There was no statistically significant difference in vitamin 25(OH)D3 levels in patients with and without PCOS. Statistically significant differences in vitamin 25(OH)D3 levels were found in women with PCOS, depending on the waist circumference (WT). In these subgroups, differences were also found in the level of insulin, LDL, TG.

Conclusion. The values of the level of vitamin 25(OH)D3 do not differ in the groups of patients with PCOS and without PCOS, but significantly correlate with the metabolic profile of patients.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(1):48-54
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