Vol 8, No 2 (2021)

Polycystic ovarian syndrome (PCOS) is a fairly common disease that occupies one of the leading positions among the reasons of endocrine infertility. Women with this diagnosis have an increased risk of developing diabetes mellitus, cardiovascular disease, metabolic syndrome (dyslipidemia, decreased sensitivity to peripheral tissue insulin, hyperinsulinemia). Currently, a step-by-step and individual approach to treatment has been applied, including both conservative treatments and surgical ones.

The analysis of works devoted to studies of predicting perinatal outcomes is carried out.

The goal of these studies in obstetric science and practice is to reduce perinatal morbidity and mortality. The strategy of effective assessment of the degree of perinatal risk should be aimed at choosing a rational strategy for managing pregnancy and childbirth, taking into account possible complications for the mother and fetus. Currently, various methods of perinatal diagnosis are used in the world, but the inability to accurately assess the antenatal and intranatal state of the fetus by instrumental methods actualizes the prediction of perinatal outcomes by assessing the degree of perinatal risk.

Premature rupture of the fetal membranes is a complication of pregnancy, causing premature labour and birth of a premature newborn. Premature birth rate consist of 6 to 12%.

MATERIALS AND METHODS: We perform a retrospective analysis of 71 cases of patients with a premature rupture of the fetal membranes with active and expectant management and perinatal outcomes. The 1st group consisted of 19 patients with a gestation age of 22–28 weeks, the 2nd group ― 52 patients with a gestation age of 29–34 weeks.

RESULTS: The duration of the period between rupture of membranes and delivery in patients of the first group (22–28 weeks) was: up to 48 hours ― 3 patients, 48 hours – 14 days ― 15 patients, more than 14 days ― 1 patient. In patients of the second group (29–34 weeks), respectively: up to 48 hours ―17 patients, 48 hours – 14 days ― 30 patients, more than 14 days ― 5 patients. The duration of expectant management for PRFM in premature pregnancy is determined by the duration of pregnancy, the condition of the mother of the fetus, the presence of clinical and laboratory signs of chorioamnionitis, the amount and changing of the volume of amniotic fluid. The management of prolongation preterm pregnancy led to the fact that the gestational age at the time of delivery compared to the time of hospitalization significantly increased. In the group of patients, 22–28 weeks gestation, the increase averaged 6.7 days, the maximum increase was 25 days, in the group of patients 29–34 weeks gestation, the increase averaged 6.8 days, the maximum increase in gestational age was 35 days.

CONCLUSION: The expectant management of premature pregnancy in PRFM allows to increase the gestational age (by an average of 6.8 days), to increase the weight of the fetus, to reduce perinatal mortality, to reduce the need for prematures in mechanical ventilation by more than half, to ensure a high level of discharge of newborns home.

Endometriosis is a chronic hormone-dependent progressive disease characterized by the presence of ectopic endometrioid tissue. Most often, endometriosis affects the ovaries, fallopian tubes and the abdominal cavity, but endometrioid foci are also found in the intestines, heart, lungs, skin and other atypical localizations. This article presents a clinical case of retrocervical endometriosis diagnosed based on the results of pathological and histological examination. It is important to note the complexity of the differential diagnosis of this form of endometriosis due to secondary changes in the area of the colon and the absence of characteristic clinical manifestations.