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Vol 8, No 2 (2021)

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Polycystic ovarian syndrome: long-term surgical outcomes (literature review)

Gracheva T.S., Sosnova E.A.


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.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):61-66
pages 61-66 views

Differential diagnosis of obstetric thrombotic microangiopathy: a review

Kukina P.I., Moskatlinova A.V., Bogomazova I.M., Timokhina E.V.


Thrombotic microangiopathy (TMA) is a clinical and morphological syndrome, which is based on damage of the endothelium. Clinically, TMA is characterized by a triad of symptoms: thrombocytopenia, microangiopathic hemolytic anemia, and target organ damage. In obstetric practice, TMA most often occurs with preeclampsia or HELLP syndrome, atypical HUS, TTP. The review presents the basic differential criteria for the diagnosis of TMA during pregnancy and after childbirth, as well as the management of patients.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):67-74
pages 67-74 views

Methods for prediction of perinatal outcomes in modern obstetrics

Fatkullina I.B., Stetsenko N.A., Fatkullina Y.N., Galeeva S.A.


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.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):75-80
pages 75-80 views

The use of inositol stereoisomers for the treatment of patients with clinical and biochemical signs of hyperandrogenism

Alyautdina O.S., Prilutskaya V.Y., Krylova E.I.


For many years, the use of combined oral contraceptives (COC) with antiandrogenic effects was the main treatment of clinical and biochemical hyperandrogenism in patients with polycystic ovary syndrome (PCOS). At the same time, the creation of an alternative therapy regimen for patients who have contraindications to taking hormonal drugs, as well as planning pregnancy, is obvious. Various combinations of inositol stereoisomers (myoinositol ― MI, and D-chiro-inositol ― DCI) are being actively studied. The review reflects the current understanding of the etiology, pathogenesis of hyperinsulinemia and androgen-dependent dermatological manifestations of polycystic ovary syndrome. The mechanisms of action of inositols at the molecular level are normalization of carbohydrate metabolism in the body and the reduction of hyperinsulinemia, as well as the levels of male sex hormones in PCOS. A comparative analysis of studies with various combinations of inositols was conducted on the effectiveness of treatment of clinical manifestations of hyperandrogenism, such as hirsutism and acne. The use of MI in conjunction with DCI reduces the risk of developing metabolic syndrome and improves the endocrine profile and manifestations of insulin resistance, but further multicenter studies on this problem are required.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):81-92
pages 81-92 views

Original articles

Premature rupture of the fetal membranes during premature pregnancy. Management: reality and prospects

Timokhina E.V., Lebedev V.A., Karpova A.M., Kurbanzade P.F., Mikheeva M.V.


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.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):93-100
pages 93-100 views

Vaginal extirpation of the uterus using implants made of titanium silk to prevent recurrence of the disease

Ishchenko A.I., Gavrilova T.V., Ishchenko A.A., Gorbenko O.Y., Dzhibladze T.A., Khokhlova I.D., Aleksandrov L.S.


INTRODUCTION: The frequency of post-hysterectomy prolapse of the vaginal dome reaches 43% in patients after surgical treatment for complete uterine prolapse. Goal ― improving the effectiveness of surgical treatment with titanium mesh implants in pre- and postmenopausal patients with complete uterine prolapse.

MATERIALS AND METHODS: The study involved 21 patients with complete uterine prolapse who underwent the proposed new method of transvaginal surgical prevention of post-hysterectomy prolapse of the vaginal dome. The result of surgical treatment was evaluated by analyzing the data of vaginal examination and ultrasound.

RESULTS: Patients were observed for 2 years ― after 1, 6, 12 and 24 months. Analysis of vaginal examination and ultrasound data showed no displacement of the vaginal dome, pelvic organs and deformation of titanium implants. There were no mesh-associated complications during follow-up.

CONCLUSIONS: The use of the developed surgical method for the correction of post-hysterectomy prolapse of the vaginal dome with the use of implants made of titanium silk is a reliable tool that provides anatomical efficiency in pre- and postmenopausal patients.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):101-108
pages 101-108 views

Clinical case reports

Clinical case of differential diagnosis of retrocervical endometriosis

Levakov S.A., Mamedova A.E., Azadova G.Y., Paukov S.V.


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.

V.F.Snegirev Archives of Obstetrics and Gynecology. 2021;8(2):109-115
pages 109-115 views

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