Vol 2, No 3 (2015)

The pathogenetic mechanisms of pre-eclampsia are reviewed, modern risk factors are described, and probable consequences for the mother during the postpartum period and for the fetus in postnatal life are discussed.

A total of 31 patients of reproductive age with uterine myomas were examined and treated after standard MRT diagnosis. The patients were divided into 3 groups by the variants of organ-sparing treatment, suggested on the base of the MR-histological parallels. Twenty (64.5%) patients received MRgFUS therapy (group 1). Embolization of the uterine arteries was carried out in 8 (25.8%) patients (group 2). Myomectomy was carried out in 3 (9.7%) patients (group 3). The treatment effi ciency was evaluated 1, 3, 6, and 12 months by MRT, detailed ultrasonic examination, and quality of life score (PBAC tables (Higham, Janssen); Short-Form MacGill Pain Questionnaire; UFS-QoL Questionnaire).

The aim of this study was to optimize the diagnosis and therapy for benign hyperplastic diseases of the uterus in women with endocrine metabolic disorders. The study was carried out in 154 women with endometrial hyperplasia, uterine myoma, adenomyosis, and combinations thereof. The patients were divided into 2 groups. The main group included patients with endocrine metabolic disorders, the reference group consisted of patients without disorders of this kind. Comprehensive clinical, laboratory, and instrumental studies were carried out in all patients. Endocrine metabolic disorders were evaluated, and pathomorphological fi ndings were analyzed. Detection of the clinical, biochemical, and morphological parallels in the studied cohort of patients with metabolic shifts prompted us to distinguish (for the fi rst time) three pathogenetic variants of the endocrine metabolic disorders. The role of leptin resistance in the pathogenesis of uterine myoma, adenomyosis, and endometrial hyperplasia was evaluated more precisely. The fi ndings indicated that hyperleptinemia was a potent endocrine factor of clinical manifestation of uterine myoma, adenomyosis, and endometrial hyperplasia. Measurements of serum leptin can serve as an important laboratory test for predicting the progress of latent benign hyperplastic diseases of the uterus and formation of combined forms of the organ involvement. Based on the results, a pathogenetically-based algorithm for examinations and treatment of patients with benign hyperplastic uterine diseases was created. Metabolic rehabilitation of patients, aimed at leptin resistance and insulin resistance control, body weight and lipid tissue control, was suggested. Early correction of the endocrine and metabolic disorders in accordance with the pathogenetic variants defi ned should be the key component of combined therapy and secondary prevention of benign hyperplastic uterine diseases.

The relationship between previous induced abortions and fetal biometrical and functional parameters and course of labor were studied. The status (Apgar score) of newborns whose mothers had a history of abortions was worse 5 min after birth than the status of newborns whose mothers were primigravida/primipara. The newborns of mothers with a history of abortions had lesser head circumference, body length, and a low Vervek’s index, indicating a trend to brachimorhism.

A modern approach to the management of pregnancy and labor in women with heart disease is presented. The 3-level system of follow-up of this patient population is based on stratification of cardiological risks, determining the algorithm ofphysician’s steps and optimizing the strategy of outpatient and inpatient treatment. Risk stratification is supplemented by quantitative EchoCG values, reflecting the hemodynamic overloading of the myocardium and facilitating the work of the doctor. Special attention is paid to pregnant women with a history ofpalliative cardiosurgery, with intact myocardial contractile function, with a good prognosis for pregnancy prolongation and often spontaneous labor.

Protocol the surgical conservative management of obstetrical hemorrhage associated with Caesarean Section was applied in more than 120 C/S. Good effect has got in 92%. Hysterectomy has made in 8%.