HEALTH OF WOMAN WH_№6_2012
Мітченко О. І., Корнацька А. Г., Романов В. Ю., Сопко О. В.
Особливості кардіоваскулярного ризику в пацієнток із синдромом полікістозу яєчників.
Медична реформа в Києві відбудеться тоді, коли в неї повірять ліка-рі і їхні пацієнти.
Профилактика репродуктивных потерь на ранних и поздних сро-ках, современные подходы, направленные на снижение перина-тальной заболеваемости и смертности.
Manukhin I. B., Markova E. V., Stryuk R. I.
Optimization of combined treatment for pregnant women with gestosis and fetoplacental insufficiency.
Thirty pregnant women with mild and moderate gestosis and fetoplacental insufficiency with first-to-se-cond degree uteroplacental circulatory impairment were examined. The authors studied the parameters of fetometry, Doppler study of placental blood flow, and hemorheology at baseline and during combina-tion therapy with diosmin (phlebodia 600) and actovegin for a month. All the pregnant women received combined antihypertensive therapy with bisoprolol in a daily dose of 2.5-5 mg and slow-release nifedipine in a daily dose of 30 mg. Placental blood flow parameters became normal; fetoplacental insufficiency compensation was achieved; and baseline abnormal blood rheological and viscosity properties were corrected.
Key words: gestosis, fetoplacental insufficiency, uteroplacental and fetoplacental blood flow, diosmin (phlebodia 600), actovegin.
Khashcha I. I., Chaban А. Т., Dorchynets О. І.
Vaginal childbirthin women with a scarontheuterus: pro et contra (the-prosandcons).
A retrospective cohort of clinical and statistical analysis of 200 stories of birth, which occurred in the Pe-rinatal center of Uzhgorod and 200 maps of newborns for the period 2009-2011. All pregnant women were divided into 2 cohorts: group 1 – 100 women re-delivery by cesarean section in the lower segment, group 2 – 100 women, delivery by vaginal childbirth. We found that in these two groups of women, no statistically significant differences compared to rates in middle age, type of residence, birth weight, Apgar score at 1 min. life, the thickness of the uterine scar after a previous cesarean section. The statistical difference was found in terms of duration of labor operations, the volume of blood loss, length of stay of mother and child in a hospital. Thus, vaginal birth after cesarean section has both strengths and weak-nesses. The choice of method of delivery of pregnant women with a uterine scar should be weighed indi-vidually elected in each case based on a comprehensive analysis of survey data. If successful vaginal childbirth after cesarean section significantly less blood loss and reduced length of hospital stay, as mothers and children.
Key words: vaginal child birth after cesarean section, scar on the uterus, elective Caesarean section, the thickness of the scar on the uterus, uterine rupture, complications, analysis, unsuccessful attempt.
Kornatskaya A. G., Revenko O. А., Danilenko E. G., Chubey G. V.
Chronic pelvic pain syndrome: a look gynecologist.
The results of the proposed scheme of complex therapy of chronic pelvic pain syndrome inflammatory etiology with the use of nonsteroidal anti-inflammatory drugs – NIMESIL® and DEKSALHIN® (Berlin-Chemie). The research established a high therapeutic efficacy and long-term clinical effect of these drugs in the treatment of chronic pelvic pain syndrome inflammatory etiology, that allows to recommend the said scheme for broad clinical use.
Key words: chronic pelvic pain syndrome, nonsteroidal anti-inflammatory drugs, treatment, nimesil, deksalhin.
Олийник Ю. В., Леуш С. С.
Новая стратегия лечения хронического воспалительного процесса внутренних половых органов у женщин репродуктивного возраста. Эффективность применения Ремесулида® и комплекса плацента-рных регуляторных пептидов.
На основании проведенного анализа клинических, микробиологических и иммунологических иссле-дований доказана высокая эффективность применения Ремесулида® и комплекса плацентарных регуляторных пептидов с целью лечения и профилактики рецидивов хронического воспалитель-ного процесса внутренних половых органов у женщин репродуктивного возраста.
Ключевые слова: внутренние половые органы, хронический воспалительный процесс, болевой синдром, Ремесулид®, комплекс плацентарных регуляторных пептидов.
Gerasimova T., Gopchuk E.
Effective antibiotic therapy – modern aspects of the use of combined drugs in gynaecology.
The article presents an overview of the relevance of rational antibiotic therapy and prophylaxis in gynecological practice at the present stage with the use of widely available and highly effective substances, combined in one drug.
Key words: tinidazole, ciprofloxacin, treatment, prevention, inflammatory processes.
Громова О. А., Торшин И. Ю., Лиманова О. А., Никонов А. А.
Патофизиология вегетативно-сосудистых пароксизмов (приливы) у женщин в период менопаузы и механизм действия β-аланина. Но-вая клинико-фармакологическая концепция.
Astakhov V. M., Gusev V. M.
Сharacteristics of obstetric and perinatal pathology in women with syphilis infection. (Literature review).
The article presents data on the dynamics and structure of the morbidity of syphilis in the Ukraine, some features of the current syphilis infection nowadays. Provides information on the impact of syphilis on preg-nancy and childbirth, pathomorphological and immunohistochemical changes in the placenta in syphilis and the clinical manifestations of syphilis in newborns are described.
Key words: syphilis, pregnancy, placenta, immune complexes.
Shurpyak S. A.
Venous thromboembolism in obstetrics – prevention and treatment issues.
The paper presents an analysis of the problem of venous thromboembolism during pregnancy and an overview of the various classes of antithrombotic drugs used in the world and in Ukraine in order to prevent and treat venous thromboembolism in obstetrics.
Key words: venous thromboembolism, pulmonary embolism, antithrombotic drugs.
Makarenko M. V., Govseiev D. O., Stanishevskaya M. L., Gridchin S. V., Zhukova S. M., Syvak V. V.
Experience of extracorporeal antibiotic therapy in various obstetric and gynecological pathologies application in 5th Kiev municipal mater-nity hospital.
Extracorporeal antibiotic therapy (ECAT) is one of the most promising ways to perform the transportation of drugs directly to the pathological focus, which greatly increases the clinical efficacy of treatment. There are reports about the use of ECAT in various chronic inflammatory pathologies, including gynecological. This paper deals with the effectiveness of the ECAT procedure for the treatment of several chronic inflam-matory states in obstetrics and gynecology in the 5th Kiev municipal maternity hospital. 96 patients with parovarium purulent tumors, pelvioperitonitis, acute adnexitis, postoperative septic complications, renal carbuncle of pregnant have been treated. The ECAT procedure was performed according to the standard method with some variations, using different antibiotics – ceftriaxone, unazin, augumentin, ofloksin, ave-lox, amoxiclav. 1-ECAT procedure were performed a week under control of body temperature and blood parameters. It has been shown the efficacy of extracorporeal antibiotic therapy in different septic patholo-gies in obstetrics and gynecology. The positive effect of ECAT was observed after 2–3 treatments, depen-ding on the pathology and the initial state of patients for all the antibiotics used.
Key words: extracorporeal antibiotic therapy (ECAT), pyoinflammatory conditions in obstetrics and gynecology.
Golyanovskyy O. V., Mekhedko V. V., Zhezher A. A., Kulakovskiy M. M., Bachynska M. A.
The methods of the regional analgesia in the labor.
The mechanisms of appearance and conjunction of pain during the delivery and methods of regional analgesia for relief of the delivery pain are described in this article. Techniques of performing spinal, epidural and caudal analgesia are also described. Indications, contra-indications and common complications of the given techniques are stated. Differential approach for usage of each analgesia method is offered.
Key words: pain during the delivery, methods of regional analgesia, differential approach for usage.
Корнацька А. Г., Дубенко О. Д.
Фітоселективна терапія у жінок з безплідністю та доброякісними захворюваннями молочних залоз на етапах реабілітації репро-дуктивної функції.
Жабченко І. А., Похитун М. В.
Корекція дисбіотичних станів у вагітних з безсимптомною бактеріу-рією.
Spiridonova N. V., Basina E. I., Melkadze E. V.
Nonspecific vaginitis in pregnants: is it possible to treat with lactoba-cillus maintenance?
Indication of combined medications with wide spectrum of action is more reasonable in treatment of non-specific vaginitis in pregnants, taking into account frequency of combined infection. The objective of cur-rent research was to reveal the impact of complex antiinfective medication on quantity of lactobacillus in pregnant women with nonspecific vaginitis. 33 pregnant women at 18,34±1,46 weeks of gestation with different obstetric pathology were included into the study. According the results of clinical and laboratory examination patients with nonspecific vaginitis, undergoing complex therapy with Polygynax (neomicine sulfate 35000 ME+nistatine 100000 ME, additional substances-dimeticone, vitamins A, E,D, soya lecitine, aminoacides, phospholipids) were enrolled into the study. Clinical monitoring was made before treatment, at 3-4th day from therapy beginning and at the end of the therapy (13>14 day). Objective methods demo-nstrate normalization of clinical values, decrease in the microbic contamination in vaginal discharge. As a result of treatment with Polygynax normal vaginal microbiocenosis was restored in 78,8% of pregnant women.
Key words: pregnancy, nonspecific vaginitis, lactobacillus, vaginal microbiocenosis, antiinfective therapy, neomicine sulfate, polymixine B sulfate, nistatine, Polygynax.
Makarov O. V., Kozlov P. V., Dulenkov A. B., Taktashova R. N., Vorontsova Yu. N.
Ways of prevention of perinatal morbidity and mortality during prema-ture pregnancy.
The analysis of perinatal issues and the most widespread pathology of preterm infants during pregnan-cies complicated by premature rupture of membranes (PROM) was carried out. The benefits of active prolongation of pregnancy complicated by PROM till 31 weeks of gestation were shown. Prolongation of pregnancy with premature rupture of membranes after 31 weeks is actual only for the period of prophyla-xis of respiratory distress syndrome because further prolongation of anhydrous time leads to the increase of frequency of septic complications.
Key words: preterm delivery, premature rupture of membranes, perinatal morbidity, perinatal mortality, Ginipral.
Gryshchenko O. V., Lakhno I. V., Storchak A. V., Tkachov A. E.
The functional reserve of the liver and fetal condition in pregnant wo-men with preeclampsia.
It was performed the investigation of functional reserve of the liver and fetal heart rate variability in 102 pregnant women with preeclampsia in the terms of 34–40 weeks. The 52 of them in combination therapy have been administered hepatoprotective drug Enerliv. It was determined that preeclampsia was accom-panied with the decreased functional reserve of the liver. This was due to vasospasm and the lesion of hepatocytes. It was researched that the uncoupling of regulatory mechanisms of fetal and maternal he-modynamics has suppressed fetal heart rate variability. Enerliv medication application in pregnant women with preeclampsia has contributed to the restoration of impaired liver function and activation of compen-satory hemodynamic trophotropic reactions of the fetus. The usage of Enerliv has optimized the treatment of preeclamptic patients which has improved fetal and maternal pregnancy outcomes.
Key words: preeclampsia, liver, fetus, Enerliv.
Nazarenko L., Tarusina O., Yermolayev V.
The use of oral probiotics in the treatment of bacterial vaginosis in pregnant women at risk of miscarriage.
The ground and experience with oral probiotic lactobacilli for the treatment of bacterial vaginosis as mo-notherapy in pregnant women with threatened miscarriage in midtrimester. The conclusion of high clinical and laboratory efficiency, reliable performance security eligibility.
Key words: bacterial vaginosis, probiotics, oral, miscarriage.
Payenok O. S., Cypkun A. G., Kostiv M. O.
Parameters of nitric oxide metabolism and nucleic acids homeostasis in pregnant women with endemic thyroid gland pathology.
Peculiarities of nitric oxide metabolism, according to L-arginine concentration in the blood serum and nitrates in the urine, as well as nucleic acids homeostasis were evaluated in 160 pregnant women with thyroid disorders and 20 pregnant women with physiological course of gestation. Received data suggest participation of nitric oxide and nucleic acids in the mechanisms of disturbances of systemic and regional blood flow in pregnant women with thyroid gland pathology, and therefore the possibility of using these indicators in assessing the effectiveness of therapy.
Key words: thyroid gland pathology, pregnancy, nitric oxide, nucleic acids, nucleases.
Sergiyenko S. N., Yudina, T. V., Koleko N. O.
Features of the condition of immune system at pregnant women with the metabolic syndrome.
Prevalence of a metabolic syndrome (MS) takes from 5 up to 20 % and continues to increase. However, mutual relations of current MS and gestation process, and also a role of immune shifts in development of obstetric complications at patients with MS are studied in an insufficient measure. At inspection of 105 pregnant women with superfluous weight of a body formation of secondary immune insufficiency in hypo-supressive variant (for which prevailing decrease in level Т-supressors on a background of the general Т-lymphopenia are characteristic), dysimmunoglobulinemia and activation of immunocomplex reactions has been established. Expressiveness of immune infringements densely correlates with level of bodyweight index. At the individual analysis of immunograms of patients with MS connections between character of immune shifts and features of current of pregnancy, namely dependence of development of threated abo-rtion and early gestosis from value of index CD4/CD8 and concentration of CIC has been established.
Key words: a metabolic syndrome, complications of pregnancy, infringements of immunity.
Шурпяк С. О.
Аналіз стану біоценозу піхви при терапії звичного невиношування вагітності.
Hetsko N. V.
The peculiarities of the phoetus-placentar complex at pregnants with high oncogenical risk human papillomavirus.
The peculiarities of the phoetus-placentar complex of pregnant women with high oncogenical risk human papillomavirus is displayed in the article. The high percent of pathological course of pregnancy, labour, postpartum period is note.
Key words: pregnancy, high oncological risk human papillomavirus, phoetus-placentar complex.
Podolsky Vl. V.
Features of menstrual function in women with chronic inflammatory diseases of genital organs.
Тhe results of cliniko-epidemiological research of features of katamnesis of chronic pelvis inflammatory diseases in fertile aged women are represented in the article. Rate and structure of violations of menstrual function and risk factors in dependence of clinical manifestation rate was found.
Key words: violations of menstrual function, chronic pelvic inflammatory diseases, rate, structure.
Бойчук А. В., Берегуляк О. О.
Вплив різних способів профілактики та терапії посткастраційного синдрому на стан кісткової тканини.
Vdovychenko Yu. P., Mel’nychenko A. Yu.
Cervical diseases early diagnostics increased effectiveness taking into account clinical and hereditary risk factors.
The paper substantiates the expediency of genetic consultation of patients with the view to form the deve-loped cervical carcinoma risk groups, it deals with the optimization of the early diagnostics and prevention of neoplasms. The clinical and genetic data of the examined 267 women, who appealed to Kyiv regional oncologic dispensary and the antenatal clinic of polyclinic № 1 (Kyiv, Darnyts’kyi region) in 2005–2008 are described in the paper.
Key words: cervical neoplasms, early diagnostics, clinical and genetic examination, risk group.
Grishchenko O. V., Lakhno I. V.
The antimicrobial resistance overcoming in patients with pelvic infla-mmatory disease.
It was performed the investigation of gradual application of Sorcef and Citeral in patients with acute sal-pingo-oophoritis. It was indicated in such category of women the presence of the associations of proto-zoa, aerobic and anaerobic microorganisms as well as a combination of two or more pathogens of STDs in 84,5% of cases. It was determined that combined usage of the Sorcef and Citeral was superior to the antimicrobial effect of doxycycline and contributed to the full completion of the inflammatory process and the restoration of normal microflora in the internal female genital organs.
Key words: acute salpingooophoritis, treatment, Sorcef, Citeral.
Dubossarskaya Z. M., Greek L. P.
Differential therapeutic tactics in combined benign genital disease, accompanied by chronic pelvic pain syndrome.
Immunohistochemichal research of expression level of hormones reception is conducted in endo-, myo-metrium and endometrial geterotopia with combined benign diseases of genitalia (CBDG) with the syn-drome of chronic pelvic pain. It was found the decline of receptor activity of steroid hormones as far as the increasing distance of endometriosis hearth from an uterus, that is correlated in our research with expressed pain syndrome and presence of inverse correlation dependence to the nuclear nonhiston albumen Ki-67 – the factor of proliferation. Differentiated therapeutic strategy was the Gn-RH appoint-ment to the patients with CBDG, with pronounced expression of estrogen and progesterone receptors and proliferative activity in endometrial glands and in the stroma, followed by the appointment of COC. The conducted treatment contributed to the elimination of pain syndrome in 64,4 % cases for thematic patients, normalization of menstrual function, thus improving the efficiency of CBDG with a pain syndrome treatment.
Key words: expression level of hormones reception, combined benign diseases of genitalia, chronic pelvic pain, differentiated therapeutic strategy, dienogest 2 mg.
Ganzhiy I. U.
Reproductive anamnesis peculiarities in women with polycystic ovary syndrome, depending on their age.
In the study was analyzed the reproductive anamnesis peculiarities in women with polycystic ovary syndrome (PCOS), depending on their age. Authors have founded that these women more often have pri-mary infertility and every fifth pregnancy terminates in 9–10 weeks. The average number of pregnancies is 1 only in late reproductive period, and only every fourth patient has a history of childbirth.
Key words: polycystic ovary syndrome, reproductive anamnesis, pregnancy, childbirth, abortion.
Kishakevich I. T.
Features mineral density of a bone fabric at women with natural meno-pause.
Results of the spent researches testify to necessity of an estimation of mineral density of bones at women with natural menopause. Thus the most significant risk factors of development of an osteoporosis are: late menarhe and early menopausa; a low index of weight of a body; presence extragenital pathologies. The received results are necessary for considering by working out of algorithm of diagnostic and treat-ment-and-prophylactic actions.
Key words: natural menopause, mineral density of a bone fabric.
Kornatsky A. G., Vovk I. B., Chubej G. V., Raksha I. I.
Tactics of treatment of the women with uterus myoma taking into ac-count their reproductive intentions.
Results of inspection of 45 women of reproductive age with uterus myoma have shown that the combined approach to their treatment which included preoperative preparation by introduction of agonists gonado-tropin-rilizing hormone and conservative myomectomy has allowed to normalise menstrual function at 90% of women and has led to functioning normalisation of hypothalamus-hypophysis-ovaries systems at these contingent of patients. For the purpose of preventive maintenance of relapse of disease it is necessary to make the rehabilitation therapy which effective method presents the intraparent system «Mirena». It has allowed to prevent relapse myoma a uterus at all surveyed women who did not schedule pregnan-cy.
Key words: uterus myoma, combined treatment.
Simrok V. V., Tananakina E. N., Talabishka V. I.
Assessment of extragenital pathology in women with abnormal uterine bleeding.
The article presents the results of a retrospective analysis of 275 cases of uterine bleeding (not related to pregnancy) among women of reproductive age, held in-patient treatment in gynecological department of Feodosia maternity hospital. According to the results of the study suggests that factors that complicate the disease and increase the duration of bleeding is extragenital pathology.
Key words: uterine bleeding, reproductive age, extragenital pathology.
Dubossarskaya Yu. А., Dubossarskaya Z. М.
Tergynan is the drug of choice in the treatment of bacterial vaginosis.
This article presents a current understanding of the pathogenesis of vaginal microbiocenosis and com-mon gynecological disease – bacterial vaginosis associated with the formation of biofilms. There are presents modern approaches to diagnosis and treatment of this disease in accordance with international recommendations. It is shown that according to many authors Tergynan is effective and safe drug of choice in the treatment of bacterial vaginosis in obstetric practice.
Key words: vaginal microbyocenosis, biofilm, bacterial vaginosis, treatment, Tergynan.
Shcherbina N. О., Dynnik O. O.
Peculiarities of blood leptine content in patients with pubertal uterine bleeding.
The paper presents the summerizing data of studying 93 patients with pubertal uterine bleeding. The incidence of changes in the secretion of leptine, related with body mass index, was determined in our patients. It has been established that hyperleptinemia is characteristic of patients with body weight excess. No agerelated dynamics in leptine increase was observed in the study. Some alterations concerning carbohydrate and lipid blood spectra were registered in patients with a high leptine level.
Key words: pubertal uterine bleeding, leptine, carbohydrate and lipid spectra.
Зелинский А. А., Ермоленко Т. А., Самсонова В. В., Шаповал Н. В., Чумак З. В.
Оптимизация терапии климактерического синдрома в перименопа-узе.
Проведено открытое мультицентровое рандоминизированное сравнительное исследование. Обс-ледовано 446 женщин (средний возраст 47,3±0,6 года) с климактерическим синдромом (КС) в пери-менопаузе. Анализ применения монотерапии препаратом Климактоплан Н, комбинации препарата Климактоплан Н и ЗГТ для лечения КС показал разную скорость снижения интенсивности симптомов КС и разное «качество» самочувствия в течение периода лечения, но в итоге через 3 мес те-рапии у пациенток всех групп получен хороший клинический эффект. Путем математического мо-делирования определена возможность прогнозировать динамику изменения интенсивности клинических проявлений КС при проведении различных видов лечения, что позволит правильно подо-брать индивидуальную программу терапии КС в перименопаузе. Применение комбинации препа-рата Климактоплан Н и ЗГТ для лечения КС (пошаговый переход на снижение дозы эстрогенного компонента ЗГТ и на монотерапию Климактопланом Н) ведет к улучшению переносимости и повышению безопасности терапии, что в конечном счете повышает комплаентность лечения.
Ключевые слова: климактерический синдром, перименопауза, лечение, Климактоплан Н, ЗГТ.
Voloshin A. A.
Forecasting risk factors of development of adhesive process at pati-ents with various number laparotomy in the anamnesis.
The received results have allowed to define forecasting risk factors of occurrence of adhesive process in a belly cavity at patients with laparotomy in the anamnesis. Them concern: repeated laparotomy, especi-ally in a combination with upmedium laparotomy; an adverse current of the postoperative period; opera-tive interventions concerning a peritonitis. The received results are necessary for using by working out of tactics of performance laparoscopical operations and conducting the postoperative period.
Key words: adhesive process, laparotomy in the anamnesis, forecasting.
Kaliuta A. A.
Papillomavirus infection of genitals : modern methods of diagnostics.
The article is sanctified to the problem of diagnostics of papillomavirus infections of genitals. The modern methods of determination of human papilloma virus are in article considered, their advantages and de-fects are analysed in diagnostics of this pathology.
Key words: human papilloma virus, clinical and visual method of diagnostics, colposcopy, Digene-test, cytologic and histological methods of diagnostics, hyperexpression of protein of р16(INK4a/CDKN2a), immunocytohistochemical research.
Пирогова В. І., Литвинюк С. І., Козловський І. В., Вереснюк Н. С.
Роль і місце імуномодулюючої терапії в оперативній гінекології у пацієнток із генітальним інфікуванням.
Булавенко О. В., Льовкіна О. Л.
Особливості функціонального стану ендометрія та яєчників у жінок раннього репродуктивного віку зі стрес-індукованим безпліддям.
Виявлені значні порушення функціонального стану ендометрія та яєчників у жінок зі стрес-індуко-ваним безпліддям, що зумовлює неповноцінне внаслідок недостатньої гемодинаміки формування жовтого тіла та недостатні секреторні зміни в ендометрії. Зазначені порушення негативно вплива-ють на стан тканин ендометрія і не забезпечують адекватних умов для імплантації заплідненої яйцеклітини.
Ключові слова: стрес, безпліддя, функціональний стан ендометрія, функціональний стан яєчників.
Sulima G. M.
Evaluating of endosurgical tubal plastic effectiveness for the restoration of reproductive function at women with pelvic peritoneal adhesions and infertility.
A retrospective analysis was carried out for the evaluation of effectiveness of pelvic peritoneal adhesions to restore the natural fertility in operative laparoscopy at women with pelvic peritoneal adhesions and infertility.
Key words: peritoneal pelvic adhesions, infertility, endosurgical treatment.
Vinnyk Yu. O., Tkachuk T. V.
Modern trends in the breast cancer treatment.
The survey is dedicated to the urgent problem of Oncology – coverage of current views on the combined and complex breast cancer treatment. The analysis of many sources of domestic and foreign literature was carried out. The evaluation of advantages and disadvantages of surgical, radiation, chemotherapy and hormonal treatments and their combination was given. The role of targeted therapy in the breast cancer treatment was evaluated.
Key words: breast cancer, combined and complex treatment.
Sukhin V. S.
Clinical peculiarities of vulvar cancer patients.
In this article we have presented the morbidity rate of vulvar cancer. The mean age of vulvar cancer patients was raised recently up to age of 70,3 years old. The vulvar cancer at initial stage was revealed in 36% of patients. The tumor localization in the most cases is in region of large pudendal lips. Regional lymphatic nodes were affected in 26,3% of patients.
Key words: vulvar cancer, morbidity-rate, tumor localization.
Точка Грефенберга: гинекологический миф или источник женско-го удовольствия?