Vol 2, No 1 (2015)
- Year: 2015
- Articles: 11
- URL: https://journals.rcsi.science/2313-8726/issue/view/2020
Original study articles
Feto-fetal hemotransfusion syndrome
Abstract
The development of accessory reproductive technologies led to an increase in the incidence of plural pregnancies, including cases with monochorial twins. A specific feature of monochorial gestation is the formation of shunts between the circulation systems of the two fetuses. The resultant interfetal hemotransfusion can lead to the development of the feto-fetal hemotransfusion syndrome (FFHTS). Analysis of published data on the epidemiology, early diagnosis, and treatment of FFHTS indicates that the syndrome develops in 5-15% of monochorial twins at <32 weeks of gestation. The mortality in untreated cases reaches 80-90%. Te main diagnostic methods are ultrasonography, dopplerography, and magnetic imaging. The therapies used most often are amnion reduction and selective laser photocoagulation of vascular anastomoses. The survival of at least one of the fetuses after therapy is 85-92%, of both fetuses 44-70%. In cases with postoperative complications the survival reduces to 29-88% for one and 0-58% for both fetuses. Hence, poor survival parameters necessitate the development of new diagnostic and therapeutic methods for timely detection of the syndrome and elimination of its causes.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):4-12
4-12
Modern aspects of treatment for uterine myoma (Review of foreign literature)
Abstract
The efficiency of therapies for uterine myoma is discussed. The results of randomized studies of the efficiency and safety of combined oral contraceptives, gonadotropin releasing hormone agonists and antagonists, progesterone receptor selective modulators, and antiprogestins are presented. The efficiency of vascular embolism and macgnetic therapy are discussed.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):13-17
13-17
β-Lactamase activity in the amniotic fluid
Abstract
Beta-lactamase activities were measured in the amniotic fluid and serum of pregnant women. The relationship between the parameters was analyzed and the clinical significance of biological resistance to beta-lactam antibiotics in this patient population was evaluated. A total of 40 women were distributed into groups by the following parameters: pregnancy (pregnant/nonpregnant), gestation term, and inflammatory process (present/not). Serum beta-lactamase activity was measured by the Biolactam test system. All patients exhibited beta-lactamase activities in the amniotic fluid and serum. High level of the blood beta-lactamase activity is a factor preventing effective therapy by beta-lactam antibiotics. Hence, evaluation of biological resistance to beta-lactam antibiotics before therapy prevents their unjustified prescription and improves the treatment efficiency.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):18-21
18-21
Vaginal microbiocenosis in patients with HPV-associated and HPV-negative cervical intraepithelial neoplasias
Abstract
Vaginal microbiocenosis was studied in 311 patients with cervical intraepithelial neoplasias (CIN) by RT-PCR (Femoflor-16 test, DNA-Technologies). The results indicated that HPV-asociated and HPV-negative CIN were associated with the development of pronounced vaginal dysbiosis caused by mainly obligate anaerobes, predominantly Gardnerella vaginalis in associations with Atopobium vaginae, Megasphaera spp./Veillonella spp./Dialister spp., and Eubacterium spp. A great variety of the agents dictated comprehensive studies of the vaginal microbiocenosis in patients with cervical precancer conditions in order to prescribe individual therapy.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):22-26
22-26
Uterine artery embolization: Efficiency in women with unrealized reproductive function
Abstract
The study was carried out in 151 women aged 35-47 years with uterine myomas of different location in the myomatous nodes (the exception were subserous myomatous nodules on a thin base), clinically manifesting by profuse menses and pain, with normal hormonal profiles. Patients with unrealized reproductive function were excluded from the study. The ovarian function and ovarian reserve after embolization of the uterine arteries (EUA) were evaluated by the levels of antimuller hormone (AMH), inhibin B, FSH, LH, estradiol, and progesterone. Positive results were attained in 82.4% cases. Menorrhea became less painful in 69.2% cases and less intense in 74.9%, the cycle normalized in 42.9%. Pain reduced or completely regressed in 63.4% cases, urination improved in 41.7%, defecation in 38.6%. Hormone measurements were carried out in 66 women 6 and 12 months after EUA. The levels of AMH and inhibin B were low after 6 months in 37 (24.7%) and 55 (36.4%) patients, respectively, which indicated reduction of the ovarian reserve. The women’s ages varied from 41 to 47. The levels of AMH normalized 12 months after EUA in two women, aged 42 and 44 years. The levels of inhibin B remained critical under conditions of a regular cycle. The levels of FSH and LH were high 6 months after EUA in 14 (9.3%) and 9 (6%) patients, respectively. The age of these patients was 44-47 years. These patients had high levels of estradiol (12-16% higher than normally) and progesterone (8-11% higher than normally). The patients complained of hot flushes, irritability, and liable to change of moods. The cycle was irregular in only 4 women. The hormonal profile normalized after 12 months in 6 patients, menopause ensued in 5 women. These results indicated the efficiency and safety of EUA as a method for the treatment of uterine myoma. Importantly that EUA was an organ-sparing method, preventing the disease relapses. However, EUA modulated the ovarian reserve and hence, reduced the fertility. Spontaneous pregnancy was hardly probable after this treatment, more likely as a result of accessory reproductive technologies. This fact should be decisive in choice of the treatment strategy for patients with uterine myoma, planning pregnancy in future.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):26-30
26-30
Fetoplacental failure in cervical disease
Abstract
Fetoplacental failure in patients with inflammatory diseases of the cervix uteri was studied. The study was carried out in 112 pregnant women, forming 2 groups: with (n = 74) and without cervical disease (n = 38). The patients’ ages varied from 22 to 42 years (29.1 ± 2.14 years). The study was carried out by instrumental, cytological, and bacteriological methods. Antiinflammatory therapy and correction of local immunity promoted elimination of bacterial agents and reduction of inflammatory changes in the cervix uteri. Fetoplacental failure was treated by vasodilatants and drugs normalizing the microcirculation in the placenta and uterus.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):30-34
30-34
Prevention of thromboembolic complications in women with atrial fibrillation: A clinical case
Abstract
A clinical case is presented and the hemostasis system in women is analyzed from the conclusive medicine viewpoint. The authors suggest a formulation of the specific strategy of anticlotting therapy in postmenopausal patients with atrialfibrillation.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):35-39
35-39
Giant tumor of the labia majora (dinical case)
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):39-39
39-39
Initial therapy for sepsis and septic shock in obstetrics: Federal clinical recommendations
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):40-47
40-47
Summing up a multicenter prospective comparative randomized study of the efficiency and safety of Pabal® (carbetocin) and oxytocin
Abstract
A multicenter prospective comparative randomized study was carried out to evaluate the efficiency and safety of Pabal® (carbetocin) and oxitocin, used for prevention of the postpartum hemorrhages in abdominal delivery. The volume of blood loss in patients treated by Pabal (n=163) and oxitocin (n=180) were compared in the patients with uterine cicatrix, large fetus, in cesarean section combined with conservative myomectomy, in twin pregnancy, placental presentation, and preterm detachment of normally located placenta. Pabal proved to be highly effective and safe; blood loss was significantly lower in response to Pabal in comparison with preventive oxitocin.
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):48-54
48-54
Eduard Karpovich Ailamazyan (on the occasion of his 75 th birthday)
V.F.Snegirev Archives of Obstetrics and Gynecology. 2015;2(1):55-56
55-56