Vol 66, No 1 (2017)
- Year: 2017
- Articles: 11
- URL: https://journals.rcsi.science/jowd/issue/view/359
- DOI: https://doi.org/10.17816/JOWD661
Articles
Efficacy and safety of labor induction methods using prostaglandin E1
Abstract
Vacuum extraction of the fetus: the version and controversy
Abstract
Actuality. Although in the developed countries of the surgical vaginal delivery by a vacuum extraction of the fetus the widespread introduction, this method is not sufficiently popular in our country, due to the unfounded opinion of the highest injury to the mother and fetus. However, due to the improvement of models and the obvious advantages of simplicity and ease of use, the application of this operation becomes reality.
Aim. The assessment of the surgical vaginal delivery by a vacuum extraction of the fetus on the shape of parturient women and newborns.
Materials and methods. Made a retrospective analysis of the outcome of the 192 vaginal operative deliveries by using a single use vacuum system KIWI according to the labor histories and stories of newborns for 2014-2015 in regional perinatal center, Kursk. We studied the anamnestic data and the results of monitoring the pregnancy, childbirth, postpartum and newborn state. The calculations were made using the package of standard programs.
Results. In the majority of cases the postpartum period was uneventful, the cases of severe obstetric injury was not revealed. 80.21% of the children were recovered in a satisfactiry condition, although acute fetal hypoxia was observed in 90.1% of cases, suggesting the efficacy of using the vacuum extraction. Clinically significant lesions, such as subgaleal hematoma, skull fracture are not registered.
Conclusions. Analyzing the consequences of this method, we can confidently say that the operation of vacuum extraction with timely and correct use of a technical execution has no negative impact on the organisms of mother and child and is justified by positive outcomes in emergency situations.
Morphological characteristics of uterine fibroids among women of reproductive age
Abstract
The article deals with modern views on etiopathogenesis of uterine fibroids. Increased knowledge of the markers of proliferation and their study will help to predict the course of the disease and thus to develop the optimum tactics of the further treatment of the early stages. Much attention is paid to the study of markers that characterize apoptosis. By immunohistochemistry in tissue fibroids 15 patients studied protein expression Ki-67 and Bcl-2. Analyzed values of the correlation expression of the proteins according to the clinical and morphological features of the tumor. It showed a reduction in the proliferation marker Ki-67, and increased expression of apoptotic Bcl-2 inhibitor.
Background. Presented by changes in the nature of proliferation and apoptotic activity in myoma nodes among women of reproductive age who underwent conservative myomectomy.
The aim of the research was to study the performance of protein antibody Ki-67 proliferation and apoptosis inhibitor of Bcl-2 in women with uterine myoma.
Material and methods. Surveyed 15 women with uterine fibroids who underwent conservative myomectomy. Inclusion criteria were: the reproductive age, uterine fibroids the size of which does not exceed the 12-week pregnancy. Exclusion criteria were the size of fibroids greater than 12 weeks of pregnancy, acute inflammatory diseases of the pelvic organs, severe somatic diseases, cancer of the reproductive organs. It was carried out histological and immunohistochemical study of remote myoma node. We examined by immunohistochemistry proliferation protein monoclonal antibody Ki-67 (Clone MIB-1, 1 : 150, Dako), inhibitor of apoptosis Bcl-2 (NCL-bcl-2-486). (Novocastra). Evaluation of the expression of markers studied conducted qualitative and quantitative methods in computer image analysis system “Morphology 5.0” (Video Test, Russia). Statistical processing of the results was performed using statistical analysis packages (STATGRAPHICS v. 6.0).
Results. Age of women surveyed averaged 33,4 ± 4,1 years. Histological study of benign tumors of the uterus body showed the presence of degenerative changes, necrosis and inflammatory infiltration in every fourth case of the material.
Conclusions. Immunogistohimichesoe study of uterine leiomyomas body revealed a significant increase in the expression of apoptosis inhibitor of Bcl-2 and reducing the proliferation marker Ki-receptor expression in all 67 tested samples, which is consistent with a histological study of the absence of mitotic activity in leiomyomas.
Effect on ovarian reserve using various techniques to reduce blood loss for myomectomy
Abstract
Evaluation of the content and the pathogenetic role of cytokines in the peritoneal fluid in patients with deep infiltrative endometriosis
Abstract
Background. Deep infiltrative endometriosis (DIE) is characterized by the invasion of endometriosis lesions in tissues and organs to a depth of over 5 mm. In recent years, the proportion of infiltrative forms of endometriosis has been steadily increasing. The main clinical manifestations is chronic pelvic pain syndrome and infertility. A key element in the pathogenesis of deep infiltrative endometriosis is an ineffective inflammatory response.
Objective. Evaluate the content and the role of pro- and anti-inflammatory cytokines, growth factors and chemokines in the pathogenesis of deep infiltrative endometriosis for pathogenetically grounded immunomodulatory therapy.
Materials and methods. The present study included 120 women with deep infiltrative endometriosis. In the peritoneal fluid, using IFA determined the level of IL-33, and with the help of running cytofluometry format NEA has estimated the levels of IL-2, IL-6, IL-10, IP-10, MCP-1 and growth factors – FGF, TGF-β.
Results. In the study of peritoneal fluid of patients with DIE was a significant decrease in the level of IL-2 and IL-10 6.7 times compared to the control group. The level of IL-6 was increased in 1.5 times, as well as the level of IL-33, and was awarded the data link cytokines with the severity of pain. DIE is characterized by increased levels of MCP-1 in 2 times and decrease in IP-10 1.3 times, as well as increased levels of FGF 1.5 times and reduced levels of TGF-β in 1.9 times in comparison with the control group.
Conclusion. For effective treatment of DIE and to increase the duration of recurrence-free period actual and pathogenetically justified is the inclusion of a combined treatment of immunomodulatory therapy with recombinant IL-2 aimed at the elimination of immunological disorders in the pelvic cavity.
Vaginal vault reconstruction and apical sling in the treatment of post-hysterectomy prolapsE
Abstract
Introduction. Frequency of vaginal vault prolapse (VVP) requiring surgical repair is up to 6-8% and 11.6-45% in patients with prior hysterectomy for uterine prolapse. Reported recurrence rate of VVP following different techniques of surgical correction is up to 10%.
Objective: to evaluate the effectiveness of the novel technique: bilateral sacrospinous fixation of reconstructed vaginal wall (neocervix) by monofilament polypropylene apical sling (Urosling 1; Lintex, Saint Petersburg, Russia) in surgical treatment of VVP.
Methods. This prospective study involved 61 women suffering from post-hysterectomy prolapse. To evaluate the results of surgical treatment, data of a vaginal examination (POP-Q), uroflowmetry, bladder ultrasound, validated questionnaires were used. All listed parameters were determined before the surgery and at control examinations in 1, 6, 12 months after the treatment.
Results. Mean operation time was 35 minutes. No cases of intraoperative damage to the bladder/rectum, as well as clinically significant bleeding were noted. 12-months anatomical cure rate (≤ stage I, POP-Q) was 100%, 94.4% and 100% for apical, anterior and posterior vaginal compartments, respectively. At 1 month of follow-up stress urinary incontinence de novo and urgency de novo were noted in 6.5% and 4.9%, respectively. Statistically significant (p < 0.05) improvement in peak flow rate was observed according to uroflowmetry. Comparison of the scores by the questionnaires revealed a significant improvement in the quality of life in the postoperative period.
Conclusion. Bilateral sacrospinous fixation of reconstructed vaginal wall (neocervix) by monofilament polypropylene apical sling appears to be effective and safe method for treatment patients with vaginal vault prolapse.
The use of a synthetic analogue of prostaglandin Е1 misoprostol for induction of labor
Abstract
Effects progestogel for postpartum engorgement of the breast
Abstract
Background. Severe breast engorgement can cause substantial discomfort for mothers and interfere with an infant’s ability to feed at the breast.
Aim of the study was to clarify the possibility of the influence of percutaneous the progesterone-containing gel (progestogel) to eliminate strong postpartum engorgement of the breast in lactating women.
Materials and methods. 23 patients were examined. The progestogel for transdermal therapy in an amount of 2.5-3 g was applied to the breast. Before application and after 20 min application progestogel measured the density of the mammary glands with the help of tonometer.
Results. According to our observations, application of 2.5-3g of the progestogel on the breast skin is not leading to reduction of breast swelling, engorgement and tenderness.
Conclusions. Transdermal application progestogel does not reduce the degree of engorgement of the mammary glands in the postpartum period.