Perinatology and reproductology: from research to practice

The pregnant have features of hormonal status with uterine fibroids and them newborn

Marina Kuzyomenska — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-01
УДК 618.14-006.36-06/618.3:616-053.31]-039:612.018

The objective: to estimate the features of hormonal status for pregnant with uterine fibroids and them new-born.
Materials and methods. The conducted analysis is 299 variable maps and histories of births of patients, delivered by caesarean section in a term 38–40 weeks, including 235 – with a multiple uterine fibroids. In connection with the put purpose groups were created: I a group (n = 101) is patients and them new-born, motion of pregnancy of which is associated with a multiple uterine
fibroids, with the sizes of most node there is more than 5 sm; II group (n = 134) is patients and them new-born, motion of pregnancy of which is associated with a multiple uterine fibroids, with the sizes of most node there is less than 5 sm; III group (n = 64) is patients without uterine fibroids, delivered by caesarean section, and them new-born. Researches of level of hormones conducted the method of immunoenzyme analysis on an automatic immunoenzyme analyzer. Determination of level of estriol free, estradiol, prolactin, progesterone, thyrotropic hormone, thyroxine, triiodo-thyronine, cortisol, dehydroepiandrosteronesulfat it was conducted a with the use of standard test system.
Results. By us found out tendencies to the decline of progesterone, testosterone, estriol and estradiol in blood in new-born from mothers with uterine fibroids as compared to a III group, however findings were within the limits of normative values and reliable differences by us it is not discovered (p > 0,05). In the that test of blood we learned the level of hormones of thyroid and adrenal glands of mothers and them new-born I and III groups. In I group the level of triiodo-thyronine made, on the average, 18,27 ± 7,9 nmol/l, in III – 25,7 ± 14,01 nmol/l remained within the limits of norm. Will mark that this index on 27% was below in I group, however reliable differences are (p > 0,05). Thyroxine free at blood of patients I group, on the average, there was 12,12±2,15 pmol/l, in III – 11,49±2,72 pmol/l were in normative limits. The level of thyrotropic hormone for patients I group, on the average, made 2,02±0,84 μIO/ml, in the III – 2,24±1,6 μIO/ml. This index was in normal physiology values. Reliable differences, at the study of hormones of thyroid in blood of mothers I and III groups it is not discovered by us, without regard to tendencies to the decline of level of triiodo-thyronine for patients with a uterine fibroids (p>0,05).
Conclusions. Without regard to absence of reliable differences between groups, for women with a uterine fibroids the level of such hormones as estriol and estradiol was below (on 27% and 36% respectively). The same tendency is marked and in the indexes of blood new-born: on 18% reduced estriol and on a 16,5% estradiol. At the analysis of levels of testosterone found out the decline of this index on 16%, prolactin on 27% for women with uterine fibroids. In new-born the level of testosterone was below on 28% in I group. For patients with a uterine fibroids the increase of levels of thyroxine, decline of triiodo-thyronine and thyrotropic hormone was marked, but reliable differences were not (p>0,05). In new-born levels of triiodo-thyronine and thyrotropic hormone were a bit higher, the level of thyroxine тироксину lower, than in new-born III groups. Similarly in blood for patients with a uterine fibroids found out a tendency to the increase of level of cortisol, however unreliable differences are. Findings must be taken into account at development of algorithm of diagnostic and treatment-and-prophylactic measures.

Features of motion of pregnancy for women with different somatotype and by age of the first births

Andrey Semenyuk — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-02
УДК 618.2-005.25-071.2-039

The objective: to estimate the features of motion of pregnancy for women with different somatotype and by age of the first births.
Materials and methods. For implementation of the put tasks it was inspected 104 pregnant of woman on the early terms of gestation with the different types of stature. Age of the inspected patients was scope from 19 to 38 years. Were conducted somatometry and somatotype, hormonal researches. From the inspected women 29 (27,9%) were macrosomatic type of stature, 47 (45,2%) – mesocomatic, 28 (26,9%) – miscrosomatic. From them 62 (59,6%) women were primiparous, and 42 (40,4%) – multiparous. Studied features of motion of the real pregnancy and births, appraised state of the fetoplacental system, fetus, studied features of motion of early neonatal period in new-born. Anamnestic information was brought in the specially developed map, information about age, somatic state, obstetric-gynaecological anamnesis.
Results. The got results testify that threat of terminating pregnancy from the early terms of gestation, anaemia of pregnant, vaginitis more frequent met for the women of miscrosomatic type of stature. The low location of placenta, placenta previa, polyhydramnios and oligohydramnios more frequent was observed for the patients of miscrosomatic type. Such complication of pregnancy, as a premature detachment of a normally located placenta, it was only for one woman, representatives of macrosomatic type a stature. Placenta dysfunction more frequent met for the women of macrosomatic and miscrosomatic types of stature, rarer – for the representatives of mesosomatic of type. It should be noted that in all supervisions placenta dysfunction was in the stage of indemnification. Edema took place in all inspected groups. In the group of pregnant with the macrosomatic type of stature – in 10,4%; from mesosomatic – 6,4% and with miscrosomatic – 7,1%. Preeclampsia more frequent met for the representatives of macrosomatic type of stature.
Conclusions. More frequent all somatotype of expectant mothers, that meets, there is mesosomatic type of stature (45,2%), macrosomatic and miscrosomatic type of stature meet at 1,6 time rarer and practically with identical frequency of f 2. Motion of pregnancy for the women of macrosomatic type of stature is characterized by higher frequency of gestosis, as compared to the representatives of other types of stature, for the women of miscrosomatic type of stature there is a characteristic high level of threat of termination pregnancy, anaemia of pregnant, complications of births and puerperium.

Morphological features of the system are a motherplacentafetus at a antenatal hypoxia with fetus losses

Olena Susidko — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-03
УДК 618.39-001.8-06:618.33/.36-039:572.7

The objective: to estimate the morphological features of the system mother-placenta-fetus at a antenatal hypoxia with fetal losses.
Materials and methods. The study included 55 cases of fetal death from a antenatal hypoxia in terms of 23–40 weeks at a singleton pregnancy: 55 placentas and 52 fetuses (in 3 cases a section was not produced). These 55 the most difficult for diagnostics supervisions of antenatal fetal death were included by us in our study of research on the basis of the unspecified nosotropic role of placenta and not clear thanatogenesis, they were 52% all antenatal losses. Cases of antenatal death of the set etiology - with infectious fetopathy, by congenital malformations, incompatible with a antenatal period, - from research eliminated, as well as multiple pregnancy.
Results. Among principal reasons of fetal death, associated and combined, dysfunction of fetoplacental complex prevailed in both sub-groups. In a 1th sub-group dysfunction of placenta was conditioned severe preeclampsia in 37,5%, and also premature detachment of a normally located placenta. Pathology of umbilical cord appeared principal reason of antenatal death of 3 fetuses in a 2th sub-group: actual node with the thrombosis of vessels in 23 weeks of pregnancy and with strangulation of umbilical cord in 39 40 weeks of pregnancy, tight neck cast-over in 39 weeks. A sharp ascending amniotic infection as combined factor of thanatogenesis is marked at 3 fetuses of 2th sub-group: with funiculitis, complicated thrombosis of vessels of umbilical cord (1), in combination with willit (2) and by antenatal death in 31, 33-34 and 39 weeks pregnancies. The markers of viral infections were found out in 10 from 19 inspected cases of antenatal fetal death with the search of herpetic, cytomegalovirus, chlamydial, mycoplasma, ureaplasma infections: in 9 from them it was got positive results in single locus with one of markers, here there were signs of focal willit in 2 cases, and in 7 such absented, as well as infectious fetopathy.
Conclusions. It is set two types of fetal losses at a antenatal hypoxia, which differ pathogenesis and thanatogenesis. The basic factors of pathogenesis and type of antenatal losses is dyschrony of villiferous tree of placenta, presence maternal and fetal vasculopathy. Pathogenesis of the first type of antenatal losses is characterized severe preeclampsia, maternal vasculopathy, by a uterine-placental ischemia and premature ripening of villi, dense spatial structure and vertical orientation of villiferous tree, low mass of placenta, fetal hypotrophy. Pathogenesis of the second type of antenatal losses is conditioned by immaturity of villiwith fetal vasculopathy, by the loose spatial structure of placenta with the spiralling and chaotic location of villi, by enhanceable mass of placenta and fetus with his tissue immaturity.

A role of infectious factor is in genesis of relapses of retrochorial haematomas

Olexandr Talko — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-04
УДК 618.344-003.215-036.87-06:618.14-022

The objective: to estimate the role of infectious factor in genesis of relapses of retrochorial haematomas.
Materials and methods. For the decision of the put purpose it was conducted complex clinicaland-laboratory and instrumental inspection 90 women, what were up-diffused on three groups on the basis of results of clinical inspection and information of ultrasonic research: 30 pregnant of woman with a relapses retrochorial haematoma (basic group), 30 pregnant with a retrochorial haematoma, which appeared only on the early terms of pregnancy (6–12 weeks inclusive) (group of comparison) and 30 the prospective inspected patients with uncomplicated pregnancy, which do not have meaningful extragenital pathology and burdened factors obstetric-gynaecological to anamnesis (control group). To the complex of the conducted researches were included clinical, echographic, doppler, microbiological and statistical.
Results. By us were found out reliable differences in composition the microflora of sexual ways for the inspected women with a retrochorial haematoma (relapses and early terms) as compared to uncomplicated pregnancy. Thus, and an incurrence of women with a urogenital infection was meaningful (64,4% in a basic group, 33,75% – in the group of comparison, and only 5,7% – in a control group), and women with a mixed infection (45,2%, 26,25% and 11,4% respectively). But most interest presents, certainly, the comparative analysis of violations of microbiocenosis for pregnant with a sporadic and relapses retrochorial haematoma.
Conclusions. Information is got by us underline meaningfulness of infectious factor in genesis of uterine-placental hemorrhages, especially relapses and violations of placentation. The got results must be taken into account at development of algorithm of diagnostic and treatment-andprophylactic measures.

Role of placental morphological audit in the diagnosis of subclinical intrauterine inflammation and in the prediction of preterm birth: original research

Olena Yaroshchuk — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-05
УДК 618.34-002-022.7:618.36-076.4:618.39-037

The objective: to determine the association between morphological features of chorioamnionitis and systemic inflammatory biomarkers, clinical, hormonal, and psychological indicators for predicting spontaneous preterm birth.
Materials and methods. The study included 223 patients whose placentas underwent postpartum morphological examination. Based on placental histology and the timing of delivery, three groups were formed: subgroup A – preterm birth with histological chorioamnionitis (n = 74); subgroup B – term birth with histological chorioamnionitis (n = 43); subgroup C – term birth without morphological signs of chorioamnionitis (n = 109). All participants underwent evaluation of C-reactive protein, leukocyte count, procalcitonin, GroEL, and cortisol levels in plasma; cervical length measurement; and assessment of psychological status using the Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis included intergroup comparisons, p-value calculation, and assessment of gradient changes across subgroups.
Results. In subgroup A, the median C-reactive protein level was 12.0 mg/L, compared with 1.0 mg/L in subgroup B and 0.5 mg/L in subgroup C (p < 0.001). Leukocyte count was highest in subgroup A – 13 × 109 /L compared with 10 × 109 /L and 8.2 × 109 /L, respectively (p < 0.001). Median procalcitonin in subgroup A was 0.15 ng/mL versus 0.10 and 0.05 ng/mL (p = 0.001), while cortisol levels reached 7.3 μg/dL compared with 3.0 μg/dL and 2.8 μg/dL (p = 0.005). Psychological assessment showed a median EPDS score of 22 in subgroup A compared with 12 and 11 points (p < 0.001). Median cervical length was shortest in subgroup A – 22 mm versus 25 mm and > 35 mm (p < 0,001). Prelabor rupture of membranes occurred in 50% of subgroup A, 32.6% of subgroup B, and only isolated cases in subgroup C (p = 0.082). Prolapse of the fetal membranes was observed exclusively in subgroup A (23%; p = 0.009).
Conclusions. Histologically confirmed chorioamnionitis is associated with systemic inflammatory activation, hormonal alterations, and structural cervical changes, which substantially increase the risk of preterm birth. The observed gradient between morphological, laboratory, and clinical indicators underscores the multifactorial nature of extremely early spontaneous preterm birth. The findings support integrating morphological criteria with systemic biomarkers to develop highly accurate prediction models for preterm birth and early detection of intrauterine inflammation. The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution specified in the manuscript, and written informed consent was obtained from all participants. The authors declare no conflicts of interest.

The role of pelvic floor innervation disorders associated with neural tube pathology in the development of genital prolapse and sexual dysfunction in women aged 35–45 years

Alla Vitiuk — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-06
УДК: 616.61-007.43-055.2:616.831-007.253-053.8

Genital prolapse in middle-aged women is a multifactorial condition involving mechanical, anatomical, and neuromuscular disturbances. However, the contribution of occult neural tube anomalies—particularly spina bifida occulta – to the early development of prolapse and sexual dysfunction remains insufficiently explored. In women aged 35–45 years, the clinical presentation often includes a combination of mild or moderate prolapse, chronic pelvic pain, sexual disorders, and psych emotional symptoms, which may be associated with impaired pelvic floor innervation.
The objective: to evaluate the role of neurogenic disorders related to neural tube pathology in the development of genital prolapse and sexual dysfunction in women aged 35–45 years.
Materials and methods. A total of 55 women were examined and divided into three groups: 20 patients with radiologically confirmed spina bifida occulta and stage I prolapse; 15 women with stage II prolapse without neural tube anomalies; 20 women as the control group. All participants underwent clinical examination, perineal 2D/3D ultrasound, electromyography, manometry, psychosexual assessment (FSFI, PHQ-9, GAD-7), and L5–S2 radiography. Statistical analysis included the t-test, χ2-test, and ANOVA.
Results. Radiological signs of spina bifida occulta were identified in 100% of Group 1 patients and were accompanied by marked neurofunctional deficits, including reduced M-response amplitude (82 ± 12 μV vs. 157 ± 11 μV in controls), prolonged motor conduction time (7.3 ± 0.9 ms), and decreased pelvic floor contraction strength according to manometry (18.7 ± 3.2 cm H2
O). Despite only minimal prolapse severity (POP-Q I), these women exhibited the most pronounced sexual
dysfunction: FSFI reduction to 18.4 ± 4.7, high rates of dyspareunia (65%), hypolibidemia (50%), and anorgasmia (35%). Psych emotional status was also poorest in this group: mean PHQ-9 was 11.2 ± 3.5, and GAD7 was 10.6 ± 3.1, demonstrating a significant correlation between neurogenic impairment and psychological maladaptation (r = 0.61; p < 0.05). In Group 2, anatomical injuries predominated, including levator avulsion (60%), enlargement of the levator hiatus to 29.3 ± 3.8 cm2, and reduced pelvic floor contraction strength (15.1 ± 2.7 cm H2O). Sexual dysfunction was present but had a predominantly mechanical-pain etiology and was less severe than in Group 1 (FSFI – 22.1 ± 4.3). All parameters in the control group remained within normal ranges.
Conclusions. Occult neural tube defects represent a significant risk factor for the early development of prolapse and sexual dysfunction. The findings support the inclusion of radiography and neurofunctional assessment in the early diagnostic algorithm for women with minimal prolapse symptoms. An individualized therapeutic approach should incorporate neurorehabilitation, physiotherapy, correction of sexual dysfunction, and psych emotional support.

Patients have a prophylaxis and treatment of diseases of mammary glands after hysterectomy

Oleksandr Zabudskіy — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-07
УДК 618.14-006.36-089.85-089.168.1-06:618.19-084

The objective: to develop and inculcate the method of prophylaxis and treatment of diseases of mammary glands for patients after hysterectomy.
Materials and methods. By us it was inspected 156 patients by a uterine fibroids, which is a basic certificate for implementation of hysterectomy. All patients with a uterine fibroids depending on age parted on 2 clinical groups: a 1 group was 67 patients which was added hysterectomy in late reproductive age (36–44 years, on the average in 40,9 ± 0,9 year); to 2 groups entered 89 patients which are operated in premenopause (45–47 years, on the average in 45,9 ± 0,2 year). A control group was made 20 practically healthy women of analogical age. To the complex of the conducted researches clinical, laboratory, instrumental and statistical methods were included.
Results. Objectively the positive dynamics of treatment was traditionally determined at a review, palpation and ultrasonic research of mammary glands. By the criteria of positive effect of reception a indole-3-carbinol was served: diminishing of edema, sickliness, heterogeneity of structure of mammary glands, decline of echogenicity tissue, diminishing of size of cysts in a diameter on 2–3 mm (from 0,5–1,2 mm to 0,3–0,9 mm) and diameter of mammary channels, improvement of expressed connecting tissue pattern. An effect from the use of preparation developed gradually, arriving at a maximum in 6 months after the beginning of reception. The best effect from treatment in 3 months of reception a indole3-carbinol was marked for patients diffuse fibrocystic mastopathy with predominance of cystic component. On the whole objective positive dynamics, through 3 and 6 months after the beginning of treatment marked in 72,5% and 91,3% patients respectvely. In 7 (8,7%) patients diffuse fibrocystic mastopathy with predominance of fibrotic component, without regard to the established subjective diminishing of pain syndrome, objectively any dynamics it was not discovered.
Conclusions. Preparations on basis a indole-3-carbinol is effective targeted therapy for patients with the different forms of diffuse fibrocystic mastopathy after surgical treatment of uterine fibroids in the volume of hysterectomy. As a diffuse form is the initial stage fibrocystic mastopathy, the timely nosotropic grounded treatment will prevent progress of disease in noncommunicative forms, that will reduce the risk of development of cancer of mammary glands in the end. The methodology is accessible and can be recommended for use in practical healthcare.

A rehabilitation of women is after the ovarian apoplexy

Ganna Kolesnyk — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-08
УДК 618.11-005.1-036.82

The objective: to develop the nosotropic grounded complex of rehabilitation measures, directed on the improvement of reproductive health of women after the carried ovarian apoplexy decline of frequency of relapse of disease.
Materials and methods. We are study 450 cases of ovarian apoplexy, from them 303 – retrospectively on case history of women, treated in the gynaecological department and 147, charts – prospectively patients are inspected and treated. Depending on clinical motion diseases were formed two groups: I – 175 women with a hemorragic form, II –275 women with a pain form. In all cases the anamnesis of life of patients, disease studied in detail, information objective and bimanual research. The quantitative analysis of hormones of blood was conducted by the method of electrochemiluminescence after the generally accepted methods. At a receipt in permanent establishment in 40 patients of I of group and 40 – II studied concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, progesterone, estradiol; in 1 month after an extract from permanent establishment respectively in 40 and 40 (on the 7–8th day of menstrual cycle - folliclestimulating hormone, prolactin, estradiol, on 14-15 is a luteinizing hormone, estradiol and 21-24 is progesterone, estradiol); in 12 months - in 30 and 30 (on the 7-8 day of menstrual cycle – follicle-stimulating hormone, prolactin, estradiol and 21-24 day is progesterone, estradiol). The estimation of function of ovaries (estimation of basale temperature, phenomenon of pupil, degree of tension of the cervical mucus, colpocytology) was conducted on 7–8, 14–15, 21–24 days of menstrual cycle through 3, 6, 12 months after an extract from permanent establishment in 40 women of I of group and 40 – II, in 18 months – in 30 and 30.
Results. As a result of estimation the functions of ovaries were marked, that in 3–6 months after ovarian apoplexy more than 50,0% women had an anovulatory menstrual cycle, in 12 months – 18,8%, 18 months – 8,3%. Statistically meaningful differences between the groups of I and II it was not discovered. Hormonal background of patients in 12 months after ovarian apoplexy for certain did not differ from the indexes of healthy women. Information cerebral hemodynamics on a background the conducted therapy characterized by normalization of all parameters, except for the index of pulse of blood supply, which was saved by enhanceable in the II phase of menstrual cycle at inspected both groups of disease in the fronto-mastoidal extension. The desired pregnancy came in 27,2% women, last – used protection. The relapse of disease was found out in 6 months in 2,9% inspected the II groups and in 12 months in 1,2% – I of group (in all 3,9%).
Conclusions. The conduct of two courses of the nosotropic grounded rehabilitation therapy during 12 months resulted in normalization of almost all studied indexes of cerebral hemodynamics, index of resistance of vascular resistance in before to the staggered ovary, and also proceeding in a diphasic menstrual cycle in 91,6% women and decline of frequency of relapse of ovarian
apoplexy to 3,9%.

Features of pathogeny of plural hyperplastic processes of organs of the reproductive system

Iryna Netskar — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-09
УДК 618.17/.5-002.18-092-039

The objective: to estimate the features of pathogenesis of plural hyperplastic processes of organs of the reproductive system.
Materials and methods. For the decision of the put purpose 74 women are inspected. To the basic group entered 54 patients with two and by more hyperplastic processes of organs of the reproductive system (uterine fibroids, hyperplasia and endometrial polyps, adenomyosis, external genital endometriosis, fibro-cystic mastopathia). A control group was made by 20 women from ovulatory menstrual cycle, middle duration of 28,4 ± 0,8 day. Except for clinical and echographic methods, for research to the function of ovaries determined maintenance in blood of estradiol on 5–7 day of menstrual cycle, progesterone on 20–24 days of menstrual cycle. Quantitative determination in the whey of blood of insulin-like growth factor-1 was conducted on 5– day of menstrual cycle with the use of solid-phase of immunochemiluminescent method on the automatic analyzers of Immulite and Immulite 1000, Diagnostics Products Corporation (USA). Determination in the whey of blood of epidermal growth factor, transforming growth factor-β1 and vascular endothelial growth factor conducted in both phases of menstrual cycle with the use of sets of Biosourse International, Inc. Human EGF, TGF-βl, VEGF (ELISA) Biosourselnternational (Europe S.A.) on the basis of solid-phase of enzyme-linked immunosorbent assay.
Results. In the real research was not it succeeded to get objective information, indicative on connection of increase of thyroid with content of epidermal growth factor, transforming growth factor-βl, vascular endothelial growth factor and insulin-like growth factor I in blood of the inspected women. However, the vascular endothelial growth factor which is the basic factor of angiogenesis appeared considerably enhanceable in blood of women with the plural hyperplastic processes of organs of the reproductive system, thus in reverse dependence on the level of progesterone. Similar results before in literature did not come into question and correlated with information about the increase of level of vascular endothelial growth factor for women with the polycystic ovary syndrome.
Conclusions. The level of vascular endothelial growth factor in blood of women with the plural hyperplastic processes of organs of the reproductive system (199,1 ± 20,5 pg/ml) for certain exceeds the proper index for healthy women (94,7 ± 7,0 pg/ml), here is reverse dependence of level of vascular endothelial growth factor from content of progesterone in blood. Findings must be taken into account at development of algorithm of diagnostic and treatment-andprophylactic measures.

Hormonal and metabolic predictors of recurrent endometrial hyperplasia in women of late reproductive age

Olga Gorbunova — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-10
УДК 618.14-007.61-02:616.379-008.64-07-08

Endometrial hyperplasia is one of the most common gynecologic pathologies in women of late reproductive age and is characterized by a high recurrence rate, which is associated with infertility and precancerous transformations. Hormonal and metabolic disturbances-particularly hyperestrogenism, progesterone deficiency, insulin resistance, and obesity-play a key role in the recurrence of the disease.
The objective: to determine the characteristics of hormonal and metabolic homeostasis disorders in women of late reproductive age with recurrent endometrial hyperplasia (REH).
Materials and methods. A total of 90 women aged 36–45 years were examined and divided into three groups: 60 patients with REH, 20 women with newly diagnosed non-recurrent endometrial hyperplasia, and 10 practically healthy controls. Clinical parameters (BMI, waist circumference, blood pressure), hormonal profile (FSH, LH, estradiol, progesterone, prolactin, testosterone), metabolic indicators (glucose, insulin, HOMA-IR, lipid profile), as well as histological and ultrasound findings were evaluated. Statistical analysis included the t-test, χ2 -test, ANOVA, and Pearson correlation analysis (p < 0.05).
Results. Women with REH demonstrated significantly higher BMI values (29.8 ± 4.2 kg/m2) compared with those with primary hyperplasia (27,1 ± 3,8 kg/m2, p = 0,032) and controls (23,5 ± 2,6 kg/m2, p < 0.001). Abdominal obesity (waist > 88 cm) was identified in 68,3% of REH patients versus 40,0% and 10,0% in comparison and control groups, respectively (p < 0,001). The hormonal profile showed pronounced hyperestrogenism (E2: 210 ± 56 pmol/L, p < 0.05) and progesterone deficiency (5,2 ± 1.1 nmol/L, p < 0.01). Significant metabolic abnormalities were revealed: fasting insulin (18,5 ± 5,1 μU/mL) and HOMA-IR (4,1 ± 1,3) were higher than in primary hyperplasia (p < 0.05) and controls (p < 0.001). The most pronounced dyslipidemia was observed in the REH group (triglycerides 2,1 ± 0,5 mmol/L, HDL-C 1,0 ± 0,2 mmol/L, p < 0,05). A direct correlation was found between HOMA-IR and recurrence frequency (r = 0,46; p < 0,001), estradiol levels and endometrial thickness (r = 0,37; p = 0,014), and an inverse correlation between progesterone and proliferative changes (r = –0,44; p < 0,01).
Conclusions. Recurrent endometrial hyperplasia in women of late reproductive age is associated with combined hormonal and metabolic disturbances, supporting the role of metabolic syndrome as a leading pathogenetic factor in recurrence. Optimization of management strategies must include not only hormonal therapy but also targeted correction of metabolic abnormalities.

Algorithm of prognostication and preclinical diagnostics of proliferative processes of endometrium for women different age

Yuliya Strakhovetska — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-11
УДК 618.14-031:611.64]-007.61-07-037

The objective: to develop the algorithm of prognostication and preclinical diagnostics of proliferative processes of endometrium for women different age.
Materials and methods. All patients which entered in research parted on three groups of comparison depending on character of pathology of endometrium: I a group is 138 patients with the of benigh hyperplastic processes of endometrium; The II group is 509 patients with the cancer of endometrium part on three sub-groups: IIa – 200 patients from highly differentiated adenocarcinoma; IIb – 171 sick with moderately differentiated adenocarcinoma; IIc – 138 patients with low-grade differentiated adenocarcinoma; The III group is 67 patients without pathology of endometrium. The laboratory methods of researches were included by biochemical, endocrinology and immunological indexes. For prognostication the calculation of indexes of relative risk was conducted in obedience to a method, accepted at epidemiology researches on a method «case-control». For the estimation of prognostical methods (echography, doppler, hysteroscopy) calculated and analysed the followings descriptions: sensitiveness, specificity, value of positive result which provides for, value of negative result which provides for, prognostical exactness.
Results. The got results allow to assert that most investigational by us nicotinamide adenine nucleotide phosphate-dependent enzymes suitable as markers of metabolism. Enzymatic activity, determined in peripheral blood of patients of endometrial cancer of different degree differentiation, in a substantial measure represents character of metabolic changes in tumour tissue. The pair of indexes («tissue–blood») of the most studied enzymes positively correlate between itself with the level of authenticity not less than 99%. Determination of activity of nicotinamide adenine nucleotide-dependent malate dehydrogenase will allow with the high degree of authenticity to foresee the presence of low-grade differentiated adenocarcinoma of endometrium on the preoperated stage, for the adequate planning of volume of operative treatment and conduct of subsequent ad’juvant therapy which substantially will improve the results of therapy and will reduce the indexes of death rate.
Conclusions. The results of the conducted researches allow to complement the new scientific questions of pathogenesis of proliferative processes of endometrium and offer the algorithm of prognostication and preclinical diagnostics of proliferative processes of endometrium for women different age.

Women have features of quality of life with genital endometriosis

Natalia Sukhostavets — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-12
УДК 618.1-007.415-030:303.022:314.47

The objective: to estimate quality of life for women with genital endometriosis.
Materials and methods. In research 90 patients were plugged in age from 18 to 45 years (middle age of 30,8±0,4) with external genital endometriosis. General clinical inspection was conducted all patients – studied anamnesis of disease, complaint of patients with the estimation of gynaecological status. Quality of life of patients was estimated by a general questionnaire SF-36 (Health Status Survey), and original, developed questionnaire «Quality of life of patients with external genital endometriosis».
Results. At research of quality of life for patients with external genital endometriosis, it was discovered 3 basic specific parameter of scale: pain syndrome, emotional state, infertility, achievement of one positive or negative effect of these parameters, drew an improvement or worsening of indexes of other constituents is a self-appraisal of quality of life, physical capacity, social role, which enable comprehensively to estimate the state of health of woman. Taking into account findings it is possible to offer mifepristone in clinical practice as adjuvant therapy of external genital endometriosis for the women of reproductive age, in which is even one of signs of this disease.
Conclusions. The estimation of quality of life for patients with external genital endometriosis allows to define the spheres of vital functions, which require a correction in a postoperative period and to estimate efficiency of in-use treatment.

Results of comparative analysis of dynamics clinicalandfunctional changes for women on the different stages of treatment after functionally sparing gynaecological operations

Olha Tkachenko — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-13
УДК 618.1-008-089.168.1-07-0368

The objective: to estimate the results of comparative analysis of dynamics clinical-and-functional changes for women on the different stages of treatment after functionally sparing gynaecological operations. Materials and methods. As a result of clinical-and-statistical research of primary medical document of gynaecological permanent establishment of copies information from 520 medical histories of gynaecological patients, which was executed functionally-sparing operations. A structure and dynamics of gynaecological diseases was analysed, the specific weight of organ-preserving operations was determined with the different types of accesses and volume of surgical treatment. From this group of gynaecological patients a basic group (224 women) and group of comparison (108 women), which parted on 2 sub-groups (after radical operations and after conservative therapy), was selected (with the observance of rules of statistical and clinical selection), comparable on age, by the stage and severity of disease. Plugging criteria in a basic group were women with specific gynaecological diseases (prolapsus of front and back wall of vagina II, III degree, from the elongation of cervix, cystocele and rectocele; by the uterine fibroids of different form and sizes (to 16–17 weeks pregnancy); of high quality formations of appendages of uterus and by the ovarian apoplexy for the women of reproductive period).
Results. High prognostic meaningfulness of action is set: to the choice of types of operating access; clinical diagnosis at a receipt; expressed and dynamics of clinical symptoms; personal anxiety, depression, metabolic and psycho-emotional changes; obstetric and gynaecological anamnesis; age, presence of concomitant chronic diseases; subjective estimation of health; level of the medical being informed and competence; to the timeliness and availability of clinicodiagnostic services and others like that on authenticity of changes of indexes of quality of life (on the types of functioning). In accordance with the developed algorithm of analysis of discriminant the operated women were up-diffused on the groups of the forecast changes (with the positive dynamics of indexes of quality of life; without the dynamics of indexes of quality of life; with the negative dynamics of indexes of quality of life) the made table on which it is possible with high authenticity (88,6%) to forecast efficiency of surgical treatment. The use of method of «tree of classification» allowed to estimate the degree of expressed of high-quality descriptions (diagnosis, localization, type of operating access and others like that). Presented prognostic calculations allowed to estimate grade priority of influences on efficiency of treatment with determination of the most meaningful factors (clinical diagnosis at a receipt, expressed of clinical symptoms, eyelids of women, indexes of scale of the social and hygienic functioning, presence of concomitant chronic diseases, gynaecological anamnesis, social and psychologic state, expressed of anxiety and depression, is burdened, level of the medical being informed and others).
Conclusions. More favourable and more reliable clinical and medical-and-social advantages of conduct of organ-preserving gynaecological operations are set as compared to radical operations. Analysis of efficiency of surgical treatment with conduct functionally sparing operations testifies laparoscopic access to the most favorable (as compared to other types of accesses) indexes of basic types of functioning in the structure of quality of life on all stages of medical process (to and after operations and at the estimation of remote results). At laparoscopic access the best descriptions of the physical functioning, social adaptation and capacity are marked for self-service, psycho-emotional prosperity, expressed of clinical complaints, sickly displays and total scale of quality of life.

Women, operated concerning the ovarian tumours, have features of assisted reproductive technologies

Olga Gavrish — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-14
УДК 618.11-006-089.168.1-06:618.177.886.11-039

The objective: to estimate influence of operative interferences concerning the ovarian tumours on the results of assisted reproductive technologies.
Materials and methods. From 342 patients with infertility 143 women (57,5%) had in anamnesis operative interferences on the appendages of uterus, 288 cycles in vitro fertilization - transplantation of embryos completed and made the basic group of research (group 1). Operative interferences were executed: 58 (41%) patients in anamnesis took place to the operation on ovaries; 37 (26%) patients in anamnesis took place to the operation on salpinxs; to 48 (33%) patients the united operations were conducted on ovaries and salpinxs. A basic group (group 1) parted thus: a 1А group is patients (73) which had in anamnesis operations on ovaries concerning tumor-like formations. On the basis of study of gynaecological anamnesis this group parted on 3 sub-groups. A control group (2А) was made by 106 women which appealed to the that interval of time in the separation of assisted reproductive technologies and in which during an inspection and preparation to procedure in vitro fertilization were found out different tumor like formations in one or both ovaries. The small size of cysts, duration of infertility, refuse of women, from an operation was allowed to this cohort of women to conduct the program in vitro fertilization without previous surgical treatment. This group similarly parted on 3 sub-groups. To the complex of the conducted researches were included clinical, laboratory instrumental and statistical.
Results. The real results demonstrate, that prehumulone surgical treatment of tumular formations of ovaries for patients with infertility worsens the results in vitro fertilization. Patients with operations on ovaries in anamnesis had less of follicles, oocytes at the greater amount of ampoules of exogenous gonadotropins, necessary for induction of ovulation. Low results in vitro fertilization for patients with operations in anamnesis it is possible to explain that during an operation there is an irretrievable loss of genetic (ovarian supply) ovary. Moreover, in time and after an operation, possible worsening of blood supply of ovaries, which results in diminishing of stimulation of ovaries endogenous gonadotropins.
Conclusions. Efficiency in vitro fertilization for women with infertility and operations on ovaries in anamnesis depends on quality of previous operative interference, and factors which promote authenticity of offensive of pregnancy is an adequate volume, careful technique of operative treatment, waiver of temporizing tactic and conduct in vitro fertilization after completion of surgical treatment.

Evaluation of the effectiveness of HPV genotyping in the primary screening of cervical pathology

Khrystyna Zarichanska — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-15
УДК 618.3/.7-06:618.146-006/03:618.177-089.888.11

The objective: to study the course of pregnancy, childbirth, and the condition of newborns after the use of assisted reproductive technologies (ART) in women with benign cervical pathology.
Materials and methods. A clinical analysis of the course of pregnancy in 90 women who became pregnant after ART cycles was performed. Group I (main) included 30 women with benign cervical pathology who underwent ablation treatment for benign cervical pathology before pregnancy; group II included 30 women with benign cervical pathology who did not undergo surgical intervention on the cervix before pregnancy. Group III (control) included 30 women without somatic and gynecological pathology. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistical 6.0 programs.
Results. A physiological course of pregnancy was observed in 6 (20.0%) women in the control group and in 4 (13.3%) women in group I. In group II, there were no women who had a pregnancy without complications. The most common complications of pregnancy in patients in the main group compared to the control group were: threatened miscarriage, threatened premature birth, placental dysfunction, ZRP, anemia of pregnant women, and bacterial vaginosis. In pregnant women in group I, the frequency of complications was significantly lower compared to patients in group II: threatened miscarriage in group I – 15 (50.0%), and in group II – 25 (83.3%); preeclampsia 7 (23.3%) and 11 (36.6%); bacterial vaginosis – 2 (6.6%) and 11 (36.6%), respectively. As for perinatal outcomes, pregnancies that ended in live births in group I – 29 (96.7%), in group II – 26 (86.7%), in the control group – 30 (100.0%). Physiological deliveries occurred in 19 (63.4%) patients in the control group and in 29 (52.7%) women in the main group, of which only 7 (26.9%) were in group II. The highest frequency of pathological deliveries was observed in group II – 15 (57.7%), which differed from group I and the control group. The most common indications for cesarean section in women in group I were abnormalities of labor that could not be corrected with medication – 4 (13.8%), in groups II and the control group – fetal distress 8 (30.8%) and 5 (16.7%), respectively. The most common complications encountered in the postpartum period in the examined women, both in the main and control groups, were anemia. In the main group, lochiometra in 6 (10.9%) and uterine subinvolution in 3 (5.5%) are noteworthy.
Conclusions. Women with benign cervical pathology who became pregnant through ART are at risk for miscarriage, premature birth, and placental insufficiency; they are characterized by the lowest number of pregnancies resulting in live births and a high percentage of pathological births. The lowest incidence of complications during gestation was observed in women who became pregnant after ART and in women who underwent ablative treatment for benign cervical pathology and became pregnant 1.5 years later thanks to ART, with a negative cytological conclusion regarding intraepithelial lesions. The research was conducted according to principles of Declaration of Helsinkі. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research.

Prognostication of role of husband is in gestation

Andrey Shchedrov — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-16
УДК 618.2/.3:159.942:616-055.1:316.663

The objective: to develop the algorithm of prognostication of role of husband in gestation.
Materials and methods. We are conduct instantaneous transversal research which includes complex clinical-and-laboratory inspection 72 matrimonial pair with miscarriage of pregnancy in anamnesis (basic group). The group of comparison was presented 22 by matrimonial pair which became the parents of healthy children for period covered without the burdened reproductive anamnesis. With the purpose of decision of purpose of prognostication of involuntary abortion taking into account a masculine factor on the basis of the got results by us three analyses of discriminants were conducted: two step-by-step and one with the forced including of information. For development of mathematical model spermatic factors were used and clinical-and-anamnestic information husbands. The first analysis of discriminant is conducted step-by-step with the complete including of indexes of spermogram and spermatic glycodelinа, which one predictor of involuntary abortion is selected as a result of – spermatic glycodelin.
Results. As a result of estimation of informing of the got model it is calculated that 90,9% the initially grouped supervisions classified correctly. A model sensitiveness is evened 85,7%, and specificity – 100%. This model has the greatest among three the presented sensitiveness and specificity. Thus, with the use of analysis of discriminant 3 equalizations are modelled functions of discriminant, which have a high enough sensitiveness and specificity and own good statistically meaningful dividing ability.
Conclusions. In all three functions of discriminants as predictor of masculine factor of miscarriage to pregnancy present of spermatic glycodelin. The offered models are simple in the use in clinical activity and own a high enough sensitiveness and specificity.

A rehabilitation of women is after ectopic pregnancy

Petro Patiei — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-17
УДК 618.31-06-036.82

The objective: to develop and inculcate the complex of rehabilitation measures for women after ectopic pregnancy taking into account the features of psychosomatic status.
Materials and methods. For the decision of the put purpose was conducted clinical-andstatistical analysis of indexes complex clinical-and-laboratory inspection, surgical treatment and rehabilitation period in 165 patients, who were undergoing operative treatment concerning ectopic pregnancy. The division of contingent of patients with was conducted 2 groups: 1 group – operated laparoscopically (96 women) and 2 groups – operated laparotomically (69 women). The complex estimation of the state of women with ectopic pregnancy was conducted in gynaecological permanent establishment to and after to the operation, and also in a rehabilitation period. The criterion of authenticity of diagnosis was a complete surgical diagnosis and him morphological confirmation. A supervision and inspection of patients was carried out during 3 after surgical interference concerning ectopic pregnancy with the analysis of remote results of treatment. By the criterion of efficiency of measures which are conducted, in a rehabilitation period there was the state of sexual sphere of women and them reproductive function. Age of the inspected patients hesitated from 16 to 44 years, on the average – 29,8 ± 2,2 year. For patients the extrasomatic was studied and obstetric gynaecological anamnesis, a complete clinical inspection was conducted by the generally accepted methods, that included estimation of general somatic and gynaecological status. For the estimation of psychological status of patients methods were used: 1) clinical conversation; 2) tests STAI on determination of the personal and reactive anxiety; 3) method of diagnostics of self appraisal of mental conditions; 4) adapted variant of test of MMPI; 5) consultation of clinical psychologist.
Results. An uterogestation comes for patients, which are operated concerning ectopic pregnancy laparoscopically in 1,7 times more frequent than for patients which are operated concerning ectopic pregnancy of laparotomically. Infertility comes for patients, which are operated concerning ectopic pregnancy laparoscopically in 2,2 times rarer than for patients which are operated concerning ectopic pregnancy of laparotomically. The got results specify on circumstance that operative interference by laparotomy is frequently accompanied by strengthening of violations of menstrual cycle for gynaecological patients, while after interferences laparoscopically a correction appears toward normalization of menstrual cycle in parts of patients. Adding up of findings, allowed to develop and inculcate in practice the algorithms of diagnostics, choice of method of operative interference and program of postoperative rehabilitation.
Conclusions. In the period of rehabilitation after the carried operative treatment of tubal pregnancy favourable psychological adaptation takes place in 65,0% women, in 35,0% is pathological psychological adaptation. Normalization of menstrual and fertile functions more effective takes place for women which carried an operation laparoscopic access. The use of psychological support of women in the period of rehabilitation is instrumental in greater optimization of menstrual (70,0% and 53,8%) and fertile (60,0% and 30,8%) function of patients of both groups (by laparoscopic access and laparotomic access respectively).

Features of forming of intestinal microflora clinical displays of dysbiosis of intestine for children, bear in natural way and by a way caesarean section

Andrey Prishchepa — 2025-12-20

DOI: 10.52705/2788-6190-2025-4-18
УДК 618.4+618.5-089.888.61-06:616.34-008.87-053.31-08-039

The objective: to estimate the features of forming of intestinal microflora clinical displays of dysbiosis of intestine for children, bear in natural way and by a way caesarean section.
Materials and methods. We analysed clinical symptoms of dysbiosis of intestine in 77 children, bear a way caesarean section, and 72 children, bear in natural way. In addition, we are conduct a bacteriological inspection 72 pair mother-child concerning the clinically expressed forms of dysbiosis for children. To the complex of the conducted researches were included clinical, microbiological, virologic, biochemical and statistical.
Results. Dysbiosis of colon found out for mothers in 76,3%, to the pharynx – in 77,8%, nose – in 55,6% cases. Microecological violations for women, mainly, appeared on a background the chronic diseases of organs of digestion (47,2%) and chronic festering inflammatory processes of different localization: chronic tonsillitis (16,2%), furunculosis (5,6%), disease of the urinary system (20,8%) and others. In 47,2% cases to the mother produced complaint about dysfunction of intestine, mainly in form locks. For every second woman looked after the deficit of indigenous bacteria (mainly bifidobacteria and normal E.Coli), and in 40,3% cases of mother were colonized conditionally pathogenic microflora (S.aureus, Candida sрp. and Clostridium spр.). At comparison of microbal maps of feces of mother and child in any pair it is not discovered complete accordance of composition of intestinal microflora. In 15,3% cases in mothers and child in feces found out identical kinds conditionally pathogenic microflora (S. aureus, Clostridium of difficile, E. coli Hly+). It is discovered that for children, which are reared by mothers which have a deficit of bifidobacteria, – at 2,2 time (RR = 2,2 [95% confidence interval (СI) 1,5; 2,99]), enterococcus – at 3,4 time (RR = 3,4 [95% CI 1,1; 13,2]), lactobacilli at 6,2 time (RR = 6,2 [95% СI 1,8; 20,8]) to have a greater risk a mionectic level of population of these microorganisms, what for children, whose mothers have normal level of population of indigenous flora. It was also discovered that for children which are reared by mothers, colonized S.aureus, at 1,6 time anymore risk of infecting of intestine by this microorganism, what for children, whosesoever mothers are the transmitters of staphylococcus in an intestine (RR = 1,6 [95% СI 1,2; 1,7]). From the different variants of violation of microflora of colon the deficit of bifidoflora and colonization of colon has a high prognostical value of positive result in mothers S.aureus. Authenticity of development of analogical changes of composition of intestinal microflora for a child in the period of the pectoral rearing is 77,8 92,4%.
Conclusions. For children, bear a way caesarean section, characteristic protracted forming of intestinal microflora. In age 2–3 years only in these 25,8% cases children have composition, proper to the generally accepted norm. To 2-years-old age for certain more frequent than for children, bear in natural way, for them mionectic amount of bifidobacteria (42–53,8%) and lactobacilli (17,4– 27,4%), and also associations (31,8–72,5%) and persistence appear conditionally pathogenic microorganisms. To put, bear a way caesarean section, have more expressed clinical symptoms of dysbiosis of intestine and greater risk of development in early age of chronic enterocolitis (RR = 1,5), atopic dermatitis (RR = 2,2), candidosis (RR = 3,4), iron-deficiency anaemia (RR = 2,02), syndrome of neutropenia (RR = 2,9), frequent respirator infections (RR = 2,7), what to put, bear in natural way.