Perinatology and reproductology: from research to practice

Obstetric consequences of delivery of women are after assisted reproductive technologies

Olga Kitsаk — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-01
UDC 618.5-059:618.177-089.888.11

The objective: to learn influence of assisted reproductive technologies (ART) on the obstetric
results of delivery.
Materials and methods. Retrospective research in which 100 women were plugged with single
fetation (1 group) and 50 was conducted, – with a multifetation after assisted reproductive
technologies (2 groups).
Results. Basic obstetric complications in a 1 trimester of pregnancy were: removing layer by layer
of chorion in 22% at single fetation and 38% at a multifetation; the syndrome of overstimulation
of ovaries took place in 5% women of a 1 group and 10% – in 2 groups; the involuntary breaking
of pregnancy in a 1 trimester is marked in 9 (9%) patients with a single fetation and in 6 (12%) –
with multifetation; principal reasons of the involuntary breaking of one pregnancy was pregnancy
which does not develop – (5 from 9) and anembryony (4 from 9).
Conclusions. Pregnancy for women after ART is characterized by high-frequency of obstetric
complications, thus in all trimesters of pregnancy. At the estimation of frequency of different
complications it should be noted higher level at a multifetation as compared to single fetation.
By basic complication women after ART regardless of number of fetuses have miscarriage and
premature births. The got results testify to the necessity of improvement of algorithm of diagnostic
and treatment-and-prophylactic measures.

Perinatal aspects are at the intrauterine infection

Andrey Prishchepa — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-02
UDC 618.3-07-08-06:618.33-022:618.36-008.6

The objective: а decline of frequency of perinatal pathology is at the intrauterine infection of fetus
on the basis of study of features of the functional state of fetoplacental complex, system immunity
and microbiocenosis of sexual ways and intestine, and also development and introduction of
complex of treatment-and-prophylactic measures.
Materials and methods. By us 150 patients were inspected, among what 100 pregnant with
the intrauterine infection, which were up-diffused on such groups: 1 group – 50 pregnant which
got the generally accepted treatment-and-prophylactic measures; 2 group – 50 pregnant which
got the method offered by us. A control group was made 50 pregnant which gave birth for the
first time, without obstetric and somatic pathology, delivered through natural maternity ways.
In the complex of methods of researches were included clinical, instrumental, microbiological,
immunological and statistical.
Results. The use of the treatment-and-prophylactic measures, directed on the correction of
hormone-synthesizing function of placenta, state of system and local immunity improvement of
uteroplacental circulation of blood for pregnant at the intrauterine infection, offered by us was
instrumental in activating of structural mechanisms of adaptation of placenta, to the maintainance
of morphometric and diffusive indexes of villiferous tree at the level of proof indemnification which
is a major adaptive mean for support of viability of fetus and prevention of his infection. It allowed
to reduce frequency caesar section at 2,3 time, premature break of fetus shells at 3,6 time,
placenta disfunction at 1,9 time, delays of growth of fetus at 1,7 time, fetal distress in 4,5 times,
realization of the intraamnial infection at 3,7 time.
Conclusions. The results of the conducted researches testify to the necessity to all pregnant at
the intrauterine infection ultrasonic research it is required to conduct in 24-26 week to pregnancy
for by determination of localization and thickness of placenta, it echostructure, to the degree of
maturity and Doppler research of the crooked speeds of circulation of blood in uterine arteries
and vessels of umbilical cord, in a venous channel for early diagnostics of placenta disfunction of
infectious genesis.
For the prophylaxis of obstetric and perinatal complications for pregnant it is necessary to use
additionally to the generally accepted recommendations of tivortin, chophytol or essentiale in the
generally accepted dosages by courses for 14–21 days in the followings terms of pregnancy:
18–20; 28–30 and 36–38 weeks pregnancy. With the purpose of control after efficiency of the
conducted treatment-and-prophylactic measures, except for the functional methods of research,
from 22 weeks of pregnancy it is necessary to determine in the whey of blood a level placenta
lactogen, estriol and progesterone, and also and the state of microbiocenosis of sexual ways and
intestine, as markers of efficiency of the conducted therapy.

Influence of hysterectomy is on the functional state of ovaries

Vladyslavа Klimova — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-04
УДК 618.1-071:616.35-018

The objective: to learn the clinical aspects of posthysterectomy syndrome, and also anatomicalfunctional
to the state of ovaries for the women of perimenopausal period.
Materials and methods. By us 150 women of perimenopausal period, middle age of which
made 46,9±1,1 years, were inspected. To 120 women with different gynaecological diseases
was mine-out hysterectomy, thus a 1 clinical group was made by 60 patients which was executed
hysterectomy without appendages; 60 patients after hysterectomy with appendages were 2 clinical
group, and in the group of control 30 women entered without operative treatment in anamnesis.
Results. Ultrasonic research allowed to learn a structure and sizes of ovaries for the inspected
patients. Thus, in an early postoperative period the volume of ovaries as compared to preoperated
was increased on 60% in A to the sub-group and on 70% in the sub-group of B. Wherein, the
change of volume of ovaries took place due to diminishing of number and sizes of follicles and
increase hereupon of homogenity of ovaries.
The similar structure of ovaries, presumably, foresaw diminishing of steroidogenesis, what the
results of the conducted endocrinology researches testify to. Such increase of volumes of ovaries,
probably, arises up as a result of one bandaging of basic sources of blood supply of ovaries,
which results in oppression of regional hemodynamics, development of ischemia to the edema
of ovaries. Possibly, exactly this process results in the decline of steroidogenesis in ovaries and
development of posthysterectomy syndrome in the first 10 days after an operation.
Conclusions. Frequency of origin and degree of severity of posthysterectomy syndrome for the
women of perimenopausal period has direct cross-correlation dependence on general-somatic
status (presence two and more extragenital diseases, including endocrine-dependent pathologies)
and volume of operative interference.
Hysterectomy results in the substantial changes of anatomic descriptions of ovaries which
remained, expressed in the increase of volume, decline of echogenicity and disappearance of
ordinary «ultrasonic» structure of ovaries, that blood supply of ovaries related to violation is during
an operation. Spontaneous renewal of volume of the operated ovaries originates from 9 to 12
months after surgical treatment. The got results it must draw on at development of complex of
rehabilitation measures.

Gynaecological patients have a role of echographic researches in diagnostics of postoperative complications

Valery Kostikov — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-05
UDC 618.12-007.274:534-8:616-089

The objective: to estimate the diagnostic value of ultrasonic research in diagnostics of
postoperative complications for gynaecological patients.
Materials and methods. The analysis of results of ultrasonic inspection is conducted 90
patients which acted for endoscopic operative treatment and have had previous surgeries on
the organs of abdominal region and small pelvis. Echographic research consisted of two stages:
transabdominal and transvaginal, which was conducted on a certain chart. The area of skin
postoperative scars was aiming estimated, projection on the front abdominal wall of cut of parietal
peritoneum during previous operations and periomphalic area. A few special tests were used:
traction and compression test.
Results. Most informing with the purpose of diagnostics of complications are the followings
echographic signs: local bulge of parietal peritoneum with strengthening of echo-signal, presence
of educations with a liquid in a small pelvis, unconnected with an ovary, positive traction and
compression tests. The results of echographic researches fully coincided with information of
clinical inspections during the repeated surgical treatment.
Conclusion. Echographic research is the informing method of diagnostics of complications (to
the adhesive process) in an abdominal region and small pelvis and location for the first trocar
during laparoscopic operations.

Optimization of treatment of recurrent diseases of servix is on the stage of pregravid preparation

Iryna Kostiuk — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-06
УДК 618.146-08

The objective: to promote efficiency of treatment of recurrent background diseases of servix on
the basis of study of basic clinical-and-functional, biochemical, immunological and microbiological
changes, and also improvement of algorithm of treatment-and-prophylactic measures.
Materials and methods. By us it was conducted complex clinical-and-functional and laboratory
inspection 120 women in age 20–40 from recurrent background diseases of servix: ectopia of
servix, leukoplakia and papilloma servix, which developed on a background a urogenital infection.
All patients were up-diffused on four groups depending on in-use medical measures. Were used
clinical, instrumental, microbiological, immunological, cytological and statistical.
Results. For patients with the recurrent background diseases of servix a disbalance is marked
from the side of cellular and humoral immunity, and also decompensated changes of the functional
state of phagocytosis and cytokine status. To our opinion it is conditioned by negative influence
of chronic urogenital infection which is confirmed by high-frequency of semination of sexual ways
pathogenic and de bene esse pathogenic by a microflora.
The got results are a ground for the conducting of specific preparation with the obligatory use
of immunocorrection and sanation of sexual ways. The decision of clinical signs of disease for
all inspected patients was observed during 2–4 weeks from the beginning of treatment and
accompanied by normalization of picture of strokes of scraping material from an urethra, vagina,
cervical channel: diminishing of number of leucocytes, amount of mucus, disappearance of
yeast mycelium, diminishing of number of cocci, shallow sticks, appearance of large number of
lactobacterium. Elimination of pathogenic agent which is set on the basis of polymerase chain
reaction was attained for almost all patients, plugged in an inspection during 6 weeks after the
beginning of treatment which testifies to efficiency of the individually conducted treatment.
Conclusions. The use of the offered algorithm of treatment-and-prophylactic measures
for patients with the recurrent background diseases of servix promotes the less expressed
inflammatory reaction of surrounding tissue, to reduction of term of wound healing, formation of
thin and barely visible scar, complete epitelialization of defect already to the fifth days, to minimum
necrosis of tissue, poorly expressive inflammatory reaction and development of granulation tissue
complete epitelialization of wound in 7–10 days.
The remote results of the offered algorithm of treatment-and-prophylactic measures (to 1 year)
testify to absence of anomalous colposcopic picture, minimum relapse (1 case) at simultaneous
normalization of microbiocenosis of sexual ways and local immunity. It allows to recommend this
method for the wide use in a practical health protection.

Women have medicalandsocial and dermatological aspects with a premenstrual syndrome

Myroslava Kosyuta — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-07
UDC 618.17-008.8-036.4-058

The objective: women have a study of medical-and-social and dermatological features with the
syndrome of premenstrual tension (SPMT).
Materials and methods. For determination clinical-pathogenetic variants of SPMT 2 groups of
inspected were selected: 100 patients with the SPMT (basic group) and 50 practically healthy
women which had menstruations (control group). Women which entered in a basic group had
different displays of SPMT. By us 20 basic symptoms of SPMT were selected, each of which was
estimated in bulk-tankers from 0 to 3.
Results. Research of social status of women rotined with the SPMT, that a most percent was occupied
by housewifes 39,0% in basic and 36,0% in a control group; 25,0% were such which serve,
from them 24,0% in basic and 26,0% in a control group; 18,0% worked on industrial enterprises;
4,0% women were the workwomen of agriculture and the 14,0% inspected was such which study.
The estimation of domestic status also did not find out reliable differences in groups which was
studied. There were most women of both basic (43,0%) and control group in the first registered
marriage (42,0%). Almost fourth of women, both in a basic and in control group were not married
(25,0% and 28,0% respectively); 18,0% inspected tendon in civil marriage. The last patients were
in the second registered marriage (12,0%). Substantial differences according to the domestic
regulations for the women of basic and control group discovered it was not. At the same time interestingly
to mark that the more than half (51,0%) of women of basic group estimates mutual relations
in families as «bad» or difficult to estimate them, and in the control group of such women was
reliable less than (20,0%; р<0,001). Frequency of dermatological diseases (acne) was 30,0%.
Conclusions. The results of the conducted researches testify to the substantial role of medicaland-
social factors and dermatological diseases for patients with the SPMT. It must be taken into
account at development of complex of diagnostic and treatment-and-prophylactic measures.

Hyperplastic processes of endometrium: clinic of different forms early in life

Olga Leshchova — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-08
UDC 618.14-002-007.6-039:611.664

The objective: to set the clinical features of different forms of hyperplastic processes of endometrium
for the women of young age taking into account the role of chronic endometritis.
Materials and methods. It was conducted clinical-and-laboratory inspection 100 patients to
30 years with the uterine bleeding of different character and presence of echographic signs
of pathology of endometrium.
Results. The analysis of the got data testifies that more frequent all gynaecological diseases
met for patients with simple hyperplasia of endometrium without atypia in combination
with chronic endometritis and women with chronic endometritis and reactive hyperplasia is
of high quality pathology of servix (80,0% and 75,0% respectively), violation of menstrual
cycle (90,0% and 75,0%), urogenital infection (85,0% and 95,0%). In addition, in these
groups of supervisions the most of cases is marked verified earlier chronic endometritis –
10,0% and 20,0%.
Conclusions. For the patients of young age with combination of hyperplasia of endometrium and
chronic endometritis and with reactive hyperplasia, as compared to hyperplasia without atypia
and with atypia, more early beginning and expressed of clinical symptoms of disease, duration
of which exceeds 2 years, is marked. For women from an outage and difficult typical and atypia
hyperplasia connection between the morphological variant of pathological process and pathognomonic
clinical no symptoms.
In the structure of concomitant diseases for patients the inflammatory processes of organs of
small pelvis prevail (as compared to hyperplasia without atypia and with atypia) with the presence
of chronic endometritis, the of high quality diseases of servix, hyperplastic processes of
endometrium which testifies to the expressed system character of pathology. The got results must
be taken into account at development of algorithm of diagnostic and treatment-and-prophylactic
measures for women with the hyperplastic processes of endometrium, including, and on a background
chronic endometritis.

Comparative aspects of different methods surgical treatment of the combined pathology of uterus

Iryna Netskar — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-09
UDC 618.14-006+618.14-007.415]-089

The objective: to learn the comparative aspects of different methods of surgical treatment of the
combined pathology of uterus.
Materials and methods. 362 women are plugged in research, that has signs of adenomyosis
and uterine fibroids. To the operation the followings symptoms served certificates: subjective
complaints of patient about a pain syndrome, irregular bloody protracted excretions (bleeding)
from sexual ways, abdominal discomfort, related to disfunction of nearby with an uterus organs.
At laboratory control to the basic certificates the presence of protracted chronic anemization
served to operative interference, to the uncomplying pharmacological correction. In an obligatory
order to all patients ultrasonic research of organs of small pelvis was conducted with the coloured
Doppler lodging of uterine vessels.
Results. It is discovered that increase of volume of organ which retires, the risk of damage of
urinoexcretory ways increases time of operation laparoscopic access (р<0,05). The use of vaginal
access is increased by the risk of forming of dispaurenia for patients with the large organ size
which retires, and at the increase of time of operation (р<0,05) which can be constrained from
traumatisation tissue at the oncotomy of large size and greater blood loss at lengthening of time
of operation.
Consequently, there are grounds to draw conclusion about the necessity of bringing of limitations
of the use of littleinvasion accesses at the large size of tumour of uterus. At the sizes of tumour
more than 14 weeks, in behalf of patient it is expedient to use transabdominal access in order to
avoid heavy intraoperative complications, bleeding and negative symptoms in a late postoperative
period, related to forming of proof pain syndrome and forming of dispaurenia.
Conclusions. The results of the conducted researches testify to the necessity of the use of
the differentiated going near the use of different methods of surgical treatment (abdominal,
laparoscopic and vaginal) for patients with combination of uterine fibroids and endometriosis.
Rational use of modern methods of operative treatment taking into account age of patients, sizes
of tumour, presence of concomitant extragenital pathology and others like that will allow to reduce
frequency of early and late postoperative complications, and also instrumental in more rapid
renewal of patients.

Modern aspects of polycystic ovary syndrome

Olha Pritulyak — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-10
UDC 618.11-006.2-008.6-053.6-07-08-035

The objective: The girls of pubertal period have an increase of efficiency of treatment of polycystic
ovary syndrome (PCOS) on the basis of study of clinical and echographic and endocrinology
features, and also improvement of algorithm of diagnostic and treatment-and-prophylactic
measures.
Materials and methods. It is conducted clinical-and-laboratory and functional inspection 160
girls of pubertal period, from what 140 were with PCOS. 80 girls were got by the different method (hormonal and unhormonal) of treatment. 20 girls without pathology of ovaries made a control
group. Research methods: clinical, endocrinology, biochemical, morphological, instrumental and
statistical.
Results. For teenagers with PCOS of the use of hormonal correction in the mode 63/7 appeared
effective in 87,5 cases and accompanied by the meaningful braking of the pituitary-ovarian system
diminishing of volume of ovaries (р≤0,01), that at 1,4 time increases the chance of proceeding
in the rhythm of menstruations after abolition of treatment as compared to the mode of the use in
a 21/7 mode (RR=1,4; 95% CI: 1,1–2,1, p=0,05).
The use of hormonal correction in 4 times more frequent causes the proof adjusting of rhythm of
menstruations for girls at the exposure of mixed-caliber type of structure of ovaries as compared
to equal caliber.
The prognostic criteria of efficiency of the use of hormonal correction for teenagers with PCOS
is: diminishing of volume of ovaries to ≤10 cm3, decline of luteinizing hormone ≤1 IU/l, increase of
level of testosteron-estradiol binding globulin ˃81 pmol/l.
Conclusions. Findings allowed scientifically to ground the necessity of improvement of algorithm
of diagnostic and treatment-and-prophylactic measures for girls with PCOS in a pubertal period.
The algorithm of diagnostic and treatment-and-prophylactic measures is improved and inculcated
for the girls of pubertal period with PCOS, which gives a right to recommend him in a practical
health protection to us.

Echographic markers of combined pathology of uterus for women reproductive age

Serhij Sendetskiy — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-11
UDC 618.14-007.61-007.415-002.18:611.664]-073.43-055.2-053.84

The objective: the women of reproductive age have a study of echographic features of the united
pathology of uterus.
Materials and methods. Were inspected 153 patients from adenomyosis in combination with the
pathological processes of endometrium. The set clinical diagnosis of adenomyosis appeared the
criterion of selection on the basis of careful analysis clinical-and-anamnestic, instrumental-diagnostic
and morphological information. In the cases when after complex clinical-and-instrumental
and histological inspection the clinical diagnosis of adenomyosis caused doubts, this fact was the
criterion of exception. Fact of combination of adenomyosis with the leiomyoma of uterus by sizes
15 and more than weeks also was pregnancy the criterion of exception. Research echographic
we applied as a screening instrumental method in diagnostics of adenomyosis for all inspected
patients.
Results. During the leadthrough of echography, taking into account development of adenomyosis
at the invasion of endometrium from a basale layer in a myometrium, and also taking
into account the structural changes adjoining to endometrium areas of myometrium verified at
morphology, the special attention was spared to the scan-out of the so-called «bordeline» area.
The followings signs of echo appear during the detailed visualization of this area: an unclear
limit is between a myometrium and endometrium; uneven bulge of «bordeline» area; a heterogeneous
structure of limit is a «endometrium- myometrium», where the hyperechoic including
appear as shallow, more frequent than the rounded or linear structures. Bulge of back wall at
adenomyosis, that is registered at ultrasonic research, it was marked in 68,2% cases, front wall
– 32,4%, areas of bottom – 28,3%. Adenomyosis for all patients was diffuse. Adenomyosis of
2 degrees found out in a 1 group in 47,5%, in 2 groups – in 39,3%, in 3 groups – in 23,9%, and
in 4 groups in 10,3% patients; adenomyosis of 3 degrees – in 52,5%, 61,1%, 76,1% and 90,2%
patients respectively.
Conclusions. Research echographic, especially with the use of coloured Doppler mapping, matters
very much in diagnostics of the united forms of adenomyosis and hyperplastic processes
of endometrium. Correct interpretation of the got echographic results at this united pathology
allows to develop rational tactic of conduct of such patients and conduct the adequate monitoring
of medical process. The got results must be taken into account at development of algorithm of
diagnostic and treatment-and-prophylactic measures.

A role of chronic endometritis is in development of different forms of hyperplastic processes of endometrium

Yuliya Strakhovetska — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-12
UDC 618.14-002-007.6-039:611.664

The objective: to set the clinical features of different forms of hyperplastic processes of
endometrium for women in a perimenopausal period taking into account the role of chronic
endometritis.
Materials and methods. It is conducted clinical-and-laboratory inspection 100 patients with
the uterine bleeding of different character and presence of echographic signs of pathology of
endometrium. After an inspection which included clinical-and-laboratory and echographic
methods, the separate diagnostic scraping off of uterus was conducted all patients under control
hysteroscopy.
Depending on the results of histological research of scraping of the cervical canal and cavity of uterus
complex immunohistochemical research after which five basic groups were formed for 20 patients
in each was conducted: 1 group – women with simple hyperplasia of endometrium without atypia,
2 groups – complex hyperplasia of endometrium without atypia, 3 groups are hyperplasia of atypia,
4 groups are patients from hyperplastic processes of endometrium in combination with chronic
endometritis, 5 group – women with chronic endometritis and reactive hyperplasia of endometrium.
Results. For patients with combination of hyperplasia of endometrium and chronic endometritis
and with reactive hyperplasia, as compared to hyperplasia without atypia and with atypia, more
early beginning and expressed of clinical symptoms of disease, duration of which exceeds 2 years,
is marked. For women from an outage and difficult typical and atypical hyperplasia connection
between the morphological variant of pathological process and pathognomonic clinical symptoms
stop out. In the structure of concomitant diseases for patients the inflammatory processes of
organs of small pelvis prevail (as compared to hyperplasia without atypia and with atypia) with the
presence of chronic endometritis, the of high quality diseases ofservix, hyperplastic processes of
endometrium which testifies to the expressed system character of pathology.
Conclusions. The got results must be taken into account at development of algorithm of
diagnostic and treatment-and-prophylactic measures for women with the hyperplastic processes
of endometrium, including, and on a background chronic endometritis.

A role of age of patients is in the estimation of efficiency of assisted reproductive technologies at the combined forms of infertility

Igor Mikievich — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-14
UDC 618.17-02:618.177-089.888.11

The objective: to learn the role of age of women and men in the estimation of efficiency of
assisted reproductive technologies (ART) at the combined forms of infertility.
Materials and methods. 70 matrimonial pair of reproductive age, which made the followings groups, were
inspected: basic (n=30), comparison (n=30) and control (n=10). In the complex of the conducted researches
were included clinical, echographic, endocrinology, morphological, statistical and immunological which included
determination of level of cytokines in a follicle liquid the method of the multipxleed analysis of albumens.
Results. Findings testify that strengthening of secretion in the ovary of прозапальних cytokines can
be one of mechanisms of unfavorable influence of stimulation of ovaries of gonadotropin on an oocyte.
It is presently foreseen that stimulation of ovaries, its modes influence on «quality» of oocyte,
potency of him to the impregnation and rates of early development of embryo. A negative role
high concentrations can play in blood of estradiol, and also pharmacological preparations, which
are used during stimulation of ovaries (gonadotropins, agonists and antagonists of gonadotropinreleasing
hormone), and also eyelids of patients.
The got results were confirmed by present fundamental pictures that co-operation between an
oocyte and somatic cages of ovary is critical for normal motion of oogenesis, impregnation and
early development of embryo, especially for the patients of older age.
Conclusions. To informing clinical-and-anamnestic and hormonal factors which determine the result of cycle
of ART for the patients of reproductive age with the combined forms of infertility, take: age of sick; index of
mass of body; presence pipe peritoneal factor of infertility; a level of free testosterone is in blood; a table of
contents of progesterone is in blood on 20–22 days of menstrual cycle, and also determination in the follicle
liquid of ovaries of cytokines. By us the rotined role of age of patients in the estimation of feicfiency of ART.

Modern aspects of the functional state of fetoplacental complex for women with infertility in anamnesis

Andrey Shchedrov — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-15
UDC 618.3/.36-008.6:618.177-071.1

The objective: to set the modern aspects of the functional state of fetoplacental complex for
women with infertility in anamnesis.
Materials and methods. A complex inspection is conducted 100 pregnant after assisted
reproductive technologies and them new-born (basic group). The group of comparison was made
by 50 women of analogical age, in which pregnancy came in natural way. In the complex of
the conducted researches were included clinical, echographic, doppler, cardiotocographic and
endocrinology.
Results. From complications of III trimester of pregnancy placenta disfunction which had statistically
reliable differences and was 62,0% in a basic group appeared major. It can be conditioned by that
development of the induced pregnancy in the conditions of primary placenta disfunction results in
violation of outflow of blood from a placenta, to the insufficient entering of blood into intervillous
spaces as a result of peripheral crampy, endotheliosis and thrombosis of vessels. The delay of
growth of fetus (27,0%) and fetal distress appeared the clinical displays of placenta disfunction
(24,0%). Preeclampsia of mild and moderate severity developed in 49,0% in a basic group. In
addition, in a III trimester there was pathology of amount of amniotic fluid in the same group, so
the oligohydroamnios is fixed in 18,0%, and a polihydroamnios is in 10,0% patients.
Conclusions. Testifies the results of the conducted researches to high-frequency of development
of placenta disfunction for women which became pregnant with the use of assisted reproductive
technologies. The got results testify to the necessity of development of algorithm of diagnostic and
treatment-and-prophylactic measures with a purpose to the improvement of perinatal results of delivery.

Modern aspects of early diagnostics of violations in the system motherplacentafetus

Olena Susidko — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-03
UDC 618.36-008.64-07-08

The objective: to develop the modern method of early diagnostics of heavy forms of placenta
disfunction.
Materials and methods. For realization put purpose, taking into account the developed
prognostic scale of heavy forms of placenta disfunction, there was the formed group of
supervision, which consists of 100 expectant mothers which in the terms of 18-24 weeks and
28-38 weeks gestation the conducted determination in blood of content of markers of endothelial
disfunction. Taking into account clinical motion of pregnancy, from 100 women two groups of
comparison were formed: I a group was made by 50 women with placenta disfunction; II group
– 50 women with placenta disfunction in combination with preeclampsia and by extragenital
pathology. A control group (III group) was made 30 healthy expectant mothers. In the II group
of comparison of preeclampsia diagnosed in 100% supervisions (mild severity – in 88,0%
pregnant and moderate severity – in 12,0%).
Results. The got results allowed nosotropic to ground including of the developed criteria of
placenta disfunction and degree of severity, together with an ultrasonic constituent, in the
diagnostic of this complication of pregnancy program with the purpose of increase of its
exactness. Results of early diagnostics of placenta disfunction and estimation of degree of
severity during pregnancy, based on the laboratory and ultrasonic testing (modified scale), in
comparison with the histological verified diagnosis rotined that placenta disfunction correctly
diagnosed in 91% supervisions, uncoincidences was 9%. The analysis of coincidence of clinical
and histological diagnoses at the heavy forms of placenta disfunction rotined an increase to
exactness of diagnostics at the use of the modified scale on 39,5% as compared to the use of
scale, based only on echographic criteria.
Conclusions. The results of the conducted researches testify that the clinical algorithm of
conduct of expectant mothers of risk group developed on the basis of evaluation diagnostic
scale (ultrasonic and laboratory testing) is promoted by exactness of diagnostics of placenta
disfunction on 26,1%, it heavy forms on 39,5%, instrumental in the choice of adequate obstetric
tactic, to the improvement of perinatal results at the heavy forms of placenta disfunction on
60%. The got results allow to recommend the method of early diagnostics of heavy forms of
placenta disfunction in a practical health protection.

Hysteroscopic estimation of the repeated combined pathology of uterus

Galina Tolstanova — 2024-04-10

DOI: 10.52705/2788-6190-2024-01-13
UDC 618.14-072-06:618.173

The objective: to conduct the hysteroscopic estimation of the repeated combined pathology of uterus.
Materials and methods. For the decision of the put purpose we were add to the retrospective
analysis of hospital chart 128 women and to the prospective study a 171 patient with bleeding
in a postmenopausal period. Among the retrospectively studied patients the selected group of
comparison which consists of a 61 woman with the repeated combined pathology of uterus in a
postmenopausal period (for comparison of methods of treatment of this contingent).
Results. It is set that most authenticity of diagnostics of the combined pathology of uterus for the
patients of postmenopausal age (97,3%) it was succeeded to attain the successive use these
methods, while each of them separately could give diagnostic errors. Considerable part of coincidences
of clinical and morphological diagnosis appeared confirmation of high diagnostic value
of similar algorithm for the operated patients. In addition, to the algorithm of inspection of patients
of this group, taking into account indisputable synchronicity of development of proliferative processes of sexual sphere of woman, it is necessary to include the adequate endoscopic inspection
of endocervix and exocervix.
Conclusions. Testifies the results of the conducted researches to the high degree of informing
of hysteroscopic estimation of the repeated combined pathology of uterus for the women of postmenopausal
period. The set features must be taken into account at development of algorithm of
diagnostic and treatment-and-prophylactic measures for these patients.