Perinatology and reproductology: from research to practice

Early echographic criteria of risk of premature births are at multiple pregnancy

Ievgen Ignatenko — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-01
УДК 618.3/.5-008.6:618.177-036.1

The objective: to develop the early ехографічні criteria of risk of premature births at multiple pregnancy.
Materials and methods. Work is based on the analysis of results of pregnancy in 207 pregnant with twins, from what 137 observed with the use of the developed algorithm and 70 on a standard method, accepted for a singleton pregnanacy. The term of pregnancy was determined from the first day of the last menstruation, taking into account information of bimanual research in women’s
consultation and ultrasonic research in the early terms of pregnancy. Depending on character of choriality were selected 2 basic groups: «dichorionic diamniotic twins» – 146 women and «monochorionic diamniotic twins» is a 61 woman. Choriality was set at ultrasonic research in 10–14 weeks on the basis of determining the amount of placentas, and during visualization of one placenta the place of opening of the amniotic septum was studied.
Results. By the most early prognostical criterion of premature births to 36 weeks gestation we suggest to count shortening of the cervical canal to 38 mm at pregnancy 18 weeks. A sensitiveness of this criterion in our research was 78%, specificity 97%, relation of credibility of positive result of test 26,0, relation of credibility of negative result of test 0,2. At shortening of the cervical canal in 18 weeks of gestation to 35 mm sharply grows authenticity of premature births to 34 weeks gestation with a sensitiveness 78,5% and by specificity 100%. Length of cervical canal 30 mm in 18 weeks of gestation we suggest to consider critical, as at such value births to 34 weeks gestation in our research happened for all women, a sensitiveness of criterion was 100%, specificity – 100%.
Conclusions. The adequate prophylaxis of premature births is mine-out in 55 (40,2%) pregnant. Among 137 pregnant births to 36 weeks gestation happened in 35 (25,5%), that for certain below than indexes of experimental group (p < 0,02). The got results must be plugged in the algorithm of diagnostic and treatment-and-prophylactic measures at a multiple pregnancy.

The pregnant of group of infectious risk have correlative relationships between different proteins

Andrey Prishchepa — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-02
УДК 618.3-022.7-06:612.015.348:311.14

The objective: to set correlative relationships between different proteins for pregnant of group of infectious risk.
Materials and methods. To achieve this goal, 5 groups of patients were formed. In a 1 group entered 111 pregnant with the presence of antibodies of class of G to Chlamydia of trachomatis in a title 1:5–1:40, without the clinical displays of disease in mothers, with the signs of the intrauterine infecting from the term of pregnancy 18–20 weeks, without antibacterial therapy during pregnancy,
inspected in a term 13–24 weeks and in 38–40 weeks of gestation. 2 groups were presented 45 pregnant with the presence of high-avidity antibodies of class of G to Herpes of simplex 1,2 without the clinical displays of which or disease in mothers, with the signs of the intrauterine infecting from the term of pregnancy 18–20 weeks (polyhydramnios, fetal growth retardation, thickening of placenta, suspension in amniotic fluid and ets), without medicinal therapy during pregnancy, inspected in a term 38–40 weeks gestation. 3 groups were made 45 pregnant with the presence of Candida of albicans 104–106 CFU /l, without the clinical displays of infectious disease in mothers, with the signs of the intrauterine infecting from the term of pregnancy of 18–20 weeks (polyhydramnios, fetal growth retardation, thickening of placenta, suspension in amniotic fluid and ets), without medicinal therapy during pregnancy, inspected in a term 38–40 weeks gestation. Delivery through natural birth canal in the term of gestation 38–40 weeks. 4 groups consisted of 43 pregnant from Staphylococcus of aureus, without the clinical displays of infectious disease in mothers, with the signs of the intrauterine infecting from the term of pregnancy 18-20 weeks (polyhydramnios, fetal growth retardation, thickening of placenta, suspension in amniotic fluid and ets), without medicinal therapy during pregnancy, inspected in a term 38–40 weeks gestation. Delivery through natural birth canal in the term of gestation 38–40 weeks. A to 5 group entered 157 pregnant transmitters of exciters of mixt-infection, without the clinical displays of infectious disease during all pregnancy, with
the signs of the intrauterine infecting from the term of pregnancy 18–20 weeks (polyhydramnios, fetal growth retardation, thickening of placenta, suspension in amniotic fluid and ets), without antibacterial therapy during pregnancy, inspected in a term 38–40 weeks gestation. Delivery through natural birth canal in the term of gestation 38–40 weeks. To the complex of the conducted researches were included clinical, echographic, laboratory, microbiological and statistical methods.
Results. At presence of high-avidity of IgG of antibodies to Herpes of simplex1,2, the levels of lactoferrin were back associate with concentrations alpha-1-antitrypsin and, aught trophoblastic beta-globulin, and also directly with content pregnancy associated alpha-2-glycoprotein. Last interestingly enough, as pregnancy associated alpha-2-glycoprotein from one side, assists to development of pregnancy, and from other – creates favourable terms for distribution of pathology without the expressed displays of immune answer and proper inflammatory reaction due to the immunosuppressive properties. Pays attention on itself, that in a norm levels pregnancy associated alpha-2-glycoprotein associate only from alpha-2-by a macroglobulin (straight) and alpha-1-antitrypsin (back) while at presence of antibodies to Herpes simplex orientation of connection from alpha-1-antitrypsin changes on an opposite side. Also direct connection appears with the whey concentrations of the pregnancy associated protein A also tendency to reverse dependence on the trophoblastic beta-globulin. A that tendency comes to light at the transmitter of Staphylococcus of aureus, and at presence of IgG to Chlamydia of trachomatis it becomes reliable and direct. At the transmitter of Staphylococcus of aureus, that complicates pregnancy, as well as at presence of high-avidity of IgG of antibodies to Herpes of simplex1,2, level pregnancy associated alpha-2-glycoprotein depends on content of other reserve representative of family of macroglobulins (pregnancy associated protein A). At the transmitter of Candida of albicans, as well as at presence of IgG of antibodies to Chlamydia of trachomatis in a title 1:5–1:40 there is dependence on the level of alpha-fetoprotein, but not reverse, but line.
Conclusions. The analysis of correlative relationships allowed to show, that detected before changes of concentrations of whey indexes were not casual, but in a great deal associate, that confirms participating of immunoregulatory albumens and albumens of pregnancy in development of pathological processes at the transmitter of exciters perinatal the meaningful hidden infections
and grounds the necessity of their including for a general prognostical algorithm which takes into account different indexes and that promotes them total prognostical value.

Features of motion of pregnancy and births for women different age with obesity

Andrey Semenyuk — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-03
УДК 618.3/5-6-06:616-056.52-039

The objective: to estimate the features of motion of pregnancy and births for women different age with obesity.
Materials and methods. A prospective inspection is conducted 80 multiparous women different age with superfluous mass of body or obesity (basic group); middle age of patients made 30,6 ± 0,5. It is marked at the study of the inherited inclination, that for pregnant with violation of lipometabolism of obesity in both of parents met in 2 times more frequent than for the patients of control group (35% mothers and 18,8% father). It is marked by us, that half of patients of basic group yet to the first pregnancy had surplus mass of body (47,5%), or suffered obesity And degree (10%). The middle index of mass of body for women with obesity to the first pregnancy exceeded these groups of control and made 25,9 ± 0,4 kg/m2. For first gestation of patient with violation of lipometabolism added greater weight (15,8 ± 0,4 kg) for certain, against 11,2±0,4 kg/m2 in the group of control. Pregnant with obesity the second births must were take place in 67,5% supervisions, third – in 32,5%. Determination of body mass index rotined to looked after gestation, that after births of woman of basic group not able to go back to initial weight and before this pregnancy had surplus mass of body (30%) or obesity of different degrees: I – 37,5%, II – 27,5% and III – 5%; the middle body mass index made 32,7 ± 0,5 kg/m2. To the complex of the conducted researches clinical, laboratory and instrumental methods were included.
Results. The analysis of perinatal results rotined that for pregnant frequency of premature births grew with violation of lipometabolism: in 4,5% patients with surplus mass of body, in 10% – with obesity I degree and in 17,9% – with obesity II and III degree. The greater number of premature births for patients with obesity is related to that in the last for certain more frequent preeclampsia developed and prolongation of pregnancy was not always possible. For puerperas with obesity of complication
of motion of births arose up for certain more frequent than for patients from the group of control. Every fourth puerperas with obesity I degree had the ill-timed outpouring of amniotic fluid (23,3%), at every fifth is a primary and second weakness of childbirth (20%), and also intrauterine fetal hypoxia (20%). For patients with obesity II and III degree frequency of the indicated complications of births was observed in 1,5–2 times more frequent (32,1%, 42,9% and 42,9% respectively).
Conclusions. Women different age with obesity make a risk group in relation to development of preeclampsia, placenta dysfunction, fetal growth retardation and anomalies of childbirth. Frequency of complications of gestation and births straight proportional to the degree of weight of violation of lipometabolism and in 2–3 times higher than for patients with normal mass of body.

Clinicalandfunctional features of the system motherplacentafetus at a antenatal hypoxia with fetal losses

Olena Susidko — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-04
УДК 18.39-001.8-06:618.3/.36-07-039

The objective: to estimate clinical-and-functional features of the system mother-placenta-fetus at a antenatal hypoxia with fetal losses.
Materials and methods. A basic (1th) group was made by 55 cases of death of fetus 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 death of fetus were included by us in a 1 group of research on the basis of the unspecified nosotropic role of placenta and not clear tanatofenesis, they were 52% all antenatal losses. Cases of antenatal death of the set etiology - with infectious fetopathy, by innate teratosiss, incompatible with a antenatal period, - from research eliminated, as well as multiple pregnancy. Three groups of comparing to birth living new-born, without regard to threatenings lives of fetus will become a draught pregnancies, formed on the basis of clinical estimation of weight of placenta dysfunction and result of pregnancy, – all investigational 46 placentas of new-born in terms of 25-40 weeks at a singleton pregnancy. To the complex of the conducted researches were included clinical, echographic, doppler, cardiotocographic and statistical.
Results. Obstetric-gynaecological anamnesis of pregnant with the antenatal hypoxia of fetus (n=55) was burdened by miscarriage of pregnancy with 1-4 involuntary abortions (in 11), 1-3 antenatal losses (in 7), postnatal death of new-born (in 6), gynaecological diseases of inflammatory and noninflammatory genesis: cervicitis and by a cervical ectopia (in 19), endometritis (in 6), adnexitis (in 11), urogenital infection (in 10), herpetic and by a cytomegalovirus infection (for 6 patients), primary and second infertility (in 6), cysts of ovaries, endometriosis and uterine fibroids (for 5 patients), by the anomaly of uterus (in 1), by a scar on an uterus after C-section (in 4), hyperandrogenism (in 4), by medical abortions from 1 to 5 (in 21). Pregnancy came after in vitro fertilization for a 1 patient. Pregnancy which made off antenatal death of fetus, in 26 accompanied by the threatened miscarriage, at one – isthmic cervical insufficiency. 43 pregnant in I–III trimesters got treatment concerning complications of pregnancy or basic disease, including 33 – stationary, 18 from them – with the repeated hospitalization. Antenatal death of fetus came on the prehospital stage in 19 pregnant. 36 fetuses perished in permanent establishment of antenatal, including 7 during the first days after hospitalization pregnant. Results of clinical blood nest (65), aggregogram (8), coagulograms (37), to the glycemic type (20) of pregnant 1 and 2 sub-groups were not had meaningful differences.
Conclusions. Conducted estimation clinical-and-functional features of the system motherplacenta-fetus at a antenatal hypoxia with fetal losses. The got results must be taken into account at development of algorithm of diagnostic and treatment-and-prophylactic measures.

Echographic and Doppler features of the fetoplacental system at recurrent retrochorial haematomas

Olexandr Talko — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-05
УДК 618.39-06:618.344-003.215-036.87-073.4:621.3.093-039

The objective: to estimate echographic and Doppler features of the fetoplacental system at recurrent retrochorial haematomas.
Materials and methods. For the decision of the put purpose it was conducted complex clinicaland-laboratory and instrumental inspection 90 women which 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 recurrent 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 and statistical.
Results. From findings evidently, that more frequent all the repeated haematomas arise up in a retrochorial area (30,0%), and also inter-border (20,0%). Practically for every fourth pregnant (23,3%) with recurrent haematomas were found out the internal placental areas of ischemia and local hemorrhages (infarct). The infarcts of placenta can accompany any variant of recurrent haematoma, and with identical frequency diagnosed in the second half at a sporadic or repeated haematoma. Except for visualization of haematoma for prognostication of results and correct estimation of clinical situation its volume is important. The haematomas of large volum were diagnosed in 13,3% pregnant with recurrent uteroplacental hemorrhages. As evidently from the presented information, haematoma of large volum, including totally taking into account multiplicity marked in 14,3% pregnant, as a rule, for them then and there were premature births. Haematomas, the episodes of relapse in which proceeded to 20 week gestation, marked in 59,6%, to 28 week – in 40,4% supervisions. Haematomas with the signs of active organization were found out more than in 40% supervisions (43,3%), that in future appeared the marker of favourable result of pregnancy for these women.
Conclusions. More expressed violations of hemodynamics appear for the women of basic group (with a recurrent retrochorial haematoma), mainly in the uteroplacental link of circulation of blood. It is conditioned mainly by violations of becoming and development of placenta, and also to the multifactoriality relapse of hemorrhages in placenta compartment, that includes and hormonal, and hemorheological violation.

Women have features of metabolism of estrogen and state of mammary glands after hysterectomy

Oleksandr Zabudskіy — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-06
УДК 618.18-039:618.14-089.85-089.168.1

The objective: to estimate the features of metabolism of estrogen and state of mammary glands for women 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. Level of correlation of investigated metabolites for patients with the certain size of uterine fibroids in late reproductive age and in premenopause, was comparable and did not have of principle differences. The in addition, expressed violations of metabolism of estrogen are established for patients with combination of uterine fibroids, hyperplasia of endometrium and adenomyosis – in 60,0% supervisions coefficient 2-hydroxyestrone /16а-hydroxyestrone was < 1. A study was conducted of mammary glands for the women of basic groups depending on the indexes of metabolism of estrogen in urine. For 3 patients with correlation of metabolites estrogen more than 1,5 the established absence of changes in mammary glands. At oscillation of this index within the limits of 1,0–1,5 any pathology of mammary glands to the conduct of hysterectomy absented in 20,8% patients. At correlation 2-hydroxyestrone /16а-hydroxyestrone less than 1 different forms fibro-cystic mastopathy is diagnosed for all patients.
Conclusions. Patients with uterine fibroids which the conduct of hysterectomy is foreseen with the maintainance of appendages of uterus are included in the group of enhanceable risk in relation to to the origin and progress of diseases of mammary glands in a postoperative period. Metabolism of estrogen for patients by a uterine fibroids to and after the conduct of hysterectomy, in comparing to the healthy women, is characterized by enhanceable education metabolically active 16-а-hydroxyestrone. Findings must be taken into account at development of algorithm of diagnostic, treatment-andprophylactic and rehabilitation measures.

The women of reproductive age have features of pathogeny of hyperproliferative processes of uterus and mammary glands

Olga Leshchova — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-07
УДК 618.19:618.14-002.18-007.61-092-039

The objective: to estimate clinical-and-endocrinological features of hyperproliferative processes of uterus and mammary glands for the women of reproductive age.
Materials and methods. In research the included women of reproductive age are with the hyperplastic processes of endo – and myometrium and 30 healthy women which did not have pathology of endo – and myometrium (control group). A basic group was made 90 patients which parted on 3 sub-groups: in a 1th sub-group patients are plugged with combination of leiomyoma of uterus and adenomyosis (n = 30); in a 2th sub-group are patients with the leiomyoma of uterus in combination with the hyperplastic processes of endometrium (n = 30); in a 3th sub-group are patients which have combination of leiomyoma of uterus, adenomyosis and hyperplasia of endometrium (n = 30). The group of comparison was made by 90 patients which parted on 3 subgroups: sub group A are patients with the isolated leiomyoma of uterus (n = 30); sub-group B – with isolated adenomyosis (n = 30); sub-group C – with the isolated hyperplastic processes of endometrium (n = 30). To the complex of the conducted researches clinical, laboratory instrumental and statistical methods were included.
Results. The characteristics of the remodeling process of the intercellular matrix in the myometrium were analyzed. The function of remodeling of extracellular matrix is executed by extracellular dependent for zinc of endopeptidase – matrix metalloproteinase, and them tissue inhibitors. The relative area of expression of matrix metalloproteinase-9 in a basic group made 4,76 ± 0,42%, that in 2 times more than in the group of comparison, where this index was even 2,23 ± 0,19% (p < 0,05). The absorbancy of expression of matrix metalloproteinase-9 in a basic group made 3,51 ± 0,33 conditional units, that in 3 times more than in the group of comparison – 1,17 ± 0,23 conditional units (p < 0,05). The relative area of expression of tissue inhibitors of matrix metalloproteinase-1 in a basic group made 2,11 ± 0,14%, that on 48% less than, than in the group of comparison, where this index was evened 3,12 ± 0,31% (p < 0,05 – as compared to an index in the group of comparison). The absorbancy of expression of tissue inhibitors of matrix metalloproteinase-1 in a basic group made 2,02 ± 0,21 conditional units, and in the group of comparison – there are 2,38 ± 0,29
conditional units.
Conclusions. In pathogeny of the combined forms of high quality hyperplastic diseases of uterus in reproductive age play a leading role morpho-functional the changes of intact myometrium - for certain the higher level of expression of receptors of estrogen decline of level of expression of receptors of progesterone, high expression of factor of growth of endothelia of vessels of VEGF. Findings must be taken into account at development of algorithm of diagnostic and treatment-andprophylactic measures.

Functional the state of thyroid gland for women with the plural hyperplastic processes of organs of the reproductive system

Iryna Netskar — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-08
УДК 618.1-018-007.6-06:616.441-036

The objective: to estimate the functional state of thyroid gland for women with the 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, prgesterne on 20–24 days of menstrual cycle. For research to the function of thyroid gland conducted determination of maintenance in blood of free thyroxine and thyrotropic hormone. In blood of all women determined the presence of antibodies to thyroperoxidase.
Results. 22 women (40,7 ± 7,0%) with the plural hyperplastic processes of organs of the reproductive system had diseases of thyroid gland. The diffuse untoxic goitre of I and II degree was found out in 6 patients (11,1 ± 1,3%), diffusely nodular untoxic goitre of I and II degree — also in 6 women of basic group (11,1 ± 1,3%). A nodular goitre found out in 7 patients (13,0 ± 1,6%). Diffuse and diffusely nodlar untoxic goitre discovered in 4 from 9 (44,4 ± 4,6%) women with a presence in the structure of plural hyperplastc processes of organs of the reproductive system of external genital endometriosis, in 10 from 46 (21,7 ± 2,1%) women with a uterine fibroids, in three from 15 (20,0 ± 1,3%) patients with hyperplasia and endometrial polyps and in 4 from 19 (21,0 ± 2,3%) patients from adenomyosis. Frequency diffuse and diffusely nodular untoxic goitre for women from fibro-cystic mastopathia made 25,0 ± 2,2% (12 from 48 patients). Nodular formations of thyroid gland were found out in two from 9 (22,2 ± 1,9%) women with external genital endometriosis, in 5 from 46 (10,9 ± 1,6%) patients with a presence in the structure of diseases of uterine fibroids, two from 19 (10,5 ± 1,0%) patients from adenomyosis and 5 from 48 (10,4 ± 1,4%) women from fibro-cystic mastopathia.
Conclusions.The results of the conducted researches testify that in most women (94,4 ± 3,1%) with the plural hyperplastic processes of organs of the reproductive system the function of thyroid gland is not broken. The table of contents of free thyroxine in their blood does not differ from his level in blood of healthy women, which does not ground to bind development of proliferative diseases of organs of small pelvis and mammary glands to the parafunction of thyroid gland. Findings must be taken into account at development of algorithm of diagnostic and treatmentand-prophylactic.

Features of the functional state of pituitaryovarian and immune system at the proliferative processes of endometrium for women different age

Yuliya Strakhovetska — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-09
УДК 618.14-007.415:611.664]-06:618.11-002:616.432]-008-039:612.017

The objective: to learn the features of the functional state of pituitary-ovarian and immune system at the proliferative processes of endometrium for women different age.
Materials and methods. Organizational and methodical approach consisted in that the method of continuous selection in research on the study of the state of endometrium included 647 women (basic group) with pathology of mucous membrane of the uterus. From them 138 patients are with the of high quality hyperplastic processes of endometrium, where patients entered with glandular and glandular-cystophorous hyperplasia of endometrium. 509 patients with the morphological variants of shrine of endometrium, that meet more frequent all. 67 women without pathology of endometrium, made the control group of comparison. The laboratory methods of researches were included by biochemical, endocrinological and immunological indexes.
Results. The incurrence of cross-correlation connections between the parameters of immune status digitised by us grows almost three times at the maintainance of predominance of positive connections. It is an indisputable certificate of functional tension of immunity at his specific reactions on a tumour process. Closer, than in control, copulas become among the indexes of all links of immunity: cellular, humoral and phagocytic. The new are in addition, determined cross-correlation copulas which represent close co-operation of links of the immune system in the process of immune antitumor response at the high-differentiated tumours of endometrium are important on principle. For patients with low-grade differentiated adenocarcinoma the separation of work of basic links of the immune system and decline of them is fixed functional possibilities, especially phagocytic link. The amount of intercommunications of immunological indexes for patients with low-grade differentiated adenocarcinoma by comparison to control is megascopic. Pays attention on itself absence of any correlations between the indexes of cellular and humoral links with parameters which characterize functional activity of phagocytes. At the same time, intrasystem correlations of low-grade differentiated adenocarcinoma link make practically a fourth from found out all dependences and represent the presence of the high
functional loading on phagocytosis. However much the level of indexes of this link (phagocytic index, phagocytic number, time of output on the peak of curve of induced) allows to draw conclusion about his high possibilities.
Got information, taking into account the age-old features of indexes, testify to the balanced enough work of the immune system for women without pathology of endometrium and patients with the of high quality hyperplastic processes of endometrium.
Conclusions. It is set that at the nosotropic variant of endometrial cancer activating of cellular link of the immune system, conditioned by hyperestrogenemia is marked; functional activity of phagocytic link for these patients is reduced at keeping possibility of presentation of antigens. At the second variant of disease of possibility of cellular link repressed with development of
disbalance of immunoregulatory subpopulation due to the hypersecretion of stress hormones, and phagocytic – reduced with exhaustion of metabolic backlogs of cages sharp limitation of presentation capabilities. At the first nosotropic variant of endometrial cancer the most expressed influence is on the metabolic processes of hyperestrogenia in default of antiproliferative action
of progesterone, and at the second variant a greater value for proliferation of tumour tissue has combination of hyperinsulinemia with the enhanceable concentration of somatotropin, amino acid which result in stimulation of transport, in the cages of tumour to the increase of synthesis of albumen. Findings must be taken into account at development of algorithm of diagnostic and treatment-andprophylactic measures.

Features of vasculomotor violations are in perimenopausal age

Natalia Sukhostavets — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-10
УДК 618.173-036.3-009.86

The objective: to learn the features of vasculomotor violations for the women of perimenopausal age.
Materials and methods. In accordance with the put purpose of research 90 women were inspected in age from 45 to 55 years, them middle age made 47,9 ± 5,4. For the estimation of presence and degree of severity of climacteric disorders counted up the modified menopausal index. In research appeared the criteria of including of patients: age of women from 45 to 55 years, absence in anamnesis of operative interferences on the appendages of uterus, presence of regular and irregular menstrual cycle. The criteria of exception of patients from research served as: operative interferences are on the appendages of uterus, including diathermocautery and biopsy of ovaries. All patients parted on groups depending on the indexes of the modified menopausal index. The first group was made by 48 patients with the indexes of the modified menopausal index 55,2 ± 2,9 and by the vasculomotor displays of climacteric syndrome; second group – 42 patients with the indexes of the modified menopausal index 26,0 ± 2,6 and without the vasculomotor displays of climacteric syndrome. To the complex of the conducted researches clinical, laboratory instrumental and statistical methods were included.
Results. Clinical-and-statistical description of the inspected women allowed to find out highfrequency of gynaecological and somatic morbidity for the patients of both groups. Somatic anamnesis appeared burdened both for patients with the vasculomotor displays of climacteric syndrome and without them: frequency of diseases of the digestive system (at 1,9 time) and thyroid gland (at 1,5 time) was for certain higher in the second group, varicose illness (at 1,8 time) and disease of musculosceletal system (at 2,6 time) met more frequent in the first group of the inspected women (р < 0,05). The above-mentioned explains for certain higher frequency of operative interferences on a thyroid gland (at 3,9 time) for the patients of the II group (р < 0,05). For patients with the vasculomotor displays of climacteric syndrome for certain more frequent (at 1,5 time) marked a tonsillectomy in anamnesis (р < 0,05). Without regard to that the diseases of organs of the reproductive system were found out in most inspected, women without the vasculomotor displays of climacteric syndrome for certain more frequent (at 2,3 time) suffered the of high quality diseases of ovaries by the inflammatory diseases of genitalia, what in a group with vasculomotor displays (р < 0,05).
Conclusions. The conducted research rotined that for the women inspected by us little place reliable decline of quality of life, indexes of hormonal homoeostasis, and also changes of ultrasonic parameters of ovarian reserve yet to appearance of vasculomotor violations, as one of clinical signs of climacteric syndrome, thus afterwards changes increased only.

Prognostic role of immunohormonal and ultrasound markers in the restoration of reproductive function in women with endometriosis after treatment

Karyna Voronina — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-11
УДК: 618.11-006.2-07-08:618.177-089:618.177-089.888.11

The objective: to evaluate the prognostic value of immunological, hormonal, and ultrasound markers in the restoration of reproductive function in women with endometriosis after treatment, considering the realization of fertility in natural cycles and through assisted reproductive technologies (ART).
Materials and methods. A prospective comparative study was conducted involving 120 women of reproductive age with infertility and laparoscopically and histologically confirmed endometriosis. Patients were randomized into three groups depending on the treatment strategy: laparoscopic ablation/excision with subsequent dienogest therapy (n = 40); laparoscopic resection of endometriomas with inclusion in ART programs and platelet-rich plasma (PRP) support (n = 40); preoperative gonadotropin- releasing hormone (GnRH) antagonist therapy followed by laparotomy (n = 40). The following parameters were assessed: anti-Müllerian hormone (AMH), cancer antigen 125 (CA-125), antral follicle count (AFC), pain intensity using the visual analog scale (VAS), pregnancy rates, and recurrence rates during a 12-month follow-up period.
Results. The most favorable prognostic profile for fertility restoration was observed in patients with preserved ovarian reserve (AMH ≥ 2.3 ng/mL, AFC ≥ 7), low CA-125 levels (≤ 55 U/mL), and minimal pain (VAS ≤ 3). The highest pregnancy rate within one year was achieved in the laparoscopic + dienogest group (62.5%), followed by the laparoscopic + ART group (55.0%) and the GnRH antagonist + laparotomy group (37.5%).
Conclusions. Comprehensive assessment of immunological, hormonal, and ultrasound markers provides an opportunity to create an individualized fertility prognosis and optimize treatment strategies for women with endometriosis.

Molecular–immunological mechanisms of the impact of chronic vulvovaginal and cervical infections on women’s reproductive function: optimization of pathogenetic therapy using ozone therapy

Alla Vitiuk, Svitlana Nagirniak — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-12
УДК: 618.177–089.888.61:616.97–002:615.835

Infertility associated with chronic vulvovaginal and cervical infections is accompanied by dysbiosis, persistent biofilms, and chronic inflammation, which collectively impair fertility.
The objective: to analyze molecular–immunological alterations in chronic lower genital tract infections and to assess the effectiveness of ozone therapy as a pathogenetically grounded adjuvant to comprehensive infertility treatment.
Materials and methods. This prospective study (2022–2025) enrolled 180 women, stratified into three groups of 60: I – vulvovaginal, II – cervical, III – combined infections. Each group was subdivided into subgroup A (standard therapy + local ozone therapy) and subgroup B (standard therapy alone). Ozone therapy consisted of vaginal instillations of ozonated solution (5–10 mg/L), 50–100 mL, 10–15 minutes, 8–10 procedures per course. Outcomes: IL-6, IL-8, TNF-α, CD4+/CD8+, vaginal microbiocenosis (CFU/mL), 6-month relapse rate, and clinical pregnancy rate.
Results. Compared with subgroup B, subgroup A showed significant post-treatment reductions in pro-inflammatory cytokines: IL-6 – 8.5 ± 2.1 vs 15.2 ± 3.4 pg/mL (p < 0,01), IL-8 – 12.3 ± 2.5 vs 20.5 ± 3.7 pg/mL (p < 0,01), TNF-α – 10.1 ± 1.8 vs 16.7 ± 3.1 pg/mL (p < 0,01). The CD8+ fraction increased to 29.0 ± 3.0% vs 21.0 ± 2.8% (p < 0,01), with a decrease in the CD4+/CD8+ index to 1.43 (p < 0,05). Microbiocenosis normalized: Lactobacillus 4.6×105 vs 3.1×105 CFU/mL (p < 0,05), Gardnerella vaginalis 1.5×104 vs 3.9×104 CFU/mL (p < 0,05). Six-month relapse rates were 10% in subgroup A vs 28% in B (RR ≈ 0.36; NNT ≈ 6). The clinical pregnancy rate reached 70% in subgroup A vs 45% in B (p < 0,05). The greatest benefit was observed in women with isolated vulvovaginal infections and baseline IL 6 < 12 pg/mL.
Conclusions. Adding local ozone therapy to standard treatment provides a pronounced antiinflammatory and anti-biofilm effect, promotes restoration of mucosal immunity and vaginal microbiocenosis, and is associated with a higher clinical pregnancy rate.

Medicalandsocial features of matrimonial pair are with miscarriage of pregnancy

Andrey Shchedrov — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-13
УДК 618.39-06:616-058.833-039

The objective: to learn the medical-and-social features of matrimonial pair with miscarriage of pregnancy.
Materials and methods. For the exposure of accessible clinical-and-anamnestic markers, indicative on the necessity of deep inspection of men, the medical-and-social portrait of matrimonial pair is made with miscarriage of pregnancy. For drafting of portrait the retrospective is conducted clinical-and-statistical analysis of these ambulatory maps 100 matrimonial pair which are advised and inspected concerning miscarriage of pregnancy in a matrimonial pair. 50 matrimonial pair without miscarriage of pregnancy made the group of comparison. Set is carried out by the method of continuous selection. Medical-and-social features are analysed, anamnestic information, genital, somatopathies and results clinical-and-laboratory inspection of men from pair with miscarriage of pregnancy. To the complex of the conducted researches clinical, laboratory, instrumental, microbiological and statistical methods were included.
Results. We are analyse medical-and-social information of women and men in the investigated groups. It should be noted that on the stage of inspection of men in matrimonial pair with miscarriage of pregnancy, we ran into the row of features which hamper diagnostics. Not all men agreed to the inspection. In most cases a refuse was related to absence of motivation because of fact of successful conception, also psychological discomfort and unreadyness took place to research of ejaculate, in a number of cases the waiver of inspection was explained by religious persuasions. The study of anamnestic information rotined that chronic somatopathies are more frequent diagnosed in 68,0% women of basic group and in 40,0% in the group of comparison (р = 0.022). Substantial differences between groups which are studied, on the structure of chronic somatic pathology were absent, however there is a tendency to more frequentcy of occurrence of diseases of the endocrine system for the women of basic group in relation to the participants of group of comparison (22,0% and 4,0% respectively, р=0,066).
Conclusions. Matrimonial pair with miscarriage of pregnancy more frequent are in unregistered marriage, what matrimonial pair with the successfully realized paternity. For women with miscarriage of pregnancy statistically meaningfully higher frequency of chronic somatic pathology and carried gynaecological diseases, especially inflammatory character, in relation to the women of
group of comparison. A genital ureaplasma infection is more frequent diagnosed for women with miscarriage of pregnancy. For women with miscarriage of pregnancy meaningful differences are set statistically on the body mass index toward an increase in relation to the women of group of comparison.

Dynamics of immunohormonal and ultrasound markers in predicting treatment outcomes in women at risk of ovarian hyperstimulation syndrome: multicenter analysis and prospects for personalized therapy

Alla Vitiuk, Mykola Hafiichuk — Mon, 01 Sep 2025 00:00:00 +0300

DOI: 10.52705/2788-6190-2025-02.2-14
УДК: 618.177-089.888.11:618.11-007.61-006.04-073.43:616-092.9

Ovarian hyperstimulation syndrome (OHSS) remains one of the most serious complications of assisted reproductive technology (ART) programs, especially in women with high ovarian reserve.
The objective: to evaluate the effectiveness of personalized ovarian stimulation protocols aimed at preventing OHSS and improving reproductive outcomes in high-risk patients.
Materials and methods. A randomized prospective study was conducted involving 120 women at high risk of OHSS, allocated into subgroup A (n = 43), subgroup B (n = 37), and a control group (n = 40). Subgroups A and B received antagonist GnRH protocols, dual ovulation trigger (GnRH agonist ± low-dose hCG), dopamine agonists (cabergoline), enhanced luteal phase support, and a “Freeze all” strategy. The control group underwent standard stimulation with hCG trigger and basic luteal support. Monitoring included transvaginal ultrasound, anti-Müllerian hormone, estradiol, and progesterone levels.
Results. The incidence of clinically significant OHSS was 4.7% in subgroup A and 2.7% in subgroup B, compared to 17.5% in the control group (p < 0.05). Clinical pregnancy rates were 55.8% (A), 48.6% (B), and 35% (control, p < 0.05). Miscarriage rates were 9.1% (A), 10.8% (B), and 21.4% (control, p = 0.05). The number of retrieved oocytes and estradiol levels were comparable between groups. Personalized regimens reduced OHSS risk while maintaining high ART success rates.
Conclusions. A comprehensive personalized approach including modified stimulation protocols, dual trigger, dopamine agonists, and a “Freeze-all” strategy is an effective method for OHSS prevention in high-risk women and improves clinical pregnancy rates while reducing miscarriage incidence.