Perinatology and reproductology: from research to practice

Algorithm of prenatal prognostication of the intrauterine infection

2026-04-03T14:18:37+03:00

DOI: 10.52705/2788-6190-2026-01-1
УДК 618.33-022.7-037

The objective: to develop the algorithm of prenatal prognostication of the intrauterine infection.
Materials and methods. By us a complete database (clinical and laboratory indexes, anamnesis, motion of pregnancy, results of births, information for motion of neonatal period et al) was formed about 201 pregnant, transmitters of exciters perinatal meaningful infections (Herpes of simplex 1,2, Staphylococcus of aureus, Candida of albicans and Chlamydia of trachomatis). From them healthy children gave birth in 50,3 % (101) women, and in 49,7 % (100) – to put with the intrauterine infection. Age of women, in which children gave birth with intrauterine infections, made ± 25,5 (23–30) years, and for women which gave healthy children ± 25 (24–28) years, distributing of index in both groups differently from normal (DKS = 1,43; p = 0,033 and DKS = 1,94; p = 0,001 respectively) statistically meaningful differences it is not discovered (U = 0,233; p = 0,816). To the complex of the conducted researches were included clinical, microbiological, virologic, biochemical and statistical.
Results. By a model it is classified correctly 82 % (50/61) all new-born, such which gave birth healthy, among new-born with points after a scale Apgar from 0 to 7 this index is evened 75 %. On the whole by the built model on an instructive multiplicity it was correctly classified (coefficient of concordance) 78 % (105/134) all cases. Size of coefficient of connection of D-Зоммера (SOMERS’D), which represents connection of actual frequency and logistic regression, which is foreseen on equation, is 0,573, p < 0,001. By a model it is classified correctly 79 % (11/14) all healthy new-born, among new-born with points after a scale Apgar from 0 to 7 this index is evened 76 %. On the whole, by the built model on a test multiplicity it was correctly classified (coefficient of concordance) 77 % (23/30) all cases. Size of coefficient of connection of D-Sommer (SOMERS’D), which represents connection of actual frequency and logistic regression, which is foreseen on equation, is 0,464; p = 0,004. The analysis of clinical and laboratory data at the use of mathematical model of regression of logit allowed to form the aggregate of predictors risk of development of intrauterine infection with the high level of concordance over 90 %. It underlay development of the computer program of calculation of risk of birth of children with intrauterine infections.
Conclusions. We succeeded to develop the program of screening prenatal prognostication of intrauterine infections, which includes clinical predictors of the intrauterine infection and regulator-transport squirrel at blood of expectant mothers and amniotic fluid of puerpera. Created program of calculation of risk of the intrauterine infection in an early neonatal period it is recommended to apply from the moment of determination of signs of live birth, from 22 a week’s terms of pregnancy, term of premature births, after second ultrasonic screening.

Features of motion of births and state of new-born for women with different somatotype and by age of the first births

2026-04-03T14:34:22+03:00

DOI: 10.52705/2788-6190-2026-01-2
УДК 618.5-055.25-036-02:616-053.31-039:612.014.5

The objective: to estimate the features of motion of births and state of new-born 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 different stature type. 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 stature type, 47 (45,2 %) – mesosomatic, 28 (26,9 %) – microsomatic. From them 62 (59,6 %) women were primiparous, and 42 (40,4 %) – multiparous. Studied features of motion of births and state of new-born. To the complex of the conducted researches clinical, laboratory and instrumental methods were included.
Results. The coefficient of correlation of Pearson connection found out between fatty mass of mother and Quetelet index new-born (r = 0,35; R = 0,05), by head circumference new-born (r = 0,39; R < 0,05), between muscular mass of mother and chest circumference of new-born (r = 0,37; R < 0,05) for representatives macrosomatic stature type. The coefficient of correlation of Spirmena found out a middle tie-up between fatty mass of mother and long body new-born (r = 0 > 37; R < 0,05), by the head circumference of new-born (r = 0,43; R < 0,05). In the group of patients of mesosomatic stature type fatty mass of mother, Quetelet index new-born, had the most factor loadings in the first factor (46,7 %). The coefficient of correlation of Pearson connection found out between the point of somatotype mother and Quetelet index new-born (r = 0,33; R = 0,05), by the chest circumference of new born (r = 0,32; R = 0,05); between fatty mass of mother and Quetelet index new-born (r = 0,35; R < 0,05), by the chest circumference of new-born (r = 0,34; R < 0,05); between muscular mass of mother and Quetelet index new-born (r = 0,34; R < 0,05) for the representatives of mesosomatic
stature type. The grade coefficient of correlation found out a tie-up between fatty mass of mother and Quetelet index new-born (r = 0,32; R < 0,05), by the chest circumference of new-born (r = 0,3; R = 0,05); between muscular mass of mother and Quetelet index new born (r = 0,33; R < 0,05).
Conclusions. The results of the conducted researches testify that more frequent all premature births (14,3 %), preterm premature rupture of membranes (28,6 %), weak labor (10,7 %), bleeding in the third period (7,1 %) of dung observed for the women of microsomatic type. A level of abdominal delivery in the group of women of microsomatic type was 25,0 %, for the patients of macrosomatic type – 17,2 % and mesosomatic – 10,6 %. Most high body mass index, weight height index it was been an for the new-born mothers of mesosomatic type, most low - for children which gave birth from the mothers of microsomatic type. The least number of children of mothers of mesosomatic of type gave birth in a state of asphyxia – 10,6 %, against 21,4 % and 17,2 % for the women of microsomatic and macrosomatic type, respectively. It is got by us results it is necessary to take into account at development of algorithm of diagnostic and treatment-and-prophylactic measures.

A role of violations of the system to haemostasis is in genesis of recurrent of retrochorial haematomas

2026-04-03T14:52:27+03:00

DOI: 10.52705/2788-6190-2026-01-3
УДК618.344-003.215-005.2-036.87

The objective: to estimate the role of violations of the system to haemostasis in genesis of recurrent of retrochorial haematomas.
Materials and methods. For the decision of the put purpose it was conducted complex clinical-andlaboratory 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, biochemical and statistical.
Results. At the inspection of pregnant on the genetic markers of thrombophilia were found out next results. The incurrence of pregnant with the genetic markers of thrombophilia was reliable higher in a basic group (the pregnant are with a recurrent retrochorial haematoma) – 79 (76,0 %) against 37 (46,25 %) women in the group of comparison [Or = 2,391: 95% CI 1,181–4,843 (р = 0,013)]. Meaningfully more frequent for patients with recurrent uteroplacental hemorrhages appeared mutation of FV Leiden G1691A, polymorphism of platelet receptor of Gp IIIa 1565T/C, polymorphism of gene of Fibrinogenum, polymorphism of gene of PAI-1, mutation of MTHFR C677T. For 62 (59,6 %) women with the repeated retrochorial haematomas found out the multigenic form of thrombophilia against 9 (11,25 %) women with a haematoma sporadic of early terms [Or= 2,391: 95% CI 1,181–4,843 (р = 0,013)]. In addition, in 11 (10,6%) women of basic group was found out combination of laboratory signs of antiphospholipid syndrome and genetic markers of thrombophilia. It should be noted that even at the sporadic haematoma of early terms for certain more frequent than different mutations of genes, supervisory haemostasis appeared in a control group. It should be noted that at combination of 3-4 mutations the permanent recurrent of haematomas were clinically marked during first-second trimesters, and also uncompensated placenta dysfunction, premature births, fetal growth retardation.
Conclusions. To the patients with the high risk of retrochorial haematoma very much it is necessary from early terms for the prophylaxis of severe placenta associations complications of setting of anticoagulants in a dose, neat individually. At multiple mutations or at the mutations of high throombogenic risk in combination with the procoagulant activating to haemostasis, by violations of blood stream in uterine arteries a dose makes not less than 0,8 ml of clexane in combination with antiplatelet (aspirin, curantyl). The got results must be taken into account at development of algorithm of diagnostic and treatment-and-prophylactic measures.

Ultrasound and morphological features of the placenta in women giving birth for the first time, of different reproductive ages

2026-04-03T15:06:27+03:00

DOI: 10.52705/2788-6190-2026-01-4
УДК 683.3:618.36-07:618.36-094:613.1:618.2

The objective: to conduct an analysis of the ultrasound and morphological features of the placenta in women giving birth for the first time, of different reproductive ages, to predict and optimize obstetric tactics in this category of pregnant women.
Materials and methods. The study of echographic and morphological features of the placenta was conducted in women giving birth for the first time of different reproductive ages: 286 histories of pregnancy and childbirth of women who were divided into groups: Group I of the study – 174 pregnant women giving birth for the first time: subgroup IA – 85 women aged 20–29 years, subgroup IB - 89 pregnant women aged 30–40 years; Group II – 112 pregnant women giving birth again: IIA – 54 pregnant women aged 20–29 years, IIB – 58 pregnant women aged 30–40 years. Placentagraphy was performed to determine the localization of the placenta, its thickness, degree of maturity, structure and pathological changes. For the morphological analysis of structural changes in the placenta, the following methods of research were used: organometric, macroscopic, general histological and histochemical,
Statistical processing of research results was carried out using standard programs «Microsoft Excel 7.0» and «Statistica 8.0»
Results. In group I, the placenta was located on the anterior uterine wall (38.8 % and 39.3 %; p = 0.001), mainly due to the IB subgroup, compared with the PB group (29.6 % and 31.0 %; p = 0.032); on the posterior uterine wall (45.9% and 49.4 %; p = 0.001), significantly less due to the IB subgroup, compared with the IIB subgroup (70.4 % and 62.15 %; p = 0.001); on the lateral uterine wall, significantly more (16.5 % and 10.1 %; p = 0.038) due to the IA subgroup, compared with the PA subgroup (3.7 % and 3.4 %; p = 0.010). The percentage of pregnant women with low placentation (11.8 % and 12.4 %, p = 0.001) in subgroups IA and IB was higher due to the IB subgroup versus 5.6 % and 3.4 % in subgroups IIA and IIB, p = 0.010 and p = 0.033). The number of pregnant women in subgroups IA and IB with normal placenta structure was significantly lower (5.9 % and 4.5 % versus 100.0 % and 32.7 %; p = 0.001), with the presence of dystrophic changes (calcifications of calcium salts) was significantly higher (87.1 % and 89.9 %; p = 0.001) versus subgroups IIB – 67.3 %; p < 0.05, and degenerative changes (cystic formations) in the structure of the placenta diagnosed only in group I (7.1 % and 5.6 %).
Conclusions. The structural and functional features of the fetoplacental complex of women giving birth for the first time, regardless of reproductive age, are characterized by significantly worse ultrasound placentometry indicators, a significant decrease in compensatory and adaptive reactions of the placenta, and involutional, pathological changes and their combinations are more often diagnosed in them.

Personalized treatment algorithm and prognostic model for the risk of recurrence of endometrial hyperplasia in women of late reproductive age

2026-04-03T16:24:54+03:00

DOI: 10.52705/2788-6190-2026-01-5
УДК 618.14-007.61-06:616-008.9-08-039.76

Recurrent endometrial hyperplasia (REH) in women of late reproductive age (36–45 years) is characterized by a high rate of repeated episodes, risk of progression, and limited effectiveness of standard progestin therapy. Hormonal and metabolic disturbances, particularly insulin resistance, obesity, and progesterone deficiency, are considered key factors contributing to a recurrent course of the disease.
The objective: to develop and clinically implement a personalized treatment algorithm for recurrent endometrial hyperplasia based on hormonal and metabolic profiling, and to create a validated prognostic model for recurrence risk.
Materials and methods. A prospective cohort study (2022–2025) included 120 women aged 36–45 years. The main group (n=60) consisted of patients with recurrent non-atypical hyperplasia (≥ 2 recurrences within 24 months), the comparison group (n = 30) included women with newly diagnosed hyperplasia, and the control group (n = 30) comprised practically healthy women. Within the main group, two subgroups were identified: standard therapy (n = 30) and a personalized algorithm with metabolic correction (n = 30). The follow-up period was 24 months. The primary endpoint was recurrence. Multivariate logistic regression, ROC analysis, internal validation using repeated resampling (1000 iterations), calibration assessment, and reclassification indices were applied. Results. The 24-month recurrence rate in the REH group was 38.3 % compared to 16.7 % in primary hyperplasia (p < 0.01). Independent predictors of recurrence were identified as HOMAIR > 3.5 (OR = 2.84), BMI ≥ 30 kg/m2 (OR = 2.31), progesterone < 6 nmol/L (OR = 2.58), and triglycerides ≥ 1.7 mmol/L (OR = 1.96). The prognostic model demonstrated high discriminative ability (AUC = 0.84; after internal validation – 0.82) and adequate calibration (p = 0.62). The addition of metabolic variables improved model performance (ΔAUC = +0.09). In the personalized treatment subgroup, the recurrence rate decreased to 16.7% compared to 38.3% with standard therapy (RR = 0.44; ARR = 21.6 %; NNT = 4.6).
Conclusions. Recurrent endometrial hyperplasia has a systemic hormonal–metabolic nature. Integration of insulin resistance assessment and other metabolic parameters into the treatment algorithm significantly reduces the risk of recurrence. The developed prognostic model is statistically robust and suitable for clinical risk stratification.

Features of clinical description of patients are with of benigh ovarian neoplasms after hysterectomy

2026-04-03T16:38:43+03:00

DOI: 10.52705/2788-6190-2026-01-6
УДК 618.14-089.87-089.168.1-066.88.11-006.03-036.1-07-039

The objective: to learn the features of clinical description inspection of patients with of benigh ovarian neoplasms after hysterectomy.
Materials and methods. The retrospective analysis of hospital and videotape recordings of operations charts is conducted 83 patients, ovaries operated concerning of benigh tumours. All patients entered permanent establishment in the planned order with a diagnosis: «Benigh ovarian neoplasms». 65 from 83 patients produced complaints about chronic pelvic pains and pains at sexual contacts. All patients before carried total or subtotal hysterectomy without appendages laparotomy access concerning a uterine fibroids, adenomyosis, recurrent dysfunctional uterine bleeding. 1 basic group – 48 patients were operated concerning the tumours of ovaries by laparoscopy access. The group of comparison was made by 35 patients which undergoed a laparotomy operation concerning the tumours of ovaries. Clinical, laboratory instrumental and statistical methods were included in the complex of the
conducted researches.
Results. For 62 patients after subtotal hysterectomy the state of stump uterine cervix was estimated (oncocytological examination of smears from endo- and exocervix, extended colposcopy). From them there is found out pathology of stump uterine cervix in 12 patients (17,7 %): for 2 patients is high-grade dysplasia, in 6 is endometriosis of stump uterine cervix, for 3 patients are recurrent polyps of cervical canal, bleeding from stump uterine cervix, concerning which it was decided to execute extirpation of the cervical stump. In all 83 patients determined the level of tumour marker of СA-125 in the blood serum. In 11 patients there was an increase of level of tumor marker of СA-125 to 35–54 IU/ml.
Conclusions. The results of the conducted clinical description of women with ovarian neoplasms after hysterectomy testify to actuality of this scientific problem and necessity of development of the improved algorithm of diagnostic, treatment-and prophylactic and rehabilitation measures.

A rehabilitation of women is after plastic operations on cervix

2026-04-03T16:57:44+03:00

DOI: 10.52705/2788-6190-2026-01-7
УДК 618.146-089.844-089.168.1-036.82

The objective: to develop and inculcate the complex of rehabilitation measures for women after plastic operations on the cervix.
Materials and methods. For achievement of the put purpose 104 women are inspected in age from 20 to 30 years with nonspecific chronic cervicitis on a background post-traumatic deformation of cervix. Instrumental inspection of cervix: a review of cervix is in speculum, simple and extended colposcopy, cytological research, polymerase chain reaction. At morphological research of tissue of cervix found out signs and depth of distribution of inflammatory process in tissue of cervix and content of histamine at cervical mucus. A certificate to the conduct of operation served as a presence for the patients of post-traumatic deformation of сervix of any degree. Operations executed in the planned order after complete clinical-andlaboratory and instrumental inspection. A hysterotracheloplasty was produced by the method of a stage stratification. Advantage of this method was gradual layer renewal of anatomic integrity of cervical canal. There were the included methods of the use of acupuncture and laser therapy to the complex of rehabilitation measures.
Results. In a 1 group (30 women with distribution of inflammatory process only on the epithelium of mucus shell of cervix by the moderate increase of level of histamine in the mucus secret of cervical canal, in treatment of which, acupuncture was used only) the reliable decline of concentration of histamine happened on 61,58 %. In 2 groups to the sub-group and (30 women with distribution of inflammatory process deeply on the submucous layer of cervix by the expressed increase of concentration of histamine in a cervical secret, in which for treatment of nonspecific chronic cervicitis also used only acupuncture) on 64,60 %. In 2 groups to the subgroup (34 women with localization of inflammatory process deeply in the submucous layer of cervix by the expressed increase of concentration of histamine in the mucus secret of cervical canal, in which for treatment of nonspecific chronic cervicitis acupuncture was used with the subsequent joining at the beginning of the third month of the modified method of laser therapy) on 74,19 %.
Presence of predictor risk of development of chronic persistent cervicitis is a certificate for setting of acupuncture in an early postoperative period with the subsequent use of the modified method of laser therapy in accordance with the developed charts. Successive use of acupuncture and laser therapy, considerably promote efficiency of treatment and diminish authenticity of origin of chronic persistent cervicitis for patients those which are in the group of risk.
Conclusions. Efficiency of treatment of chronic cervicitis with distribution of inflammatory process on the submucous layer of cervix by the expressed increase of level of histamine in the mucus secret of cervical canal during three months is 63% the method of acupuncture (p < 0,01). Presence of criteria of development of persistent chronic cervicitis, is a certificate for setting of acupuncture in an early postoperative period, with the subsequent use of the modified method of laser therapy. Efficiency of the general use of acupuncture and laser therapy is 94 % (p < 0,01).

The women of reproductive age have efficiency of different methods of treatment of endometrial hyperplasia

2026-04-03T17:31:29+03:00

DOI: 10.52705/2788-6190-2026-01-8
УДК 618.17/.5-06:618.14-018-007.6-08-035

The objective: to estimate efficiency of different methods of treatment of endometrial hyperplasia for the women of reproductive age.
Materials and methods. Surgical treatment is conducted to 445 patients with the uterine leiomyoma, them them: 323 – groups were included in basic, and 122 – in a sub-group I groups of comparison. At 80,9 ± 1,9% cases organ-preserving operations (myomectomy) are executed, in 19,1 ± 1,9% – hysterectomy. Operated laparoscopic access 78,1 ± 2,2 % patients, with the use of laparotomy – 6,4 ± 1,3 %. At 15,6 ± 1,9 % cases to the patients with the submucosal location of node a myomectomy was conducted by the method of operative hysteroscopy. An early and late postoperative period for all patients flowed without complications. To the complex of the conducted researches clinical, laboratory instrumental and statistical methods were included.
Results. Pays attention on itself circumstance that efficiency of the use both progestagens and the combined oral contraceptives at isolated adenomyosis was relatively high and practically identical. Less effective treatment of progestagens by comparison to the monophase combined oral contraceptives was in a basic group at the combined hyperplastic diseases of uterus. At the use of endometrial levonorgestrel excretory systems, in 3 from a 31 patient of basic group happened to the expulsion of an IUD, in all last cases of treatment it appeared successful. Obvious advantage of endometrial levonorgestrel excretory systems as compared to other hormonal facilities it is determined by high efficiency in combination with greater duration of treatment and absence of meaningful side effects.
Conclusions. Hysterocopic ablation of endometrium had high efficiency at the isolated endometrial hyperplasia – 78%. At their combination with the uterine leiomyoma frequency of successful treatment went down to 50%. In the case of combination of endometrial hyperplasia from adenomyosis and the expected result of treatment was attained a uterine fibroids only in 11,1% cases, and the number of hysterectomy grew to 78,9%, that allows to take afore-mentioned combination of endometrial hyperplasia in the number of contra-indications to hysterocopic ablation of endometrium.

Role of infectious pathogens which is selected from a cervical canal and biopsies of operating material, in genesis of hyperplastic processes of uterus for women different age

2026-04-03T17:54:00+03:00

DOI: 10.52705/2788-6190-2026-01-10
УДК 618.4-007.6-022-092

The objective: to set the role of infectious pathogens which is selected from a cervical canal and biopsies of operating material, in genesis of hyperplastic processes of uterus for women different age.
Materials and methods. For the decision of the put purpose 397 women were inspected different age. Plugging criteria are in research: presence of the combined hyperplastic processes of uterus - two and greater disease (endometrial hyperplasia, uterine fibroids and adenomyosis), verified morphologically, fertility age (18–45 years), absence in anamnesis of immunosuppressive therapy (6 months prior to entering into permanent establishment). On the basis of clinical motion of disease, information of genital status and pathomorphological conclusion the followings groups were formed: I a group was made 113 women with the hyperplastic process of endometrium and uterine fibroids, II group – 112 women with the hyperplastic process of endometrium and adenomyosis; III group – 101 patient with combination of three diseases - adenomyosis, uterine fibroids and endometrial hyperplasia. Foundation for plugging in the group of comparison was a presence exceptionally endometrial hyperplasia (without combination with uterine fibroids and adenomyosis, IV group) (information retrospective inspection, n = 71). The control V group was made by 90 women from a contingent gynaecological of healthy. To the complex of the conducted researches were included clinical, echographic, microbiological and statistical methods.
Results. Inspection of patients on all spectrum of exciters of sexually transmitted infections and conditionally pathogenic microorganisms of genital tract showed, that M. hominis was the unique etiologic agent in 80 % standards of mutated strain, in clinical isolates in default of mutations of monoinfecting of M. hominis it is marked at 2,8 time rarer (28,6 %). Found out cross-correlation copulas – positive – hyperplastic diseases of uterus with the level of CFU/ml (r = + 0,39; p = 0,006), and also with the strains of mutants of M hominis (r = +0,36; p = 0,012). From positions of confession of viability only heterogeneous population of microorganisms, presence of strains of mutants of M. hominis adds genetic heterogeneity to this population, consequently, firmness and potential for subsequent existence. The presence of direct cross-correlation connections between the level of CFU and frequency of hyperplastic processes confirms higher pathogenicity of strains of mutants of M. hominis, foreseeing their role as cofactors of diseases.
Conclusions. It is set pathomorphological researches of operating biopsies (endometrium, uterine fibroids and foci of adenomyosis), that for patients with combination of endometrial hyperplasia with a uterine fibroids and adenomyosis is: signs of chronic inflammatory process are in tissue of uterus; infecting of tissue of endometrium and myometrium conditionally pathogenic microorganisms; staggered by them not only mucus membrane but also myocytes; presence in 45,1 % strains of mutants of Mycoplasma of hominis; correlation of hyperplastic diseases of uterus is with the strains of mutants of M. hominis. The got results allow to examine infectious pathogens as cofactors of hyperplastic processes uteruses which are nosotropic related to the representatives of flora of lower departments of genital tract and take part in realization of inflammatory process.

Women have features of quality of life with the different forms of osteoporosis

2026-04-03T19:54:15+03:00

DOI: 10.52705/2788-6190-2026-01-11
УДК 616.71-007.234-055.2-039:303.022:314.47

The objective: to estimate quality of life for women with the different forms of osteoporosis.
Materials and methods. Monitoring of indexes of quality of life was conducted for 162 women with natural postmenopause and surgical postmenopause, three groups were formed: I (basic) group which consists of 35 women from osteopenia and by an osteoporosis, that got a hormone replacement therapy during 12 months. From them 10 (28,6 %) patients were in the period of natural postmenopause and last 25 (71,4 %) – in surgical postmenopause. 27 women got the continuous combined hormone replacement therapy; 3 patients – continuous monotherapy by estrogen; a tissue selective modulator of estrogen receptors is 5 women. During the first three months from treatment renounced 5 patients. The II (control) group is formed from 63 patients from osteopenia and by an osteoporosis, that got a diet, rich in a calcium (1200-1500 milligrams of calcium are on days). From them 25 (39,7 %) women were in natural postmenopause and 38 (60,3 %) – in surgical postmenopause. The III group (comparison) is presented by 64 women in the period of surgical postmenopause without osteopenia and to the osteoporosis.
Results. At the comparative analysis of data of the special questionnaire OPAQ on the points of research (T) by the method of analysis of variance in I found out a group the improvement of parameters 10 from 17 scales of questionnaire: from T2 of supervision is mobility, changing between standing and sitting positions, fear of falling, pain, sleep, fatigue, level of tension, original appearance, independence and from T3 is a mood. At comparing in pairs of four points to application of the special amendment for multiple comparisons on all scales, except for mobility and changing between standing and sitting positions, the increase of indexes of quality of life is confirmed. The scale of work (employment) was not analysed because of small number of workings women. Also positively parameters changed 2 from 4 analysable domens: symptoms are with T2 of therapy and physical activity from T3. Indexes only of 3 scales of OPAQ became better in the II group: social activity, independence and level of tension, is last at the special amendment from T3 of supervision. A domen is physical activity became better in 12 months of research. At comparison of indexes of quality of life of I and II groups found out reliable differences for 14 from 17 scales and to four domens in behalf of patients which accepted a hormone replacement therapy. The scales of I of group are listed walking and bending, retraining (time to get up and sit down), support from the side of family and friends and social activity was above complemented by scales, thus changes in the last were related to the improvement of this aspect of quality of life in the II group. Statistically the meaningful differences of scales and domens of two groups were observed from T2 of research, except for a scale mood and domen psychological status – from T3. Indexes of scales of dressing and reaching for the objects, self-service and implementation of work on a house did not differ in groups, that is related to their practically normal values in T1 and with absence of inability of patients to self-service.
Conclusions. The presented analysis of data led to the improvement of all constituents of quality of life of patients, sufferings the osteoporosis of postmenopause convincingly, under act of etiotropic hormone replacement therapy. On a background a hormone replacement therapy there is a substantial, early and stable improvement of indexes of quality of life of patients of osteopenia and by an osteoporosis on all scales of general questionnaires of SF-36 and EQ-5D, on most and all basic domens of the special questionnaire OPAQ scales as compared to women, which got a diet, rich in a calcium. The got results must be taken into account at development of algorithm of treatment-andprophylactic measures.

Dynamics of psycho-emotional changes after functionally sparing gynaecological operations

2026-04-03T20:06:09+03:00

DOI: 10.52705/2788-6190-2026-01-12
УДК 618.1-089.168.1-06:616.89-008.19

The objective: to estimate the dynamics of psycho-emotional changes 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 organpreserving 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). In the process of complex research modern and adequate methods were used clinical-andstatistical, medical-and-social, clinical, psychological research with the estimation of efficiency by the analysis of dynamics of indexes of quality of life.
Results. Cross-correlation connection is set between the type of operating access and expressed of reactive and personal anxiety (after a scale Ch.D. Spilbergera). A high reactive anxiety is marked at greater part of women after Pfannenshtiel incision and in operated by vaginal access, what for women after laparoscopic operations. A reactive and personal anxiety is expressed to the operation it was marked in 58,9 % women, through a half-year after an operation saved in 57,6 %, and in the separated period it is marked only in 24,3 % women. To the operation severe degree of syndrome (after a scale of Kupperman menopausal index) of menopause observed in most (79,5 %) women, through a half-year after an operation a severe degree was observed only in 15,4 % women, and in a remote period in 5,1 % women, that testifies to efficiency functionally sparing operations. Psycho-emotional, neurovegetative, exchange-endocrine violations are expressed at greater part of women after radical gynaecological operations (13,6 %) as compared to women after organpreserving operations (8,0 %) and for patients after conservative therapy (2,4 %) (р < 0,05). The clinically expressed alarm and depression (after a scale of M. Gamil’ton) is expressed anymore for women to the operation (11,6 %). Through a half-year and in a remote period after an operation this index reduced considerably (1,2 %) (р < ,05). It is well-proven that for women after laparoscopic operations the psycho-emotional state is more favourable (to a 64,3 ± 1,2 point), as compared to the state for women after Pfannenshtiel incision (to a 60,9 ± 2,1 point) and after vaginal operations (to a 59,7 ± 1,3 point, at р < 0,05). However after functionally sparing operations for all women irritability, fear, anxiety, is saved in an insignificant measure and other psycho-emotional displays.
Conclusion. At the use of the specialized psychological scales found out conformities to law, which testify to the expressed reactive anxiety, depression, signs of climacteric syndrome (neurovegetative, metabolic and psycho-emotional changes), which are stays after an operation (to 6 months) and sharply go down in a remote period (after 2), which is instrumental in the considerable improvement of the psycho-emotional state, self-esteem of health and quality of life.

Women, salpinxs operated concerning pathology, have features of assisted reproductive technologies

2026-04-03T20:18:46+03:00

DOI: 10.52705/2788-6190-2026-01-13
УДК 618.12-089.168.1-02:618.177-089.888.11-039

The objective: to estimate influence of operative interferences concerning pathology of salpinxs 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. To the complex of the conducted researches were included clinical, laboratory instrumental and
statistical.
Results. For patients which have in anamnesis reconstructive plastic surgery on salpinxs, as compared to patients in which was mine-out salpingectomy of one or both salpinxs, it was observed: frequency of offensive of pregnancy did not differ in both groups – 21 (33 %) and 14 (39 %); made the more than half of unsuccessful results of pregnancy ectopic pregnancy – 9 (42%), indexes of frequency of pregnancies which do not develop, and frequencies of the involuntary breaking of pregnancies were alike in both groups: 2 (10 %) and 2 (14 %), 4 (19 %) and 2 (14 %) respectively. It goes out from it, that all organ-preserving operations on salpinxs for patients with infertility and ectopic pregnancy or hydrosalpinx not enough perspective, because afterwards result in the relapse of ectopic pregnancy and hydrosalpinx in 10 times more frequent, as compared to salpingectomy. 21 (38%) patients sub-group with a hydrosalpinx during stimulation and ovulation, had in anamnesis reconstructive plastic surgery on salpinxs.
Conclusions. Violation of difficult architectonics of mucus shell of salpinxs as a result of chronic inflammatory process, and similarly their injuring during operations is reason of low efficiency plastic surgery. A presence patients with infertility of hydrosalpinx or ectopic pregnancy have a certificate for implementation of salpingectomy, in place of organ-preserving operations, with the purpose of preparation of patients to the program in vitro fertilizatio.

Married couples have reasons of miscarriage of pregnancy at infertility

2026-04-03T20:30:08+03:00

DOI: 10.52705/2788-6190-2026-01-14
УДК 618.39-06:618.177:616.697]-058.833

The objective: to find out reasons of miscarriage of pregnancy at infertility at married couples.
Materials and methods. We are conduct instantaneous transversal research which includes complex clinical-and-laboratory inspection 72 married couples with miscarriage of pregnancy in anamnesis (basic group). The group of comparison was presented 22 by married couples which became the parents of healthy children for period covered without the burdened reproductive anamnesis. To the complex of the conducted researches clinical, laboratory and instrumental methods were included.
Results. The anatomic features of uterus found out in 6 (20,7 %) women with sporadic abortion and 4 (9,3 %) women with usual abortion, р = 0,187. Chronic endometritis is morphologically verified for a 41 (95,3 %) woman with usual abortion and 22 (75,9 %) women with one involuntary abortion, р = 0,025. Thus on activity of inflammatory process of endometrium meaningful differences are not set statistically. At usual abortion of endometritis histological considered as nonactive in 26 (60,5 %) women, minimum degree of activity – in 9 (20,9 %), moderate degree of activity – in 6 (13,9 %), at one involuntary abortion of endometritis was nonactive in 16 (55,2 %) women, minimum active – in 4 (13,8 %), moderate degree of activity in 2 (6,9 %), р = 0,085. Hormonal violations are set in 15 (34,9 %) women with usual abortion and 11 (37,9 %) women with sporadic abortion, р = 0,808. A thrombophilia took place in 10 (34,5 %) women with one involuntary abortion and 17 (39,5 %) women with usual abortion, р = 0,805. Compatibility of the married couples for 2 and more discovered the antigens of the system HLA in 18 (41,9 %) married couples with usual abortion and 14 (48,3 %) couples with one involuntary abortion, compatibility for 3 and more set antigens at usual abortion for the 14 (32,6 %) married couples, at sporadic abortion – in 10 (34,5 %), р = 0,728. The variants of kariotype are certain in 6 (20,7 %) married couples with sporadic abortion and 6 (13,9 %) couples with usual abortion, р = 0,527. For a 21 (72,4 %) woman with sporadic abortion and 29 (67,4%) women with the usual miscarriage are set the combined reasons of gestational losses.
Conclusions. As a result of deep inspection it is not set statistically meaningful differences in the structure of reasons of gestational losses at sporadic abortion and usual miscarriage of pregnancy, except for chronic endometritis, which statistically meaningfully more frequent diagnosed for women with usual abortion.