Pub Date : 2022-10-27DOI: 10.30841/2708-8731.6.2022.267684
V. Pyrohova, O. Laba
Dysbiotic changes in microbial ecosystem of the female lower genital tract are risk factors for spontaneous abortions, spontaneous preterm births, intra-amniotic infection, postpartum endometritis, and adverse perinatal outcomes. However, the opinions about the expediency of antimicrobial therapy in women with bacterial vaginosis and a history of preterm birth are controversial, and discussions and the search for an effective method of treatment are still continuing. Treatment of dysbiosis of the vaginal microbiota requires a complex approach for not only the pathogen elimination, but also for the restoring of the normal vaginal biotope. The objective: to evaluate the effectiveness of correction of dysbiotic disorders of the vaginal microbiota in women with risk factors for premature birth using the prebiotic topical therapy.Materials and methods. The studied cohort included 105 women with risk factors for premature birth. I group included 38 women at the stage of pregnancy planning, II group – 39 pregnant women, III group – 28 pregnant women from the moment of their first visit to the female consultation for pregnancy monitor. The control group included 20 conditionally healthy pregnant women at the same gestational age. The patients of the I and II groups after diagnosis of bacterial vaginosis (BV), vulvovaginal candidiasis, or aerobic vaginitis received etiotropic topical therapy in accordance with the recommendations of the Centers for Disease Control and Prevention and International Union against sexually transmitted infections. Bacterial vaginosis was treated by clindamycin cream (2 %) once a day for 7 days; aerobic vaginitis – vaginal tablets which contain 10 mg of dequalinium chloride for 6 days; candida vaginitis – fenticonazole 600 mg in one vaginal capsule once followed by topical application of a prebiotic complex (oligosaccharide, sodium hyaluronate, xylitol, vitamins, lactose) for 10 days. Then pH balance and normocenosis of the vagina were supported by the use of one vaginal capsule of the prebiotic complex per week till the 22nd week of gestation. The pregnant women in the III group with similar pathologies received only classical antimicrobial therapy with antibiotics and/or antifungal drugs.The assessment of the vaginal microbiota was carried out at the time of the patients inclusion in the study and at the 17–19 weeks of gestation by determination of the vaginal pH and using molecular biological and bacterioscopic methods. Results. The effectiveness of BV and mixed vaginitis therapy in all groups was high, the frequency of BV detection after treatment decreased from 28.9 % to 2.6 % in the I group and from 32.1 % to 3.6 % – in the III group.In the I and II groups, in which the patients received complex treatment with the prebiotic complex, the quantity of women with normocenosis of the vagina increased significantly (from 39.5 % to 89.5 % in the I group; from 35.9 % to 89.7 % in the II group), the frequency of the intermediate s
{"title":"Evaluation of the effectiveness of correction of vagina dysbiosis with the use of vaginal prebiotic complex in women with risk factors of spontaneous premature birth","authors":"V. Pyrohova, O. Laba","doi":"10.30841/2708-8731.6.2022.267684","DOIUrl":"https://doi.org/10.30841/2708-8731.6.2022.267684","url":null,"abstract":"Dysbiotic changes in microbial ecosystem of the female lower genital tract are risk factors for spontaneous abortions, spontaneous preterm births, intra-amniotic infection, postpartum endometritis, and adverse perinatal outcomes. However, the opinions about the expediency of antimicrobial therapy in women with bacterial vaginosis and a history of preterm birth are controversial, and discussions and the search for an effective method of treatment are still continuing. Treatment of dysbiosis of the vaginal microbiota requires a complex approach for not only the pathogen elimination, but also for the restoring of the normal vaginal biotope. The objective: to evaluate the effectiveness of correction of dysbiotic disorders of the vaginal microbiota in women with risk factors for premature birth using the prebiotic topical therapy.Materials and methods. The studied cohort included 105 women with risk factors for premature birth. I group included 38 women at the stage of pregnancy planning, II group – 39 pregnant women, III group – 28 pregnant women from the moment of their first visit to the female consultation for pregnancy monitor. The control group included 20 conditionally healthy pregnant women at the same gestational age. The patients of the I and II groups after diagnosis of bacterial vaginosis (BV), vulvovaginal candidiasis, or aerobic vaginitis received etiotropic topical therapy in accordance with the recommendations of the Centers for Disease Control and Prevention and International Union against sexually transmitted infections. Bacterial vaginosis was treated by clindamycin cream (2 %) once a day for 7 days; aerobic vaginitis – vaginal tablets which contain 10 mg of dequalinium chloride for 6 days; candida vaginitis – fenticonazole 600 mg in one vaginal capsule once followed by topical application of a prebiotic complex (oligosaccharide, sodium hyaluronate, xylitol, vitamins, lactose) for 10 days. Then pH balance and normocenosis of the vagina were supported by the use of one vaginal capsule of the prebiotic complex per week till the 22nd week of gestation. The pregnant women in the III group with similar pathologies received only classical antimicrobial therapy with antibiotics and/or antifungal drugs.The assessment of the vaginal microbiota was carried out at the time of the patients inclusion in the study and at the 17–19 weeks of gestation by determination of the vaginal pH and using molecular biological and bacterioscopic methods. Results. The effectiveness of BV and mixed vaginitis therapy in all groups was high, the frequency of BV detection after treatment decreased from 28.9 % to 2.6 % in the I group and from 32.1 % to 3.6 % – in the III group.In the I and II groups, in which the patients received complex treatment with the prebiotic complex, the quantity of women with normocenosis of the vagina increased significantly (from 39.5 % to 89.5 % in the I group; from 35.9 % to 89.7 % in the II group), the frequency of the intermediate s","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74160556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.30841/2708-8731.6.2022.267683
V. Siusiuka, V. Potapov, A. Shevchenko, O.D. Kyryliuk, N. Guba, N. Mosol
The objective: to assess the diagnostic significance of anamnestic and clinical-psychological factors and develop the prediction criteria for the threat of premature birth (PB). Materials and methods. An analysis of the data of pregnant women who were tested in the II and early III trimesters (screening is the I stage of the study) was carried out. The pregnant women were conditionally divided into two groups. The main group included 30 women whose further course of pregnancy was complicated by the threat of PB. The comparison group included 222 women without clinical manifestations of threat of PB during the current pregnancy. During the II stage of the study, the systematization of existing anamnestic and clinical-psychological factors among the examined women was performed. At the III stage, a comparative analysis of the frequency of the symptoms identified at the I stage was carried out in pregnant women in groups with the calculation of diagnostic coefficients (DC) of measures of informativeness (MI) according to formulas. Diagnostic (prognostic) tables were created for each factor, DC and MI were calculated based on the ratio of frequencies. According to the methodology for calculating the accuracy of the diagnostic decision to achieve a probability level of 95 % (p=0.05), the limit ∑DC is a constant = ±13, to achieve a probability of 99 % = ±20, to achieve a probability of 99.9% = ±30. If there is a factor in the column of the scale that is not included in the spectrum of exclusions, put a check mark in the “yes” column of the corresponding row. In the absence of such a check mark is placed in the “no” column of the corresponding row. Regarding the filling of each row, the sum of DC is calculated by adding up the indicated DCs, in the case of reaching the value of ∑DC, a preliminary diagnostic conclusion is made about the probability for threat of PB (at ∑DC = -13), which has a confidence level of 95 % (p=0.05). If the value of ∑DK = -20 is reached, a final diagnostic conclusion is made about the probability of 99 % for threat of PB (p=0.01). If the limit of the range is -13 < ∑DC < +13, the conclusion is significant because in such case its “p” is > 0.05.Results. Based on the values of DC and MI of Kullbak (valid signs), a clinical scale to predict threat of PB with a confidence level of 95 % (p=0.05) or 99 % (p=0.01) was developed. Among the informative signs (factors) for predicting of threat of PB the following factors were established: spontaneous miscarriage in the anamnesis, high personal and situational anxiety (45 points and above), IV and more pregnancies and artificial abortion in the anamnesis, as well as the level of neuroticism (16 points and above). Conclusions. It has been established that anamnestic and clinical-psychological factors, namely, miscarriage in the anamnesis, artificial abortion in the anamnesis, IV and more pregnancies, high levels of personal and situational anxiety and neuroticism, are important and effec
{"title":"Clinical and psychological ground of principles of prognostication of premature delivery risk","authors":"V. Siusiuka, V. Potapov, A. Shevchenko, O.D. Kyryliuk, N. Guba, N. Mosol","doi":"10.30841/2708-8731.6.2022.267683","DOIUrl":"https://doi.org/10.30841/2708-8731.6.2022.267683","url":null,"abstract":"The objective: to assess the diagnostic significance of anamnestic and clinical-psychological factors and develop the prediction criteria for the threat of premature birth (PB). Materials and methods. An analysis of the data of pregnant women who were tested in the II and early III trimesters (screening is the I stage of the study) was carried out. The pregnant women were conditionally divided into two groups. The main group included 30 women whose further course of pregnancy was complicated by the threat of PB. The comparison group included 222 women without clinical manifestations of threat of PB during the current pregnancy. During the II stage of the study, the systematization of existing anamnestic and clinical-psychological factors among the examined women was performed. At the III stage, a comparative analysis of the frequency of the symptoms identified at the I stage was carried out in pregnant women in groups with the calculation of diagnostic coefficients (DC) of measures of informativeness (MI) according to formulas. Diagnostic (prognostic) tables were created for each factor, DC and MI were calculated based on the ratio of frequencies. According to the methodology for calculating the accuracy of the diagnostic decision to achieve a probability level of 95 % (p=0.05), the limit ∑DC is a constant = ±13, to achieve a probability of 99 % = ±20, to achieve a probability of 99.9% = ±30. If there is a factor in the column of the scale that is not included in the spectrum of exclusions, put a check mark in the “yes” column of the corresponding row. In the absence of such a check mark is placed in the “no” column of the corresponding row. Regarding the filling of each row, the sum of DC is calculated by adding up the indicated DCs, in the case of reaching the value of ∑DC, a preliminary diagnostic conclusion is made about the probability for threat of PB (at ∑DC = -13), which has a confidence level of 95 % (p=0.05). If the value of ∑DK = -20 is reached, a final diagnostic conclusion is made about the probability of 99 % for threat of PB (p=0.01). If the limit of the range is -13 < ∑DC < +13, the conclusion is significant because in such case its “p” is > 0.05.Results. Based on the values of DC and MI of Kullbak (valid signs), a clinical scale to predict threat of PB with a confidence level of 95 % (p=0.05) or 99 % (p=0.01) was developed. Among the informative signs (factors) for predicting of threat of PB the following factors were established: spontaneous miscarriage in the anamnesis, high personal and situational anxiety (45 points and above), IV and more pregnancies and artificial abortion in the anamnesis, as well as the level of neuroticism (16 points and above). Conclusions. It has been established that anamnestic and clinical-psychological factors, namely, miscarriage in the anamnesis, artificial abortion in the anamnesis, IV and more pregnancies, high levels of personal and situational anxiety and neuroticism, are important and effec","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87446981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-27DOI: 10.30841/2708-8731.6.2022.267681
A. Serbeniuk
The objective: to study the features of the sonographic picture of the pelvic organs in women of reproductive age who took part in combat operations and suffered a concussion. Materials and methods. Ultrasound examination of the pelvic organs with Doppler study on the 5th and 21st days of the menstrual cycle was performed in 457 women of reproductive age who took part in combat operations and suffered a concussion. 246 patients of theses persons with a history of trauma without post-concussion syndrome were included in the comparison group, 211 women with consequences of concussion in the form of post-concussion syndrome – in the main group. The control group included 30 healthy civilian women of reproductive age. The concentration of progesterone in blood serum was studied in all subjects on the 5th and 21st days of the menstrual cycle. The average age of women was 37.08±4.23 years. The period of stay in the combat zone was 60.26±42.21 months, the time since the traumatic brain injury (concussion) was 18.8±9.2 months. Results. In patients of the main group without hyperplastic processes of the endometrium the M-echo thickness on the 21st day of the menstrual cycle was 1.12 times less (p<0.001) than in the control group, and 1.15 times less in patients in the comparison group (p<0.001). In 20.71 % of women with a contusion during combat operations, there is an inferior secretory transformation of the endometrium with increased echogenicity only in the peripheral parts of the M-echo with a hypoechoic zone in the center, in 13.81 % of patients there are no secretory changes in the endometrium on echograms, which manifested by the preservation on the 21st day of its three-layer construction, typical for the preovulatory period, with a hypoechoic functional layer. Intrauterine synechiae are formed in 10.95 % of women who suffered contusions during combat operationss, hyperplastic endometrial processes – 30.24 % of women, 12.3 8% of which had hyperplasia, 17.86 % –endometrial polyps.In patients who suffered a contusion during combat operations a decrease in the vascularization of the corpus luteum with a significant increase in the resistance index of blood flow in the corpus luteum by 1.27 times and a decrease in the maximum systolic velocity by 1.19 times was, in the subjects of the main group compared to women of the comparison group – 1.07 (p<0.01) and 1.05 (p<0.01) times, respectively. On the 21st day of the menstrual cycle in women who took part in combat operations and had concussion, a correlation between the level of serum progesterone and the index of blood flow resistance in the corpus luteum – r=-0.76, p<0.05, as well as maximum systolic blood flow velocity - r=0.70, p<0.05 was established. Conclusions. According to the ultrasound examination of the pelvic organs for women of reproductive age who took part in combat operations and suffered a concussion, ultrasound changes in the structure of the tissues of the pelvic organs and their vascu
{"title":"Features of the sonographic picture in female veterans of reproductive age who suffered injuries during combat actions","authors":"A. Serbeniuk","doi":"10.30841/2708-8731.6.2022.267681","DOIUrl":"https://doi.org/10.30841/2708-8731.6.2022.267681","url":null,"abstract":"The objective: to study the features of the sonographic picture of the pelvic organs in women of reproductive age who took part in combat operations and suffered a concussion. Materials and methods. Ultrasound examination of the pelvic organs with Doppler study on the 5th and 21st days of the menstrual cycle was performed in 457 women of reproductive age who took part in combat operations and suffered a concussion. 246 patients of theses persons with a history of trauma without post-concussion syndrome were included in the comparison group, 211 women with consequences of concussion in the form of post-concussion syndrome – in the main group. The control group included 30 healthy civilian women of reproductive age. The concentration of progesterone in blood serum was studied in all subjects on the 5th and 21st days of the menstrual cycle. The average age of women was 37.08±4.23 years. The period of stay in the combat zone was 60.26±42.21 months, the time since the traumatic brain injury (concussion) was 18.8±9.2 months. Results. In patients of the main group without hyperplastic processes of the endometrium the M-echo thickness on the 21st day of the menstrual cycle was 1.12 times less (p<0.001) than in the control group, and 1.15 times less in patients in the comparison group (p<0.001). In 20.71 % of women with a contusion during combat operations, there is an inferior secretory transformation of the endometrium with increased echogenicity only in the peripheral parts of the M-echo with a hypoechoic zone in the center, in 13.81 % of patients there are no secretory changes in the endometrium on echograms, which manifested by the preservation on the 21st day of its three-layer construction, typical for the preovulatory period, with a hypoechoic functional layer. Intrauterine synechiae are formed in 10.95 % of women who suffered contusions during combat operationss, hyperplastic endometrial processes – 30.24 % of women, 12.3 8% of which had hyperplasia, 17.86 % –endometrial polyps.In patients who suffered a contusion during combat operations a decrease in the vascularization of the corpus luteum with a significant increase in the resistance index of blood flow in the corpus luteum by 1.27 times and a decrease in the maximum systolic velocity by 1.19 times was, in the subjects of the main group compared to women of the comparison group – 1.07 (p<0.01) and 1.05 (p<0.01) times, respectively. On the 21st day of the menstrual cycle in women who took part in combat operations and had concussion, a correlation between the level of serum progesterone and the index of blood flow resistance in the corpus luteum – r=-0.76, p<0.05, as well as maximum systolic blood flow velocity - r=0.70, p<0.05 was established. Conclusions. According to the ultrasound examination of the pelvic organs for women of reproductive age who took part in combat operations and suffered a concussion, ultrasound changes in the structure of the tissues of the pelvic organs and their vascu","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88746696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265474
T.G. Laskava, V. Beniuk, O. Shcherba, T. Kovaliuk, L. Lastovetska
The objective: to study the features of the psychoemotional state and quality of life of nulliparous women with recurrent squamous epithelial exocervical dysplasia of the cervical epithelium in the perimenopausal period.Materials and methods. 60 nulliparous women with recurrent cervical epithelial flat dysplasia that occurred after treatment with surgical methods in the perimenopausal period (the main group) and 38 women without gynecological and somatic pathologies in the perimenopausal period (control group) were examined. All patients were examined in accordance with the regulatory orders of the Ministry of Health of Ukraine. The assessment of neurovegetative and psychoemotional manifestations was carried out according to the Kupperman index, indicators of the quality of life and the Lusher color test.Results. The data of the medical history and clinical examination of patients were evaluated. This makes possible to identify a risk group among nulliparous women in the perimenopausal period for the development of recurrent squamous epithelial exocervical dysplasia of the cervical epithelium.In the main group, an increase in the Kupperman menopausal index by almost 1.5 times was found, as well as a significant decrease in indicators of psychosocial adaptation according to Lusher test to 40% and quality of life (physical component of health was 72.5±6.4 and 93,1±4,7 points in the main and control groups, respectively, mental component – 54.2±4.1 and 91,4±2,3 points, respectively).Conclusions. In infertile women with the menopausal changes, the recurrent squamous epithelial exocervical dysplasia of the cervical epithelium is a form of complicated course of dysplasia, and has a multifactorial genesis, in which conditions arise for the implementation of the neoplastic process. The clinical manifestations of the complicated course of the perimenopausal period significantly worsen the quality of life and general health in nulliparous women, especially on the background of recurrent squamous epithelial exocervical dysplasia of the cervical epithelium after surgical treatment, which is evidenced by more pronounced climacteric manifestations, reduction of physical and social activities, and emotional status.
{"title":"Psychoemotional state and quality of life of nulliparous women with recurrent squamous epithelial exocervical dysplasia of the cervical epithelium in the perimenopausal period","authors":"T.G. Laskava, V. Beniuk, O. Shcherba, T. Kovaliuk, L. Lastovetska","doi":"10.30841/2708-8731.5.2022.265474","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265474","url":null,"abstract":"The objective: to study the features of the psychoemotional state and quality of life of nulliparous women with recurrent squamous epithelial exocervical dysplasia of the cervical epithelium in the perimenopausal period.Materials and methods. 60 nulliparous women with recurrent cervical epithelial flat dysplasia that occurred after treatment with surgical methods in the perimenopausal period (the main group) and 38 women without gynecological and somatic pathologies in the perimenopausal period (control group) were examined. All patients were examined in accordance with the regulatory orders of the Ministry of Health of Ukraine. The assessment of neurovegetative and psychoemotional manifestations was carried out according to the Kupperman index, indicators of the quality of life and the Lusher color test.Results. The data of the medical history and clinical examination of patients were evaluated. This makes possible to identify a risk group among nulliparous women in the perimenopausal period for the development of recurrent squamous epithelial exocervical dysplasia of the cervical epithelium.In the main group, an increase in the Kupperman menopausal index by almost 1.5 times was found, as well as a significant decrease in indicators of psychosocial adaptation according to Lusher test to 40% and quality of life (physical component of health was 72.5±6.4 and 93,1±4,7 points in the main and control groups, respectively, mental component – 54.2±4.1 and 91,4±2,3 points, respectively).Conclusions. In infertile women with the menopausal changes, the recurrent squamous epithelial exocervical dysplasia of the cervical epithelium is a form of complicated course of dysplasia, and has a multifactorial genesis, in which conditions arise for the implementation of the neoplastic process. The clinical manifestations of the complicated course of the perimenopausal period significantly worsen the quality of life and general health in nulliparous women, especially on the background of recurrent squamous epithelial exocervical dysplasia of the cervical epithelium after surgical treatment, which is evidenced by more pronounced climacteric manifestations, reduction of physical and social activities, and emotional status.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79789385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265468
I. Zhabchenko, I. Lishchenko
The objective: to determine the peculiarities of hormonal support, liver enzymatic function and the state of the fetal-placental complex (FPC) in unvaccinated women with fetal growth retardation (FGR) and placental dysfunction (PD) who was ill with the coronavirus disease during the current pregnancy, on the background of the proposed correction scheme of the disorders and evaluation of its effectiveness.Materials and methods. The study included 22 pregnant women with FGR and PD who were being treated and delivered in the Department of Pregnancy and Childbirth Pathology of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova National Academy of Sciences of Ukraine» in 2021–2022 and suffered a coronavirus disease during the current pregnancy. All pregnant women had a general clinical examination and the following parameters were additionally determined: the level of placental lactogen (PL) in blood serum, indicators of liver enzyme activity (alanine aminotransferase – ALT, aspartate aminotransferase – AST, gamma-glutamyl transpeptidase – GHTP), the level of estriol in urine (after the 22d week of pregnancy). The examination was carried out before the start of treatment and preventive measures and 12–14 days after a 10-day course of therapy with simultaneous ultrasound (US) monitoring of the condition of the FPC. In the case of diagnosis of FGR and PD, a course of therapy was carried out, which included daily consecutive intravenous infusions of a balanced crystalloid infusion preparation with lactate and sorbitol in the amount of 200 ml and a solution of levocarnitine and arginine hydrochloride in the amount of 100 ml for 10 days, followed by ultrasound control of the condition of the fetus and FPC. The evaluation of the effectiveness of the treatment was carried out based on a combination of clinical, laboratory and instrumental indicators after 10 days of therapy. Results. All pregnant women had a moderate or mild course of the coronavirus disease at different terms of the current pregnancy. There were 9 (40.9 %) women who were infected with SARS-CoV-2 in the early terms of pregnancy (up to 12 weeks), and they were diagnosed the 2nd and 2nd-3rd degrees of FGR.The majority of pregnant women had gestational complications. Before treatment, 10 (45.5 %) women had oligohydramnios. FGR was diagnosed in 14 (63.6 %) pregnant women, among them: in 3 (13.6 %) persons – fetal growth retardation of the 2nd-3rd degree, in 6 (27.3 %) – of the 2nd degree, in 5 (22.7 %) – 1st degree. The analysis of laboratory indicators demonstrated the increase in the levels of ALT, AST and GHTP, and a decrease in the levels of estriol in urine. After the proposed course of treatment, oligohydramnios was found only in 2 (9.1 %) women. The average amniotic index before treatment was 10.1, after treatment – 15.3. 4 (18.2 %) women were diagnosed FGR after the treatment. As a result of the treatment, the improvement of a
{"title":"Modern possibilities of correction of postcovid disorders in the fetoplacental complex","authors":"I. Zhabchenko, I. Lishchenko","doi":"10.30841/2708-8731.5.2022.265468","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265468","url":null,"abstract":"The objective: to determine the peculiarities of hormonal support, liver enzymatic function and the state of the fetal-placental complex (FPC) in unvaccinated women with fetal growth retardation (FGR) and placental dysfunction (PD) who was ill with the coronavirus disease during the current pregnancy, on the background of the proposed correction scheme of the disorders and evaluation of its effectiveness.Materials and methods. The study included 22 pregnant women with FGR and PD who were being treated and delivered in the Department of Pregnancy and Childbirth Pathology of the State Institution «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova National Academy of Sciences of Ukraine» in 2021–2022 and suffered a coronavirus disease during the current pregnancy. All pregnant women had a general clinical examination and the following parameters were additionally determined: the level of placental lactogen (PL) in blood serum, indicators of liver enzyme activity (alanine aminotransferase – ALT, aspartate aminotransferase – AST, gamma-glutamyl transpeptidase – GHTP), the level of estriol in urine (after the 22d week of pregnancy). The examination was carried out before the start of treatment and preventive measures and 12–14 days after a 10-day course of therapy with simultaneous ultrasound (US) monitoring of the condition of the FPC. In the case of diagnosis of FGR and PD, a course of therapy was carried out, which included daily consecutive intravenous infusions of a balanced crystalloid infusion preparation with lactate and sorbitol in the amount of 200 ml and a solution of levocarnitine and arginine hydrochloride in the amount of 100 ml for 10 days, followed by ultrasound control of the condition of the fetus and FPC. The evaluation of the effectiveness of the treatment was carried out based on a combination of clinical, laboratory and instrumental indicators after 10 days of therapy. Results. All pregnant women had a moderate or mild course of the coronavirus disease at different terms of the current pregnancy. There were 9 (40.9 %) women who were infected with SARS-CoV-2 in the early terms of pregnancy (up to 12 weeks), and they were diagnosed the 2nd and 2nd-3rd degrees of FGR.The majority of pregnant women had gestational complications. Before treatment, 10 (45.5 %) women had oligohydramnios. FGR was diagnosed in 14 (63.6 %) pregnant women, among them: in 3 (13.6 %) persons – fetal growth retardation of the 2nd-3rd degree, in 6 (27.3 %) – of the 2nd degree, in 5 (22.7 %) – 1st degree. The analysis of laboratory indicators demonstrated the increase in the levels of ALT, AST and GHTP, and a decrease in the levels of estriol in urine. After the proposed course of treatment, oligohydramnios was found only in 2 (9.1 %) women. The average amniotic index before treatment was 10.1, after treatment – 15.3. 4 (18.2 %) women were diagnosed FGR after the treatment. As a result of the treatment, the improvement of a","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75154086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265469
О.V. Golyanovskiy, D.V. Kulchytskiy, A. Rubinshtein
The objective: to develop the optimal delivery algorithm in persons with Placenta previa alone and with partial Placenta accreta, using innovative technologies with the priority of organ-saving operations.Materials and methods. 106 pregnant women with prenatal diagnosis of Placenta previa and the possibility of the safe pregnancy prolongation till 34-36 weeks of gestation were included in the study. To achieve the aim of the study, two groups were formed: the first (control) group – 75 patients were delivered via standard elective cesarean section in terms of 34-36 weeks; the second (main) group – 51 patients delivered in the same terms via our organ-saving method (elective cesarean section using argon-plasma tissue coagulation, agonists of oxytocin and vasopressors; and ligation of main uterine vessels and internal iliac arteries).The following characteristics of cesarean section were taken into account: time of the fetal extraction, duration of the operation, intraoperative blood loss volume and Placenta accreta spectrum disorders (PAS) complications were compared in groups with further statistical data analysis.Results. The mean indices of the cesarean section duration and time from the start of an operation till the fetal extraction were significantly lower (p<0.05) in the second group and amounted 55.7±5.1 min and 195.0±21.0 sec, respectively, versus 74.5±4.3 min and 274.0±17.0 sec in the first group. Intraoperative blood loss volume was also significantly lower in the second group than in the first one – 775.0±60.0 ml versus 970.0±55.0 ml, p<0.05).The part of Placenta previa and PAS combination in one patient amounted to 20.0% in the first group and 17.6% in the second one. Pl. accreta was diagnosed in 17.33% cases in the first group, Pl. increta – in 1.33%, Pl. percreta – in 1.33%. Hysterectomy has been performed in 8.0% cases, all Pl. increta and percreta cases required the hysterectomy and were followed by massive obstetric hemorrhages (MOH). DIC-syndrome developed in 2.67%. In the second group Pl. accreta was diagnosed in 19.61% and Pl. increta – in 3.92%, patients with Pl. increta had hysterectomy. MOH were observed in 38.7% cases in the first group versus 9.7% cases in the second group (p<0.05). Furthermore, in the first group hysterectomy was performed almost four times more frequently than in the second group (24.0% versus 6.5% respectively, p<0.05).Conclusions. The developed delivery algorithm in pregnant women with Placenta previa alone or in a combination with PAS allowed to reduce intraoperative blood loss significantly, prevent the MOH development, therefore to reach secure hemostasis and save the uterus.
{"title":"Combined staged surgical hemostasis in a case of Placenta previa and Placenta accreta spectrum disorders","authors":"О.V. Golyanovskiy, D.V. Kulchytskiy, A. Rubinshtein","doi":"10.30841/2708-8731.5.2022.265469","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265469","url":null,"abstract":"The objective: to develop the optimal delivery algorithm in persons with Placenta previa alone and with partial Placenta accreta, using innovative technologies with the priority of organ-saving operations.Materials and methods. 106 pregnant women with prenatal diagnosis of Placenta previa and the possibility of the safe pregnancy prolongation till 34-36 weeks of gestation were included in the study. To achieve the aim of the study, two groups were formed: the first (control) group – 75 patients were delivered via standard elective cesarean section in terms of 34-36 weeks; the second (main) group – 51 patients delivered in the same terms via our organ-saving method (elective cesarean section using argon-plasma tissue coagulation, agonists of oxytocin and vasopressors; and ligation of main uterine vessels and internal iliac arteries).The following characteristics of cesarean section were taken into account: time of the fetal extraction, duration of the operation, intraoperative blood loss volume and Placenta accreta spectrum disorders (PAS) complications were compared in groups with further statistical data analysis.Results. The mean indices of the cesarean section duration and time from the start of an operation till the fetal extraction were significantly lower (p<0.05) in the second group and amounted 55.7±5.1 min and 195.0±21.0 sec, respectively, versus 74.5±4.3 min and 274.0±17.0 sec in the first group. Intraoperative blood loss volume was also significantly lower in the second group than in the first one – 775.0±60.0 ml versus 970.0±55.0 ml, p<0.05).The part of Placenta previa and PAS combination in one patient amounted to 20.0% in the first group and 17.6% in the second one. Pl. accreta was diagnosed in 17.33% cases in the first group, Pl. increta – in 1.33%, Pl. percreta – in 1.33%. Hysterectomy has been performed in 8.0% cases, all Pl. increta and percreta cases required the hysterectomy and were followed by massive obstetric hemorrhages (MOH). DIC-syndrome developed in 2.67%. In the second group Pl. accreta was diagnosed in 19.61% and Pl. increta – in 3.92%, patients with Pl. increta had hysterectomy. MOH were observed in 38.7% cases in the first group versus 9.7% cases in the second group (p<0.05). Furthermore, in the first group hysterectomy was performed almost four times more frequently than in the second group (24.0% versus 6.5% respectively, p<0.05).Conclusions. The developed delivery algorithm in pregnant women with Placenta previa alone or in a combination with PAS allowed to reduce intraoperative blood loss significantly, prevent the MOH development, therefore to reach secure hemostasis and save the uterus.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87281781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265471
S. Vozianova, L. Bolotna, O. Sarian
The article presents a review of modern ukrainian and foreign publications on the pathogenesis, clinical manifestations and diagnostics of female pattern hair loss (FPHL), which is a common type of hair loss and its frequency increases with age. The questions of terminology, disease prevalence, and risk factors of hair loss are considered. It is emphasized that FPHL is a clinical problem and that it is advisable to clarify the comorbid profile of female patients and to screen for metabolic disorders. There is still no complete understanding of the pathophysiology of FPHL. There is evidence that hormonal, genetic, and environmental factors are involved in the process of hair loss in women. Current data concerning systemic hormonal disturbances in ovarian and adrenal gland diseases in women as well as the importance of disorders of androgen-dependent mechanisms of regulation of the hair follicle growth cycle are presented.The attention is drawn to genetic abnormalities in the case of FPHL. The role of growth factors, cytokines, microinflammation, iron deficiency, perifollicular fibrosis, oxidative stress in regression of the hair follicle is considered. FPHL is characterized as non-scarring alopecia, which develops due to progressive miniaturization of hair follicles and further hair reduction, especially in the central (frontal and parietal) scalp, gradual replacement of long terminal hair by short pubic (vellus) hair. Three models of female hair loss, modern classification according to the stages of progression used in practice, possible causes of clinical differences in alopecia in men and women are presented. The main directions of diagnostics (history, clinical and laboratory examination, special dermatological tests) are outlined, the possibilities of modern noninvasive diagnostic method of dermoscopy are emphasized. Pharmacotherapy, recommended on the basis of evidence-based medicine, is limited to two drugs – topical minoxidil and systemic finasteride. The necessity of interdisciplinary approach to the management of patients with FPHL has been proved.
{"title":"Women’s hair loss: pathophysiological, diagnostic and therapeutic aspects","authors":"S. Vozianova, L. Bolotna, O. Sarian","doi":"10.30841/2708-8731.5.2022.265471","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265471","url":null,"abstract":"The article presents a review of modern ukrainian and foreign publications on the pathogenesis, clinical manifestations and diagnostics of female pattern hair loss (FPHL), which is a common type of hair loss and its frequency increases with age. The questions of terminology, disease prevalence, and risk factors of hair loss are considered. It is emphasized that FPHL is a clinical problem and that it is advisable to clarify the comorbid profile of female patients and to screen for metabolic disorders. There is still no complete understanding of the pathophysiology of FPHL. There is evidence that hormonal, genetic, and environmental factors are involved in the process of hair loss in women. Current data concerning systemic hormonal disturbances in ovarian and adrenal gland diseases in women as well as the importance of disorders of androgen-dependent mechanisms of regulation of the hair follicle growth cycle are presented.The attention is drawn to genetic abnormalities in the case of FPHL. The role of growth factors, cytokines, microinflammation, iron deficiency, perifollicular fibrosis, oxidative stress in regression of the hair follicle is considered. FPHL is characterized as non-scarring alopecia, which develops due to progressive miniaturization of hair follicles and further hair reduction, especially in the central (frontal and parietal) scalp, gradual replacement of long terminal hair by short pubic (vellus) hair. Three models of female hair loss, modern classification according to the stages of progression used in practice, possible causes of clinical differences in alopecia in men and women are presented. The main directions of diagnostics (history, clinical and laboratory examination, special dermatological tests) are outlined, the possibilities of modern noninvasive diagnostic method of dermoscopy are emphasized. Pharmacotherapy, recommended on the basis of evidence-based medicine, is limited to two drugs – topical minoxidil and systemic finasteride. The necessity of interdisciplinary approach to the management of patients with FPHL has been proved.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76924894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265475
V. Benyuk, V. Kurochka, Abedi Astaneg Niki, I. Usevych, Y. Kravchenko
The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.
{"title":"Clinical characteristics of women with endometrial hyperplasia on the background of thyroid dysfunction","authors":"V. Benyuk, V. Kurochka, Abedi Astaneg Niki, I. Usevych, Y. Kravchenko","doi":"10.30841/2708-8731.5.2022.265475","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265475","url":null,"abstract":"The objective: to define the specificities of clinical characteristics in women of reproductive age with endometrial hyperplasia associated with hypothyroidism.Materials and methods. There were 180 women with endometrial hyperplasia under our supervision. In 120 women, the pathology of endometrium was associated with newly diagnosed hypothyroidism. The patients with the thyroid dysfunctions were divided into the following groups: asymptomatic persons – 48 cases; symptomatic ones – 45 women; compensated patients with mild symptoms – 27 individuals. The control group consisted of 60 patients with endometrial hyperplasia without thyroid pathology.The data of the somatic and gynecological anamnesis, the concentration of sex hormones and thyroid hormones, the results of histological examination of the endometrium were analyzed in all the women.Results. The following data were found: the age of women with hyperprolactinemia without thyroid pathology is younger than the age of those with hyperprolactinemia and thyroid pathology; hypothyroidism in women with endometrial hyperplasia is contingent on frequently growing body weight, but not obesity; the most common concomitant pathology in women with endometrial hyperplasia and hypothyroidism was mastopathy which was diagnosed almost in every third patient. The frequency of such endocrine pathologies as polycystic ovary syndrome and hyperprolactinemia in women with endometrial hyperplasia has almost increased twice in the presence of hypothyrosis. In case of endometrial hyperplasia and hypothyrosis there was a significant decrease of estradiol concentration with a preserved level of gonadotropic hormones (luteinizing hormone and follicle-stimulating hormone), and the lowest values were defined in women with symptomatic hypothyroidism. Chronic endometritis, the detection rate of which does not depend on thyroid dysfunction, was diagnosed in 61.5 % patients with endometrial hyperplasia.Conclusions. Thyroid dysfunction is involved in the mechanisms of development of hyperplastic processes of the endometrium, which is the basis for screening the functional state of the thyroid gland in women with endometrial pathology.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85582009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265470
V. Kondratiuk, K. Kondratiuk, K. Gasparyan, N. Gorban, O. Trokhymovych, G.A. Dzuba, L.D. Zachurdaeva
Among the variety of factors that affect the female organism, obesity is of great importance in the formation, development and functioning of the reproductive system, the development of gynecological diseases in which metabolic syndrome plays an important pathogenetic role (polycystic ovary syndrome is diagnosed in 35-60% of obese women; menstrual dysfunction – in 6 times more often, primary infertility – 2 times more). The components of the metabolic syndrome have a significant effect on the body: insulin resistance, hyperinsulinemia, dyslipoproteinemia, elevated levels of thrombosis factors. This article reviews the current scientific literature on the role of sirtuins in the regulatory cellular processes and metabolic cascades, with special emphasis on the possibilities of their pharmacological activation by resveratrol. The role of resveratrol as a promoter of sirtuin activity at different levels of homeostasis disturbance was analyzed, and the properties of resveratrol, its effects and impact on the female body in the presence of metabolic pathology were analyzed in order to prescribe timely treatment and slow down the reproductive aging process.Literature data prove the importance of polyphenols (resveratrol) use as an effective and pathogenetically determined activator of sirtuins for the regulation of oxidative stress, inflammation, correction of dysbiosis and imbalance of the immune system in the concept of treatment of women with gynecological diseases and metabolic disorders. Resveratrol itself has a wide range of pharmacological effects with proven antilipogenic properties and a safe harmonizing estrogen-like effect on various regulatory levels. The natural plant composition and long history of use of resveratrol have repeatedly revealed its clinical achievements, including polycystic ovary syndrome treatment. The high clinical effectiveness and safety profile allow to recommend the inclusion of resveratrol in treatment regimens and to prevent the relapses of metabolically determined gynecological and somatic diseases in women of various age periods.
{"title":"Modern opportunities and prospects for preserving woman’s health","authors":"V. Kondratiuk, K. Kondratiuk, K. Gasparyan, N. Gorban, O. Trokhymovych, G.A. Dzuba, L.D. Zachurdaeva","doi":"10.30841/2708-8731.5.2022.265470","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265470","url":null,"abstract":"Among the variety of factors that affect the female organism, obesity is of great importance in the formation, development and functioning of the reproductive system, the development of gynecological diseases in which metabolic syndrome plays an important pathogenetic role (polycystic ovary syndrome is diagnosed in 35-60% of obese women; menstrual dysfunction – in 6 times more often, primary infertility – 2 times more). The components of the metabolic syndrome have a significant effect on the body: insulin resistance, hyperinsulinemia, dyslipoproteinemia, elevated levels of thrombosis factors. This article reviews the current scientific literature on the role of sirtuins in the regulatory cellular processes and metabolic cascades, with special emphasis on the possibilities of their pharmacological activation by resveratrol. The role of resveratrol as a promoter of sirtuin activity at different levels of homeostasis disturbance was analyzed, and the properties of resveratrol, its effects and impact on the female body in the presence of metabolic pathology were analyzed in order to prescribe timely treatment and slow down the reproductive aging process.Literature data prove the importance of polyphenols (resveratrol) use as an effective and pathogenetically determined activator of sirtuins for the regulation of oxidative stress, inflammation, correction of dysbiosis and imbalance of the immune system in the concept of treatment of women with gynecological diseases and metabolic disorders. Resveratrol itself has a wide range of pharmacological effects with proven antilipogenic properties and a safe harmonizing estrogen-like effect on various regulatory levels. The natural plant composition and long history of use of resveratrol have repeatedly revealed its clinical achievements, including polycystic ovary syndrome treatment. The high clinical effectiveness and safety profile allow to recommend the inclusion of resveratrol in treatment regimens and to prevent the relapses of metabolically determined gynecological and somatic diseases in women of various age periods.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78870289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-07DOI: 10.30841/2708-8731.5.2022.265472
Yu.R. Dyakunchak, V. Pyrohova, І.І. Okhabska
The objective: to study the medical and social characteristics of women in reproductive age who had urgent gynecological surgical operaions.Material and methods. The studied cohort consisted of 135 women in reproductive age who had urgent surgery for ovarian apoplexy (43; 31.9 %), ectopic pregnancy (57; 42.2 %), complicated ovarian tumor (35; 25.9 %). The inclusion criteria were age from 19 to 40 years; intraoperatively confirmed ovarian apoplexy, ectopic pregnancy, complicated ovarian formation; informed consent of the patient to participate in the study. Social and clinical data were registered in the developed questionnaire, which included social and household data, professional and material factors, somatic and obstetric and gynecological anamnesis. Statistical processing of the results was carried out using standard Microsoft Excel 7.0 and “Statistica 6.0” programsResults. It was determined that 26 (19.3 %) women did not visit a gynecologist at all, 18 (69.2 %) of them did not have a sexual activity, 8 (30.8 %) patients did not plan to become pregnant, so they were not considered that it is necessary to visit a doctor. Another feature of the gynecological anamnesis of patients who had urgent surgical operations was a repeated surgical intervention due to a similar gynecological pathology. Thus, 26.9 % of patients were re-hospitalized due to ovarian apoplexy, and 19.2 % had operation again. 17.3 % of women had a repeat ectopic (tubal) pregnancy, for which 13.5 % of patients had repeated surgery. Recurrence of ovarian tumor and urgent surgical intervention occurred in 25.8 % of patients.Conclusions. The lack of full coverage of patients with pathogenetically justified medical and preventive measures after urgent surgical operations leads to the recurrence of similar gynecological pathology and repeated urgent surgical interventions. The obtained results indicate the need for a multifaceted analysis of factors affecting the frequency of acute gynecological diseases and in the scientific justification of medical and diagnostic approaches with the introduction of modern organizational technologies into practice.
{"title":"Medical and social characteristics of women of reproductive age who have undergone urgent gynecological surgery","authors":"Yu.R. Dyakunchak, V. Pyrohova, І.І. Okhabska","doi":"10.30841/2708-8731.5.2022.265472","DOIUrl":"https://doi.org/10.30841/2708-8731.5.2022.265472","url":null,"abstract":"The objective: to study the medical and social characteristics of women in reproductive age who had urgent gynecological surgical operaions.Material and methods. The studied cohort consisted of 135 women in reproductive age who had urgent surgery for ovarian apoplexy (43; 31.9 %), ectopic pregnancy (57; 42.2 %), complicated ovarian tumor (35; 25.9 %). The inclusion criteria were age from 19 to 40 years; intraoperatively confirmed ovarian apoplexy, ectopic pregnancy, complicated ovarian formation; informed consent of the patient to participate in the study. Social and clinical data were registered in the developed questionnaire, which included social and household data, professional and material factors, somatic and obstetric and gynecological anamnesis. Statistical processing of the results was carried out using standard Microsoft Excel 7.0 and “Statistica 6.0” programsResults. It was determined that 26 (19.3 %) women did not visit a gynecologist at all, 18 (69.2 %) of them did not have a sexual activity, 8 (30.8 %) patients did not plan to become pregnant, so they were not considered that it is necessary to visit a doctor. Another feature of the gynecological anamnesis of patients who had urgent surgical operations was a repeated surgical intervention due to a similar gynecological pathology. Thus, 26.9 % of patients were re-hospitalized due to ovarian apoplexy, and 19.2 % had operation again. 17.3 % of women had a repeat ectopic (tubal) pregnancy, for which 13.5 % of patients had repeated surgery. Recurrence of ovarian tumor and urgent surgical intervention occurred in 25.8 % of patients.Conclusions. The lack of full coverage of patients with pathogenetically justified medical and preventive measures after urgent surgical operations leads to the recurrence of similar gynecological pathology and repeated urgent surgical interventions. The obtained results indicate the need for a multifaceted analysis of factors affecting the frequency of acute gynecological diseases and in the scientific justification of medical and diagnostic approaches with the introduction of modern organizational technologies into practice.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87929179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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