Pub Date : 2023-07-14DOI: 10.26442/20795696.2023.2.202231
O. Kravtsova, P. Kuznetsov, L. Dzhokhadze, Y. Dobrokhotova, A. M. Zatevalov
Background. Preeclampsia (PE) complicates 28% of pregnancies worldwide, negatively impacting the pregnant woman and the fetus. Therefore, its prevention remains relevant. It is believed that the cause of PE, especially early PE, is a placentation disorder. It warrants studying drugs that can improve placenta development. The leadership in this matter is maintained by acetylsalicylic acid, which, according to the ASPRE study, reduced the incidence of PE at 34 weeks of pregnancy by 82%. The use of low molecular weight heparins (LMWH), dipyridamole, and antioxidants for PE prevention remains controversial and continues to be studied by foreign and Russian scientists. Aim. To assess the efficacy of acetylsalicylic acid, LMWH, dipyridamole (Curantyl), and bovine blood derivates (Actovegin) in the Russian population of pregnant women at high risk for PE prevention. Materials and methods. The study included 244 patients. We reviewed the archived case records of 103 patients diagnosed with severe PE, who delivered in 2019 at the State Clinical Hospital №24, and 141 pregnant women from the Maternity clinic №3 at the Veresaev Moscow State Clinical Hospital, where the risk of PE was assessed as high, according to the results of extended combined screening of the first trimester of pregnancy. Eighty-nine pregnant women received acetylsalicylic acid at a dose of 75 mg and 54 at a dose of 150 mg. In addition, 22 patients received LMWH, 6 dipyridamole, and 3 Actovegin. The absolute risks, the risk ratio, and statistical significance when taking drugs in each risk group were calculated to assess the efficacy of acetylsalicylic acid and other drugs for PE prevention in the above risk groups. Results. The resulting weak inverse correlation (r=-0.31) between the PE severity at delivery and the dose of acetylsalicylic acid indicates that an increase in the acetylsalicylic acid dose was associated with a decrease in the PE severity. The effectiveness of combinations of various drugs for PE prevention was assessed by analyzing factor correspondences. Two-dimensional scaling of the most likely combinations showed that most patients received acetylsalicylic acid in the high-risk group with no PE. Additional use of LMWH, Curantyl, and Actovegin did not reduce the risk of PE. Conclusion. Acetylsalicylic acid is the only pharmaceutical method for preventing PE in high-risk groups. Higher doses of acetylsalicylic acid are associated with lower PE severity.
{"title":"Acetylsalicylic acid as the only pharmacological method for the prevention of preeclampsia: A retrospective study","authors":"O. Kravtsova, P. Kuznetsov, L. Dzhokhadze, Y. Dobrokhotova, A. M. Zatevalov","doi":"10.26442/20795696.2023.2.202231","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202231","url":null,"abstract":"Background. Preeclampsia (PE) complicates 28% of pregnancies worldwide, negatively impacting the pregnant woman and the fetus. Therefore, its prevention remains relevant. It is believed that the cause of PE, especially early PE, is a placentation disorder. It warrants studying drugs that can improve placenta development. The leadership in this matter is maintained by acetylsalicylic acid, which, according to the ASPRE study, reduced the incidence of PE at 34 weeks of pregnancy by 82%. The use of low molecular weight heparins (LMWH), dipyridamole, and antioxidants for PE prevention remains controversial and continues to be studied by foreign and Russian scientists. \u0000Aim. To assess the efficacy of acetylsalicylic acid, LMWH, dipyridamole (Curantyl), and bovine blood derivates (Actovegin) in the Russian population of pregnant women at high risk for PE prevention. \u0000Materials and methods. The study included 244 patients. We reviewed the archived case records of 103 patients diagnosed with severe PE, who delivered in 2019 at the State Clinical Hospital №24, and 141 pregnant women from the Maternity clinic №3 at the Veresaev Moscow State Clinical Hospital, where the risk of PE was assessed as high, according to the results of extended combined screening of the first trimester of pregnancy. Eighty-nine pregnant women received acetylsalicylic acid at a dose of 75 mg and 54 at a dose of 150 mg. In addition, 22 patients received LMWH, 6 dipyridamole, and 3 Actovegin. The absolute risks, the risk ratio, and statistical significance when taking drugs in each risk group were calculated to assess the efficacy of acetylsalicylic acid and other drugs for PE prevention in the above risk groups. \u0000Results. The resulting weak inverse correlation (r=-0.31) between the PE severity at delivery and the dose of acetylsalicylic acid indicates that an increase in the acetylsalicylic acid dose was associated with a decrease in the PE severity. The effectiveness of combinations of various drugs for PE prevention was assessed by analyzing factor correspondences. Two-dimensional scaling of the most likely combinations showed that most patients received acetylsalicylic acid in the high-risk group with no PE. Additional use of LMWH, Curantyl, and Actovegin did not reduce the risk of PE. \u0000Conclusion. Acetylsalicylic acid is the only pharmaceutical method for preventing PE in high-risk groups. Higher doses of acetylsalicylic acid are associated with lower PE severity.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74612868","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202223
T. Zefirova, R. R. Mukhametova, A. T. Khaertdinov, E. M. Garipova
Iron deficiency anemia is widespread among the female population. Pregnant women are a particularly vulnerable group, because the existing iron reserves are inadequate, and during pregnancy the need for iron for the formation of the placenta and fetal growth increases sharply, as a result, there is an imbalance between the intake and consumption of this trace element. Anemia increases the risks of various complications of gestation and multiplies maternal mortality. Note an increase in the frequency of premature childbirth, the threat of termination of pregnancy, placental insufficiency, weakness of labor, fetal development delay, fetal hypoxia, low birth weight of the newborn, the volume of pathological blood loss during childbirth and in the early postpartum period. At the same time, the development of these pathological conditions can be prevented by following modern protocols of pre-pregnancy preparation and pregnancy management. Prevention of anemia includes the use of various iron preparations, as well as new combinations, in particular a combination of 80 mg of elemental iron and 350 mcg of folic acid. In the article, we describe clinical cases demonstrating a rational preventive approach that prevents the development of clinical anemia and promotes safe perinatal outcomes for mother and fetus.
{"title":"Experience of the combined use of iron and folic acid preparations for the correction of latent iron deficiency in the clinical practice of an obstetrician-gynecologist. Clinical case","authors":"T. Zefirova, R. R. Mukhametova, A. T. Khaertdinov, E. M. Garipova","doi":"10.26442/20795696.2023.2.202223","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202223","url":null,"abstract":"Iron deficiency anemia is widespread among the female population. Pregnant women are a particularly vulnerable group, because the existing iron reserves are inadequate, and during pregnancy the need for iron for the formation of the placenta and fetal growth increases sharply, as a result, there is an imbalance between the intake and consumption of this trace element. Anemia increases the risks of various complications of gestation and multiplies maternal mortality. Note an increase in the frequency of premature childbirth, the threat of termination of pregnancy, placental insufficiency, weakness of labor, fetal development delay, fetal hypoxia, low birth weight of the newborn, the volume of pathological blood loss during childbirth and in the early postpartum period. At the same time, the development of these pathological conditions can be prevented by following modern protocols of pre-pregnancy preparation and pregnancy management. Prevention of anemia includes the use of various iron preparations, as well as new combinations, in particular a combination of 80 mg of elemental iron and 350 mcg of folic acid. In the article, we describe clinical cases demonstrating a rational preventive approach that prevents the development of clinical anemia and promotes safe perinatal outcomes for mother and fetus.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80263149","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202083
A. Marianian, E. Molchanova, A. M. Molchanova
The article describes a clinical case demonstrating the effect of fetal alcohol syndrome on a preschool child's development, demonstrating the challenging diagnosis of this disorder, often leading to irreversible congenital mental and physical defects. The challenging diagnosis is because doctors are unaware of the mother's alcohol consumption during pregnancy. Doctors may suspect that the child has Fetal alcohol syndrome, according to the presence of facial dysmorphism and the state of health of the mother (pronounced signs of alcohol dependence). The clinical manifestations of the adverse effects of alcohol on the development of the child described in the article indicate the need to organize early diagnosis and comprehensive habilitation.
{"title":"The effect of fetal alcohol syndrome on the mental and physical development of a preschool child: a clinical case","authors":"A. Marianian, E. Molchanova, A. M. Molchanova","doi":"10.26442/20795696.2023.2.202083","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202083","url":null,"abstract":"The article describes a clinical case demonstrating the effect of fetal alcohol syndrome on a preschool child's development, demonstrating the challenging diagnosis of this disorder, often leading to irreversible congenital mental and physical defects. The challenging diagnosis is because doctors are unaware of the mother's alcohol consumption during pregnancy. Doctors may suspect that the child has Fetal alcohol syndrome, according to the presence of facial dysmorphism and the state of health of the mother (pronounced signs of alcohol dependence). The clinical manifestations of the adverse effects of alcohol on the development of the child described in the article indicate the need to organize early diagnosis and comprehensive habilitation.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87058400","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202240
T. Belokrinitskaya, N. I. Frolova, K. A. Kargina, E. A. Shametova, M. I. Chuprova, K. Rodionova
Background. During the three years of the new coronavirus infection (NCI) pandemic, young women of low infectious risk made a certain contribution to the severe maternal morbidity and mortality from COVID-19. Aim. To establish risk factors for morbidity and give a clinical assessment of COVID-19 during epidemic outbreaks in 2020, 2021, and 2022 in low-risk pregnant women. Materials and methods. The study included three groups of pregnant women with clinically manifested and laboratory-confirmed SARS-CoV-2 infection: 163 pregnant women who became ill in the first wave of the epidemic in October-December 2020, 158 in the second and third epidemic wave in July and October 2021, and 160 in the fourth epidemic wave in JanuaryFebruary 2022. Each comparison group included 100 pregnant women who did not become ill during the same periods of the pandemic. Patients of all groups were in the III trimester of gestation, comparable in age (1835 years), social status, parity, and body mass index, and had no known risk factors for COVID-19. Results. Iron-deficiency anemia, tobacco smoking, and belonging to the East Asian ethnic group showed a stable association with the incidence of COVID-19 in low-risk pregnant women. In the first year of the pandemic (strains zero and Alpha), the clinical presentation of NCI was dominated by a loss of smell and/or taste (87.7%), drowsiness (68.7%), and dyspnea even with a mild degree of lung damage (68.1%). The epidemics of the second year of the COVID-19 pandemic (Delta strain) were characterized by a more severe course of the disease than in the first year: fever was more often reported above 38C (19.6% vs 7.4%; p2=0.006), pneumonia confirmed by computed tomography (61.4% vs 21.4%; p20.001), severe lung damage (CT-3: 11.4% vs 4.9%; p2=0.040; CT-4: 0 vs 6.3%; p20.05), intensive care unit admission (11.4% vs 6.4%; p2=0.041); there were cases of invasive mechanical ventilation (1.89% vs 0; p2=0.118) and deaths (0.63% vs 0; p2=0.492). In the epidemic of the third year of the pandemic (Omicron strain), the COVID-19 clinical presentation was similar to seasonal acute respiratory viral infection: the predominant symptoms included runny nose (66.7%) and cough (54.4%); pneumonia was rare (3.8%). Conclusion. Iron deficiency anemia, tobacco smoking, and belonging to the East Asian ethnic group are confounders of COVID-19 disease in pregnant women without known infectious risk factors. Unlike the epidemics of the first and third year of the pandemic with dominant zero, Alpha, and Omicron strains, epidemic outbreaks of the second year of COVID-19 caused by the Delta strain were characterized by the most severe disease course, a high rate of pneumonia and deaths even in low-risk patients.
背景。在新型冠状病毒感染(NCI)大流行的三年中，低感染风险的年轻女性对COVID-19严重孕产妇发病率和死亡率有一定贡献。的目标。建立2020年、2021年和2022年低危孕妇COVID-19发病危险因素并进行临床评估。材料和方法。该研究包括三组临床表现和实验室确诊的SARS-CoV-2感染孕妇:163名孕妇在2020年10月至12月的第一波流行中发病，158名孕妇在2021年7月和10月的第二波和第三波流行中发病，160名孕妇在2022年1月和2月的第四波流行中发病。每个比较组包括100名在流感大流行期间没有生病的孕妇。所有组患者均处于妊娠晚期，年龄(1835岁)、社会地位、胎次和体重指数具有可比性，且无已知的COVID-19危险因素。结果。在低风险孕妇中，缺铁性贫血、吸烟和属于东亚族裔与COVID-19发病率有稳定的关联。在大流行的第一年(0型和Alpha型)，NCI的临床表现主要是嗅觉和/或味觉丧失(87.7%)、嗜睡(68.7%)和呼吸困难，甚至伴有轻度肺损伤(68.1%)。2019冠状病毒病大流行(δ型毒株)第二年的流行特点是病程比第一年更严重:38℃以上报告的发热发生率更高(19.6% vs 7.4%;P2 =0.006)，计算机断层扫描确诊肺炎(61.4% vs 21.4%;p20.001)，严重肺损伤(CT-3: 11.4% vs 4.9%;p2 = 0.040;CT-4: 0 vs 6.3%;P20.05)，重症监护病房住院率(11.4% vs 6.4%;p = 0.041);有创机械通气病例(1.89% vs 0;P2 =0.118)和死亡(0.63% vs 0;p = 0.492)。在大流行第三年(欧米克隆株)流行中，COVID-19临床表现与季节性急性呼吸道病毒感染相似:主要症状为流鼻涕(66.7%)和咳嗽(54.4%);肺炎罕见(3.8%)。结论。在没有已知感染危险因素的孕妇中，缺铁性贫血、吸烟和属于东亚族裔是COVID-19疾病的混杂因素。与大流行第一年和第三年以0、Alpha和Omicron菌株为主的流行不同，由Delta菌株引起的2019冠状病毒病第二年的流行爆发具有病程最严重、肺炎发生率高、甚至在低风险患者中死亡的特点。
{"title":"Clinical characteristics and confounders of the new coronavirus infection in low-risk pregnant women: an analysis of three years of the pandemic: A cross sectional study","authors":"T. Belokrinitskaya, N. I. Frolova, K. A. Kargina, E. A. Shametova, M. I. Chuprova, K. Rodionova","doi":"10.26442/20795696.2023.2.202240","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202240","url":null,"abstract":"Background. During the three years of the new coronavirus infection (NCI) pandemic, young women of low infectious risk made a certain contribution to the severe maternal morbidity and mortality from COVID-19. \u0000Aim. To establish risk factors for morbidity and give a clinical assessment of COVID-19 during epidemic outbreaks in 2020, 2021, and 2022 in low-risk pregnant women. \u0000Materials and methods. The study included three groups of pregnant women with clinically manifested and laboratory-confirmed SARS-CoV-2 infection: 163 pregnant women who became ill in the first wave of the epidemic in October-December 2020, 158 in the second and third epidemic wave in July and October 2021, and 160 in the fourth epidemic wave in JanuaryFebruary 2022. Each comparison group included 100 pregnant women who did not become ill during the same periods of the pandemic. Patients of all groups were in the III trimester of gestation, comparable in age (1835 years), social status, parity, and body mass index, and had no known risk factors for COVID-19. \u0000Results. Iron-deficiency anemia, tobacco smoking, and belonging to the East Asian ethnic group showed a stable association with the incidence of COVID-19 in low-risk pregnant women. In the first year of the pandemic (strains zero and Alpha), the clinical presentation of NCI was dominated by a loss of smell and/or taste (87.7%), drowsiness (68.7%), and dyspnea even with a mild degree of lung damage (68.1%). The epidemics of the second year of the COVID-19 pandemic (Delta strain) were characterized by a more severe course of the disease than in the first year: fever was more often reported above 38C (19.6% vs 7.4%; p2=0.006), pneumonia confirmed by computed tomography (61.4% vs 21.4%; p20.001), severe lung damage (CT-3: 11.4% vs 4.9%; p2=0.040; CT-4: 0 vs 6.3%; p20.05), intensive care unit admission (11.4% vs 6.4%; p2=0.041); there were cases of invasive mechanical ventilation (1.89% vs 0; p2=0.118) and deaths (0.63% vs 0; p2=0.492). In the epidemic of the third year of the pandemic (Omicron strain), the COVID-19 clinical presentation was similar to seasonal acute respiratory viral infection: the predominant symptoms included runny nose (66.7%) and cough (54.4%); pneumonia was rare (3.8%). \u0000Conclusion. Iron deficiency anemia, tobacco smoking, and belonging to the East Asian ethnic group are confounders of COVID-19 disease in pregnant women without known infectious risk factors. Unlike the epidemics of the first and third year of the pandemic with dominant zero, Alpha, and Omicron strains, epidemic outbreaks of the second year of COVID-19 caused by the Delta strain were characterized by the most severe disease course, a high rate of pneumonia and deaths even in low-risk patients.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84579503","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202236
E. Andreeva, E. Sheremetyeva, V. Prilepskaya
Reproductive health care involves helping families in this area with the provision of the necessary information. This is recognized as a key step in improving the health of men, women and children and is a fundamental human right. Everyone has the right to have access to a correct understanding of reproductive health care, choice of contraceptive method and the opportunity to benefit from scientific progress in this area. Over the past 35 years, significant progress has been made in the development of new contraceptives: the content of hormones in combined oral contraceptives has significantly decreased, inert intrauterine contraceptives have been replaced by more progressive, levonorgestrel-containing ones including low-dose generation. Combined hormonal compounds were synthesized in the form of injections, patches and vaginal rings, progestogen implantable and injectable contraceptives. Women who use contraceptives must take into account the state of health (including the presence of endocrine pathology) in order to use them without harm to their health. Based on the World Health Organization Medical Eligibility Criteria for Contraceptive Methods 2015, the Russian Medical Eligibility Criteria for Contraceptive Methods 2023 is designed to become an important tool in daily practice of doctors.
{"title":"National medical eligibility criteria for contraceptive use 2023: focus on women's reproductive health: A review","authors":"E. Andreeva, E. Sheremetyeva, V. Prilepskaya","doi":"10.26442/20795696.2023.2.202236","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202236","url":null,"abstract":"Reproductive health care involves helping families in this area with the provision of the necessary information. This is recognized as a key step in improving the health of men, women and children and is a fundamental human right. Everyone has the right to have access to a correct understanding of reproductive health care, choice of contraceptive method and the opportunity to benefit from scientific progress in this area. Over the past 35 years, significant progress has been made in the development of new contraceptives: the content of hormones in combined oral contraceptives has significantly decreased, inert intrauterine contraceptives have been replaced by more progressive, levonorgestrel-containing ones including low-dose generation. Combined hormonal compounds were synthesized in the form of injections, patches and vaginal rings, progestogen implantable and injectable contraceptives. Women who use contraceptives must take into account the state of health (including the presence of endocrine pathology) in order to use them without harm to their health. Based on the World Health Organization Medical Eligibility Criteria for Contraceptive Methods 2015, the Russian Medical Eligibility Criteria for Contraceptive Methods 2023 is designed to become an important tool in daily practice of doctors.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87229533","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202052
M. R. Orazov, V. V. Ermakov, Dmitrii S. Novginov
One of the most effective contraception methods is combined hormonal contraceptives. According to the current prescribing information, in addition to their primary effect, they have several concomitant positive effects on the female body non-contraceptive effects. These include a well-predictable and controlled "menstrual cycle" (menstrual-like reaction), anti-androgenic effect, anti-anemic effect due to reduced menstrual blood loss, reducing the severity of dysmenorrhea and premenstrual syndrome, reducing the risk of pelvic inflammatory diseases, ectopic pregnancy, and some benign and malignant tumors of the reproductive system. Combined oral contraceptives (COCs) also have effects on the central nervous system, hypothalamic-pituitary structures that regulate sex hormones, and the psycho-emotional health of women. For a long time, the main estrogen component of COCs remained ethinylestradiol. Although not well-studied, its mechanisms of action on the nervous system are similar, regardless of the progestogen component. However, the effect was not entirely positive: taking contraceptives containing ethinylestradiol can lead to increased emotional lability, anxiety, and depressive disorders. It drives researchers to search for new estrogen without these adverse properties. Such is the long-known but overlooked esthetrol. Numerous studies indicate a pronounced neuroprotective effect of esthetrol, which can increase patients' satisfaction with hormonal contraceptives and their compliance. It also opens up great opportunities for the use of this drug beyond gynecological practice.
{"title":"Neuroprotective effects of estetrol in combined oral contraceptives: A review","authors":"M. R. Orazov, V. V. Ermakov, Dmitrii S. Novginov","doi":"10.26442/20795696.2023.2.202052","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202052","url":null,"abstract":"One of the most effective contraception methods is combined hormonal contraceptives. According to the current prescribing information, in addition to their primary effect, they have several concomitant positive effects on the female body non-contraceptive effects. These include a well-predictable and controlled \"menstrual cycle\" (menstrual-like reaction), anti-androgenic effect, anti-anemic effect due to reduced menstrual blood loss, reducing the severity of dysmenorrhea and premenstrual syndrome, reducing the risk of pelvic inflammatory diseases, ectopic pregnancy, and some benign and malignant tumors of the reproductive system. Combined oral contraceptives (COCs) also have effects on the central nervous system, hypothalamic-pituitary structures that regulate sex hormones, and the psycho-emotional health of women. For a long time, the main estrogen component of COCs remained ethinylestradiol. Although not well-studied, its mechanisms of action on the nervous system are similar, regardless of the progestogen component. However, the effect was not entirely positive: taking contraceptives containing ethinylestradiol can lead to increased emotional lability, anxiety, and depressive disorders. It drives researchers to search for new estrogen without these adverse properties. Such is the long-known but overlooked esthetrol. Numerous studies indicate a pronounced neuroprotective effect of esthetrol, which can increase patients' satisfaction with hormonal contraceptives and their compliance. It also opens up great opportunities for the use of this drug beyond gynecological practice.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82022879","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202245
V. Prilepskaya, Lana L. Bostandzhian
Combined oral contraceptives (COCs) containing synthetic analogs of sex steroids are considered the most effective and popular method of contraception worldwide. The low rate of hormonal contraceptive use is often because of the fear of side effects due to existing myths. Complex questions that most often arise among doctors and patients when choosing COCs include the risk of thrombosis and cancer, the effect on fertility after the use of COCs, the use of COCs in patients with COVID-19, etc. COCs are highly effective, well-studied, and pose minimal risks that are well understood, described in the labels, and can be avoided with proper use.
{"title":"Complex questions about combined hormonal contraception: A review","authors":"V. Prilepskaya, Lana L. Bostandzhian","doi":"10.26442/20795696.2023.2.202245","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202245","url":null,"abstract":"Combined oral contraceptives (COCs) containing synthetic analogs of sex steroids are considered the most effective and popular method of contraception worldwide. The low rate of hormonal contraceptive use is often because of the fear of side effects due to existing myths. Complex questions that most often arise among doctors and patients when choosing COCs include the risk of thrombosis and cancer, the effect on fertility after the use of COCs, the use of COCs in patients with COVID-19, etc. COCs are highly effective, well-studied, and pose minimal risks that are well understood, described in the labels, and can be avoided with proper use.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88855567","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202257
O. Serova, Galina M. Shmeleva, Natalia V. Shutikova
Background. Bacterial vaginosis is an infectious non-inflammatory syndrome with polymicrobial etiology associated with dysbiosis of the vaginal biotope. Aim. To assess the clinical efficacy and safety of Secnidox in treating bacterial vaginosis in women 2059 years. Materials and methods. The study included 30 patients (mean age 31.14.7 years) with bacterial vaginosis who received 2 g of secnidazole (Secnidox) as a single dose. All patients were followed up by an obstetrician-gynecologist at two visits. Results. Secnidazole provided sanitation of the vagina. Normalization of clinical symptoms and laboratory tests was reported. Conclusion. Secnidazole showed good therapeutic efficacy and normalization of the vaginal microflora.
{"title":"Secnidazol`s effectiveness for the bacterial vaginosis treatment","authors":"O. Serova, Galina M. Shmeleva, Natalia V. Shutikova","doi":"10.26442/20795696.2023.2.202257","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202257","url":null,"abstract":"Background. Bacterial vaginosis is an infectious non-inflammatory syndrome with polymicrobial etiology associated with dysbiosis of the vaginal biotope. \u0000Aim. To assess the clinical efficacy and safety of Secnidox in treating bacterial vaginosis in women 2059 years. \u0000Materials and methods. The study included 30 patients (mean age 31.14.7 years) with bacterial vaginosis who received 2 g of secnidazole (Secnidox) as a single dose. All patients were followed up by an obstetrician-gynecologist at two visits. \u0000Results. Secnidazole provided sanitation of the vagina. Normalization of clinical symptoms and laboratory tests was reported. \u0000Conclusion. Secnidazole showed good therapeutic efficacy and normalization of the vaginal microflora.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85073790","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202062
M. Abramova, I. Ponomarenko, V. Orlova, I. Batlutskaya, O. Efremova, M. Churnosov
Background. Preeclampsia (PE) is a gestation complication that affects not only maternal and perinatal mortality but also the quality of life of women who have undergone PE, as well as their children in later life, which determines the urgency and relevance of the search for early markers of this complication of pregnancy, including genetic determinants. Aim. To evaluate the associations of GWAS-related hypertension candidate genes with the occurrence of severe PE. Materials and methods. All patients included in this study (217 females with severe PE and 498 females with physiological pregnancies) underwent a molecular genetic study of five GWAS-significant polymorphic loci of arterial hypertension candidate genes (rs1799945 HFE, rs805303 BAG6, rs4387287 OBFC1, rs633185 ARHGAP42, rs2681472 ATP2B1) and assessed the compliance of the empirical distribution of allelic variants and genotypes theoretically expected under HardyWeinberg law (at pbonf0.01). The associative search was performed using logistic regression analysis, and the odds ratio and its 95% confidence interval were calculated in PLINK v. 2.050. For polymorphisms that showed significant associations with severe PE, their regulatory effects were considered when using international projects on functional genomics (GTExportal, HaploReg (v4.1), PolyPhen-2). Results. The GG genotype of the rs1799945 polymorphic locus of the HFE gene is significantly associated with an increased risk of severe PE within the recessive genetic model (odds ratio 2.41; pperm=0.01). The polymorphism of rs1799945 of the HFE gene is localized in the histone markers H3K4me1 and H3K4me3 in pathogenetically significant organs and tissues for the development of PE, located in an evolutionarily conserved region located in the area of hypersensitivity to DNase-1. The rs1799945 locus of the HFE gene determines the missense mutation (aspartic acid replaces the amino acid histidine at position 63 in the Hereditary hemochromatosis protein) with the BENIGN predictor potential. Conclusion. The rs1799945 polymorphic locus of the HFE gene is associated with a high risk of severe PE.
{"title":"The polymorphic locus rs1799945 of the HFE gene determines the risk of severe preeclampsia","authors":"M. Abramova, I. Ponomarenko, V. Orlova, I. Batlutskaya, O. Efremova, M. Churnosov","doi":"10.26442/20795696.2023.2.202062","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202062","url":null,"abstract":"Background. Preeclampsia (PE) is a gestation complication that affects not only maternal and perinatal mortality but also the quality of life of women who have undergone PE, as well as their children in later life, which determines the urgency and relevance of the search for early markers of this complication of pregnancy, including genetic determinants. \u0000Aim. To evaluate the associations of GWAS-related hypertension candidate genes with the occurrence of severe PE. \u0000Materials and methods. All patients included in this study (217 females with severe PE and 498 females with physiological pregnancies) underwent a molecular genetic study of five GWAS-significant polymorphic loci of arterial hypertension candidate genes (rs1799945 HFE, rs805303 BAG6, rs4387287 OBFC1, rs633185 ARHGAP42, rs2681472 ATP2B1) and assessed the compliance of the empirical distribution of allelic variants and genotypes theoretically expected under HardyWeinberg law (at pbonf0.01). The associative search was performed using logistic regression analysis, and the odds ratio and its 95% confidence interval were calculated in PLINK v. 2.050. For polymorphisms that showed significant associations with severe PE, their regulatory effects were considered when using international projects on functional genomics (GTExportal, HaploReg (v4.1), PolyPhen-2). \u0000Results. The GG genotype of the rs1799945 polymorphic locus of the HFE gene is significantly associated with an increased risk of severe PE within the recessive genetic model (odds ratio 2.41; pperm=0.01). The polymorphism of rs1799945 of the HFE gene is localized in the histone markers H3K4me1 and H3K4me3 in pathogenetically significant organs and tissues for the development of PE, located in an evolutionarily conserved region located in the area of hypersensitivity to DNase-1. The rs1799945 locus of the HFE gene determines the missense mutation (aspartic acid replaces the amino acid histidine at position 63 in the Hereditary hemochromatosis protein) with the BENIGN predictor potential. \u0000Conclusion. The rs1799945 polymorphic locus of the HFE gene is associated with a high risk of severe PE.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"114 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80129422","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 : 2023-07-14DOI: 10.26442/20795696.2023.2.202252
A. Tokareva, L. Ramazanova, E. R. Dovletkhanova, Leyla E. Alieva, P. L. Sheshko, Evgenii N. Kukaev, N. Nazarova, N. Starodubtseva, V. Chagovets, V. Frankevich, V. Prilepskaya
Aim. To determine the change of lipid levels in the cervical epithelial cells during the treatment of chronic cervicitis and low-grade squamous intraepithelial lesions (LSIL) with 0.1% activated glycyrrhizic acid. Materials and methods. The prospective cohort study included 40 patients with chronic cervicitis and 40 patients with LSIL. Cytological evaluation of cervical smears was performed according to the Bethesda system (2014). All patients received Epigen Intim Spray for 18 months. Amplification of type-specific DNA fragments of human papillomavirus (HPV) and human DNA (sampling control SC) was done using a kit of reagents to detect, type, and quantitatively determine 21 HPV types by Quantum-21 HPV PCR. Lipid extract of a cervical epithelial scraping taken before and after therapy was analyzed by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). Lipids were identified using the Lipid Match R-script and by characteristic MS/MS. Correlation analysis of the lipidome of cervicovaginal fluid and SC was performed using the Spearman test, and the Mann-Whitney test was used to compare lipid levels at the two time points. Results. During the treatment of chronic cervicitis, the levels of CL lipids 16:0_16:1_18:1_18:1, HexCer-NDS d20:0/26:0, PC 16: 0_18: 1 and 16: 0_20:4 were decreasing; during the treatment of LSIL, the levels of ceramides and glucosylceramides were decreasing. Chronic cervicitis is characterized by a positive correlation of SC smear with cardiolipins, glucosylceramides, and epithelial lipids with an ether bond; LSIL showed a negative correlation with phosphatidylcholines and phosphatidylethanolamines with an ether bond. Conclusion. As a result of treatment with activated glycyrrhizic acid, the lipid spectrum of epithelial cells significantly changed, depending on the type of lesion. It is also necessary to consider SC scrapings in further studies of epithelial cell lipidome and the type of HPV-associated lesions that affects the adjustments.
{"title":"Effect of activated glycyrrhizic acid on epithelial cell lipidome in HPV-associated cervical lesions: A prospective cohort study","authors":"A. Tokareva, L. Ramazanova, E. R. Dovletkhanova, Leyla E. Alieva, P. L. Sheshko, Evgenii N. Kukaev, N. Nazarova, N. Starodubtseva, V. Chagovets, V. Frankevich, V. Prilepskaya","doi":"10.26442/20795696.2023.2.202252","DOIUrl":"https://doi.org/10.26442/20795696.2023.2.202252","url":null,"abstract":"Aim. To determine the change of lipid levels in the cervical epithelial cells during the treatment of chronic cervicitis and low-grade squamous intraepithelial lesions (LSIL) with 0.1% activated glycyrrhizic acid. \u0000Materials and methods. The prospective cohort study included 40 patients with chronic cervicitis and 40 patients with LSIL. Cytological evaluation of cervical smears was performed according to the Bethesda system (2014). All patients received Epigen Intim Spray for 18 months. Amplification of type-specific DNA fragments of human papillomavirus (HPV) and human DNA (sampling control SC) was done using a kit of reagents to detect, type, and quantitatively determine 21 HPV types by Quantum-21 HPV PCR. Lipid extract of a cervical epithelial scraping taken before and after therapy was analyzed by high-performance liquid chromatography with tandem mass spectrometry (HPLC-MS/MS). Lipids were identified using the Lipid Match R-script and by characteristic MS/MS. Correlation analysis of the lipidome of cervicovaginal fluid and SC was performed using the Spearman test, and the Mann-Whitney test was used to compare lipid levels at the two time points. \u0000Results. During the treatment of chronic cervicitis, the levels of CL lipids 16:0_16:1_18:1_18:1, HexCer-NDS d20:0/26:0, PC 16: 0_18: 1 and 16: 0_20:4 were decreasing; during the treatment of LSIL, the levels of ceramides and glucosylceramides were decreasing. Chronic cervicitis is characterized by a positive correlation of SC smear with cardiolipins, glucosylceramides, and epithelial lipids with an ether bond; LSIL showed a negative correlation with phosphatidylcholines and phosphatidylethanolamines with an ether bond. \u0000Conclusion. As a result of treatment with activated glycyrrhizic acid, the lipid spectrum of epithelial cells significantly changed, depending on the type of lesion. It is also necessary to consider SC scrapings in further studies of epithelial cell lipidome and the type of HPV-associated lesions that affects the adjustments.","PeriodicalId":36505,"journal":{"name":"Gynecology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79786829","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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