Reproductive health of woman最新文献

{"title":"Clinical and pathogenetic mechanisms of formation of fetal growth retardation","authors":"O. Deinichenko, V.G. Sіusіuka, Y. Krut, M. Pavlyuchenko, V. Puchkov, A. Shevchenko, N.G. Kolokot","doi":"10.30841/2708-8731.3.2023.283320","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283320","url":null,"abstract":"Fetal growth retardation (FGR) is a major cause of child morbidity and mortality, and is also an important medical and social problem due to a wide range of pregnancy complications and negative outcomes in the postnatal period. The results of recent studies indicate that chronic arterial hypertension causes a number of pathological changes in a pregnant woman’s organism, in particular, it increases the risk of FGR.The wide knowledge about the pathogenesis of placental dysfunction and FGR allow to establish that the development of these pathologies is primarily caused by the changes in uterine and placental blood circulation, which leads to metabolic disorders. The important etiological reasons for FGR also include social and biological factors, the influence of narcotic substances, insufficient nutrition, alcohol abuse, tobacco smoking, as well as the use of coumarin or derivatives. The mother’s older age is also a risk factor for the FGR development.Over the past decades, both clinical and experimental studies have established that FGR, caused by the influence of the unfavorable environment of the uterus, is a risk factor for the development of hypertension, as well as various diseases in adults. There are a lot of evidences that support the association of FGR with an increased risk of hypertension in adults, but the mechanisms underlying these processes remain unclear. Both clinical and basic scientific studies have confirmed the theory of intrauterine programming of arterial hypertension in adults. That is why many countries have developed programs for the prevention of FGR. Scientific researches indicate a close relationship between social adaptation and the birth of children with low body weight.The absence of indices decrease in perinatal morbidity and mortality by FGR shows the difficulties caused by polyetiological factors and certain pathogenetic mechanisms of the mentioned complication. Today, the search for an effective pathogenetically based therapy of this pathology continues, which indicates the need for further researches, and the development and implementation of approaches to the prevention of FGR will improve the perinatal putcomes.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91112306","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}

{"title":"Features of hormonal homeostasis in women with functional hypothalamic amenorrhea and premature ovarian insufficiengy caused by posttraumatic stress disorder.","authors":"O. Horbatiuk, A. Hryhorenko, A. Shatkovska, O. Vaskiv, O. Gerych, A.I. Petrash","doi":"10.30841/2708-8731.3.2023.283324","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283324","url":null,"abstract":"Posttraumatic stress disorder can cause severe and prolonged amenorrhea in women. Since the beginning of the war in Ukraine, there has been an increased number of visits for the medical care of female military servicewomen and displaced women with this problem.The objective: to perform a comprehensive study of the characteristics of the hormonal levels of the hypothalamic-pituitary-ovarian axis and the stress hormone cortisol, as well as to analyze the presence of autoantibodies to ovarian tissue in women with secondary amenorrhea caused by posttraumatic stress disorder.Materials and methods. The levels of hypothalamic-pituitary-ovarian hormones (follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin, estradiol, progesterone, free testosterone and anti-Mullerian hormone (AMH), as well as cortisol (urine), autoantibodies to ovarian tissue from 54 military servicewomen and displaced women with amenorrhea caused by posttraumatic stress disorder (main group). 35 (64.8%) women (the 1st subgroup) were diagnosed with functional hypothalamic amenorrhea (FHA), 19 (35.2%) patients (the 2nd subgroup) were diagnosed with premature ovarian failure (POF).The control group included 23 women of reproductive age (18–37 years), who were in a state of psychological comfort and had no menstrual cycle disorders.Results. As a result of the study, a significant (p<0.05) decrease of all pituitary-ovarian hormones was found in women with FHA, except for free testosterone and AMH. In patients with POF, there was an increased concentration of pituitary hormones and a decreased amount of estradiol by 2.2 times, progesterone by 3.9 times, and AMH by 21.0 times compared to the control group.A 1.5-fold increase in prolactin level in patients with POF compared to the indicator of the control group is noteworthy. The presence of autoantibodies in the group with POF was detected in 26.3% of cases (in the group of women with FHA – only in 2.9% of cases; p<0.05), which may be a manifestation of polyglandular autoimmune syndrome.In both examined subgroups of the main group, a probable increased cortisol concentration in daily urine was determined (by 2.0 times in the 1st subgroup and by 2.1 times in the 2nd subgroup compared to the control), which indicates a stressogenic dysfunction of the adrenal glands.Conclusions. Posttraumatic stress disorder can have an irreversible pathological effect on the reproductive system of women. In women with stressogenic functional hypothalamic amenorrhea there is a deep depression of the hypothalamic-pituitary-ovarian axis with preserving the follicular ovarian apparatus.In women with premature ovarian failure (POF) with long-term stress, there is a sharp depletion of the ovarian reserve. The presence of autoantibodies to ovarian tissue indicates the involvement of the immune system in the pathogenetic chain of development of amenorrhea, the severity of the lesion and the higher speed of the follicle atresia process by POF.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89060432","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}

{"title":"Pathomorphological changes of the placenta in antenatal asphyxia of the fetus associated with the coronavirus disease (COVID-19) in pregnant women","authors":"T. Savchuk","doi":"10.30841/2708-8731.3.2023.283322","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283322","url":null,"abstract":"The objective: to determine the pathomorphological changes in the placenta by antenatal asphyxia of the fetus associated with the coronavirus disease (COVID-19) in pregnant women.Materials and methods. 21 placentas by fetal antenatal asphyxia which occurred at different terms of pregnancy in women with COVID-19 were examined. COVID-19 was diagnosed by a positive PCR test – detection of SARS-CoV-2 RNA. The study groups were defined depending on the duration of the post-covid interval (time from the diagnosis of COVID-19 to delivery). I group (n=12) included placentas of women with antenatal fetal asphyxia, in whom the postpartum interval was 1–4 weeks; II group (n=9) – placentas of women with fetal death, in whom the postpartum interval was 5–14 weeks.In the I group, antenatal asphyxia of the fetus occurred in the term from the 13th to 36th weeks of gestation, in the II group – in period from the 29th to the 41st week. Macroscopic, organometric, microscopic methods of placenta research and a statistical method were applied. Fetal-placental index (FPI) was calculatedResults. In the studied cases, antenatal fetal death occurred in different terms of pregnancy, namely, from the 14th to the 41st week of gestation (median is 32 weeks). Pregnant women had COVID-19 from the 13th to the 35th week of gestation (median is 25 weeks); when the mother was diagnosed with COVID-19 after the 35th week, there was no case of antenatal fetal death. The severity of the course of the coronavirus disease was mild in 7 pregnant women, moderate – 12 persons, and a severe course with pneumonia was diagnosed in 2 women. The severity of morphological changes in the placenta did not depend on the severity of the course of COVID-19 in the pregnant woman (chorioamnionitis, p=1.0; intervillositis, p=0.63; obliteration of arterioles, p=0.32).In the I group, a slight increase in FPI was found up to 0.19 [0.12; 0.34], in the II group – a similar indicator was 0.16 [0.13; 0.24]. However, the absolute values of the weight of the fetus and placenta in both groups were lower than those for the given gestational age.The I group of placentas there were the pronounced inflammatory changes – placentitis: chorioamnionitis – 100% (95%CI: 85.4–100) and basal deciduitis – 91.7% (95%CI: 67.1–100). In the II group the inflammatory changes of the chorioamniotic membranes and basal plate were focal and were found in 6 placentas – 66.7% (95% CI: 29.2–94.8). Intervillositis was detected in 11 placentas – 91.7% (95%CI: 67.1–100) in the I group versus 2 placentas – 22.2% (95%CI: 1.1–58.9; p=0.006) in the II group.Villositis in the I group was determined in 8 cases – 66.7% (95%CI: 35.4–91.4) and in only one placenta in the II group – 11.1% (95%CI: 0.0–43.91; p=0.034). In the placentas of both groups the fibrinoid necrosis of the arteriole wall, proliferative changes in the vessel wall and necrosis of the endothelium were detected – 100% (95%CI: 85.4–100), dyscirculatory disorders (stasis, thrombosis, ","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75149307","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}

{"title":"COVID-19: Maternal deaths in the tertiary health care center","authors":"C. Raj Smruthi, R. Rekha, B. Manjula, S. Prashanth, B. Lepakshi","doi":"10.30841/2708-8731.3.2023.283318","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283318","url":null,"abstract":"The maternal mortality rate is increasing due to associated complications of labor, the severity of infection, and co-morbidities. The impact of COVID-19 infection on pregnant women data is insufficient in the literature, so in the present study, we are evaluating the rate of maternal mortality due to COVID-19 infection in McGANN Teaching District Hospital a tertiary health care center.The objective: to evaluate the rate of maternal mortality due to COVID-19 infection.Materials and methods. This is a single-center retro-prospective study, which included all maternal mortalities with COVID-19 infection admitted to the department of obstetrics and gynecology, McGANN teaching district hospital a tertiary health care center from June 2020 to October 2021. COVID-19 infected 15 pregnant women who died during hospitalization, treatment, labor, and after labor due to various complications. Data were collected from the medical record section and presented in an excel sheet and analyzed using SPSS software.Results. In the study period, maternal mortality due to COVID-19 infection was found to be more in the less than 30 years age group (73.3 %). Nearly all cases were admitted with complaints of fever (40 %), cough (53.3 %), abdominal pain (13.3 %), and breathlessness (80 %). Out of 15 maternal deaths, most of the cases are found to be primiparous (46.7 %), and the time from delivery to a death varies from 1-14 days. Nearly 66.7 % of cases had a gestational period of fewer than 36 weeks. Pulse rate, respiration rate, inflammatory markers, prothrombin time, liver enzymes, and blood glucose levels were elevated. The total protein hemoglobin and oxygen saturation percentage declined in the cases. The known co-morbidity present in the cases associated with maternal mortality was hypertension (20 %), diabetic mellitus (13.3 %), valvular heart disease (6.7 %), and pre-eclampsia (6.7 %). The most cause of death was acute respiratory distress syndrome (80 %).Conclusions. In this study the severe infection with co-morbidities showed an increased risk of severe morbidity and mortality.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83568903","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}

{"title":"Comparison of methods of anesthetic management in hysteroscopy","authors":"V. Petrychenko, R. Tkachenko","doi":"10.30841/2708-8731.3.2023.283323","DOIUrl":"https://doi.org/10.30841/2708-8731.3.2023.283323","url":null,"abstract":"The objective: to evaluate and improve the existing methods of anesthetic support during hysteroscopy.Materials and methods. In 2021-2022 years, 40 patients who had operative treatment – hysteroscopy, were examined in the municipal non-commercial enterprise “Kyiv City Center of Reproductive and Perinatal Medicine”. The exclusion criterion was the presence of concomitant diseases (hypertension, type 1 and type 2 diabetes, bronchial asthma, etc.).All patients were randomly divided into two groups depending on the chosen method of anesthesia. In the 1st group, standard total intravenous anesthesia was performed and premedication with nefopam and paracetamol was used for the improvement the anesthetic support and compare the results in the 2nd group.The hemodynamic indicators of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were measured to objectify the level of the pain syndrome, oxygen saturation in the blood was measured also. Pain was assessed using a visual analog scale (VAS) questionnaire.Results. It was established that the anesthetic support of the 1st group of patients was accompanied by a significant (p<0.05) increase of hemodynamic indicators at the stage of the beginning of the operation versus the indicators of the 2nd group: SBP – by 13.77%; DBP – by 11.92%, MAP – by 13.08%. After the end of anesthesia (awakening), an increased blood pressure was registered in the 1st group, which had a significant difference with similar indicators of the 2nd group, namely: SBP by 22.33%, DBP – by 19.05%, MAP – by 20.51%.Heart rate in the 1st group after the installation of a laryngeal mask (induction of anesthesia) was higher by 12.85% (p<0.05) than in the 2nd group. Heart rate was also higher upon awakening in the 1st group – by 16.03% (р<0.05) than in patients of the 2nd group. In the 2nd group, the maximum VAS score in 30 minutes after waking up was 0.9±0.11 points, which did not require additional analgesia, while in the 1st group this score was 3.86±0.20 points.20% of patients who were not premedicated with nefopam and paracetamol, in 30 minutes after surgery had vomiting, which was not present in the group where premedication was performed.Conclusions. Premedication with nefopam and paracetamol as the additional analgesics can prevent the development of pain sensations in the postoperative period and reduce the incidence of vomiting. The use of a laryngeal mask during artificial lung ventilation ensured adequate tightness of the connection of the respiratory tract with the circuit of the anesthesia machine.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"21 5-6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91497593","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}

{"title":"Hemoperitoneum as a result of bleeding from a vein lying on the capsule of subserous leiomyoma of uterus (Clinical case)","authors":"V. V. Bila, O. Kostenko, O.Ya. Slobodianik, S. Leush, A.G. Ter-Tumasova","doi":"10.30841/2708-8731.2.2023.278281","DOIUrl":"https://doi.org/10.30841/2708-8731.2.2023.278281","url":null,"abstract":"Leiomyoma is a benign tumor of the uterus and it is considered to be the most sensitive tumor of the female genital organs. The tumor can have submucosal, intramural, and subserosal localizations, each of which has specific features of the course and complications. The article describes the clinical observation of a case of intra-abdominal bleeding, which was caused by the rupture of a vein lying on the capsule of a subserous uterine leiomyoma.Literature data about the leiomyoma frequency and its localization are presented in the article, as well as an explanation of the complexity of the true assessment of the frequency of this pathology, the peculiarities of a described case from a clinical and pathomorphological point of view. A review of the literature allowed to find 125 descriptions of clinical cases of bleeding from the vessel of the subserosal node during the last 100 years.The presented clinical case is interesting from the point of diagnosis. The picture of an “acute abdomen” by leiomyoma is most often associated with a blood circulation disorder of the node, and in this case it was caused by a rupture of a vessel due to twisting of the node and bleeding from the vessel. The patient with a history of subserous leiomyoma of the uterus was hospitalized with complaints of discomfort in the lower abdomen.During the objective examination, an enlarged uterus up to 16 weeks of pregnancy was diagnosed, and during ultrasound examination a leiomyoma node in the uterine fundus, which was twice larger than the uterus size itself, and up to 500 ml of blood in the abdominal cavity were found. During surgery, a subserous node in the uterus fundus with partial torsion was found, the source of bleeding was established – a vein on the posterior wall of the uterus. The patient was operated by conservative myomectomy, histological examination confirmed uterine leiomyoma, the patient was discharged in satisfactory condition.Recent systematic literature reviews have shown that myomectomy is a better surgical procedure compared to hysterectomy, as it reduces the prevalence of shock and blood loss in patients.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"62 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79770926","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}

{"title":"Peculiarities of the course of genital endometriosis and its recurrence in women of reproductive age","authors":"G. Tolstanova, О.А. Lubkovska, S. Gladenko","doi":"10.30841/2708-8731.2.2023.278279","DOIUrl":"https://doi.org/10.30841/2708-8731.2.2023.278279","url":null,"abstract":"Endometriosis remains one of the most studied pathologies in modern gynecology, as it is accompanied by such complications as constant pelvic pain, menstrual cycle disorders, and infertility. These complications not only prevent the implementation of a woman’s reproductive function, but also worsen the normal life of a woman in general. The early diagnosis and the right choice of treatment is the basis of prevention of disease recurrence. Therefore, most of the efforts of scientists are directed to this.The objective: to reduce the frequency of genital endometriosis recurrence and improve the implementation of reproductive functions based on the improved approaches to its diagnosis and treatment.Materials and methods. The study included two groups of patients. The 1st group included 60 women with a diagnosis of ovarian endometriosis, whose data were analyzed retrospectively based on the results of medical histories. The 2nd group was studied prospectively and included 60 women with a diagnosis of ovarian endometriosis.All patients had general clinical and laboratory examinations, specific laboratory and ultrasound examinations. In patients of the 2nd group tumor markers were additionally determined, in particular CA-125, HE4, CA 19-9, CA 72-4, CA 15-3, REA, and the level of anti-Müllerian hormone, magnetic resonance imaging was performed. Patients of both groups were operated and histological examination of the material obtained during the operation was performed.The difference in the management of the postoperative period in the 2nd group was that, in addition to anti-inflammatory therapy all women received hormonal therapy (gonadotropin-releasing hormone agonist (GnRH agonist) with subsequent use of combined oral contraceptives (COCs) or simultaneous use of GnRH agonist and COCs with subsequent transition in both variants for dienogest for 6 months continuously). Recurrence of the pathology was detected after 3 and 6 months on the basis of a repeated diagnosis of ovarian endometriosis.Results. The obtained data showed that in the postoperative period, 3 months after treatment 5 (8.3 %) women in the 1st group had a recurrence of ovarian endometriosis and 4 (6.7 %) patients – pelvic adhesions. Whereas in the 2nd group, there were no cases of recurrence and adhesions.In 6 months after treatment in the 1st group 11 (18.3 %) patients were diagnosed with ovarian endometriosis recurrence, and 6 (10.0 %) women were diagnosed with pelvic adhesions. In the 2nd group recurrence of ovarian endometriosis was found only in 1 (1.7 %) woman, pelvic adhesions were not detected (p<0.05). During the year after treatment the number of pregnant women among persons who wished to become pregnant and had a history of infertility was statistically higher in the 2nd group compared to the 1st group, in particular, 10 (16.7 %) and 2 (3.3 %) women, respectively (p<0.05).Conclusions. The proposed algorithm for the diagnosis and treatment of genital endometriosis minimizes t","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88628214","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}

{"title":"Pregnancy and childbirth in women with a kidney transplant (clinical observation)","authors":"L. Bulyk, A.P. Haidai, M. Kyrylchuk, S. Koval","doi":"10.30841/2708-8731.2.2023.278286","DOIUrl":"https://doi.org/10.30841/2708-8731.2.2023.278286","url":null,"abstract":"The number of pregnant women with kidney transplant is growing and will continue to increase in Ukraine and all over the world, taking into account the development of transplantology. Such patients belong to the high-risk group, however, a clear understanding and adequate evaluation of the prognostic factors which are described in the literature will allow to transfer from prohibition and intimidation to the stage of supporting motherhood and providing highly qualified medical care to women with kidney transplants.This article presents two clinical cases of pregnancy and childbirth in women with kidney transplants, which occurred in the Department of Internal Pathology of Pregnant Women of the State Institution “Institute of Pediatrics, Obstetrics and Gynecology named after Acad. O. M. Lukyanova National Academy of Sciences of Ukraine”. Both patients with kidney transplants that functioned for 4 and 5 years, respectively, visited the doctor in early pregnancy.The anamnesis of the first pregnant woman was without peculiarities, while the second patient already had an episode of acute transplant rejection in the anamnesis and organ retransplantation from her mother. In addition, she had viral hepatitis B and C, as well as an insufficient level of immunosuppression. The function of the transplants in both women was satisfactory, each of the persons suffered from secondary nephrogenic anemia. Correction of immunosuppression in both patients was difficult, especially at 28 weeks, which is associated with hemodilution of pregnant women. Both women experienced an episode of urinary tract infection, which is experienced by about 40 % of pregnant kidney recipients.The first pregnant woman was practically healthy at full term pregnancy and had no indications for abdominal operation delivery, however, due to a clinically narrow pelvis she had cesarean section, which is a technically difficult surgery in such cases. In the second patient, the last weeks of pregnancy were complicated by hypertension of non-placental origin and transplant function disorders, which became an indication for cesarean section at 38 weeks. In the postpartum period kidney function began to recover. The condition of both newborns was satisfactory.Therefore, despite the reliable pregnancy outcomes in kidney transplant patients, an increased risk of obstetric complications and adverse perinatal outcomes remains. Interdisciplinary monitoring with timely correction of kidney transplant function disorders, monitoring of immunosuppressive therapy, prevention of premature births, careful control of blood pressure and adequate fetal monitoring allows to hope for favorable obstetric and perinatal outcomes in this group of patients.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84323367","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}

{"title":"Gynecological prerequisites for the development of chronic pelvic pain syndrome – diagnosis and treatment (Literature review)","authors":"V. Pyrohova, S. Shurpyak, I. Kozlovskyy","doi":"10.30841/2708-8731.2.2023.278288","DOIUrl":"https://doi.org/10.30841/2708-8731.2.2023.278288","url":null,"abstract":"Chronic pelvic pain syndrome is a complex process and mostly includes several organ systems. The gynecologic aspects of chronic pelvic pain syndrome can be divided into four distinct components: intra-abdominal pain, vaginal pain, pelvic floor pain, and sexual pain. The сommon gynecological causes of chronic pelvic pain are endometriosis, adenomyosis, vulvovaginal pain syndrome, pelvic floor muscle dysfunction, and sexual pain in women.This article describes the gynecological examination of patients with chronic pelvic pain and discusses the most common gynecological diseases and methods of their treatment. A review of the literature was conducted, which included the recommendations of the International Society for Urinary Incontinence, the European Association of Urology, and the International Association for the Study of Pain.Gynecological examination of patients with chronic pelvic pain begins with a history taking and physical examination. Laboratory tests, imaging examinations, and diagnostic procedures can be used additional methods to make a more accurate diagnosis. Treatment methods include physical therapy, medication, trigger point injections, and surgery.Because the diagnosis and treatment of chronic pelvic pain can be complex, it is important that physicians know the various aspects of this syndrome to be able to provide appropriate care for patients. Detailed history taking and physical examination for identifying the cause of the pain can help to determine the next step in evaluation and treatment. However, gynecological pathology is one of many, but not the only, that can be associated with chronic pelvic pain. This, it is necessary to perform a multimodal and multidisciplinary approach in the management of patients with chronic pelvic pain.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82132148","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}

{"title":"The importance of the genital tract microflora in the endometriosis development","authors":"L. Pakharenko, I. Basiuha, V. Zhurakivskyi, O. M. Lasytchuk, N. Kurtash","doi":"10.30841/2708-8731.2.2023.278155","DOIUrl":"https://doi.org/10.30841/2708-8731.2.2023.278155","url":null,"abstract":"Endometriosis is a common pathology among women of reproductive age. In the pathogenesis of its development a great importance is paid to the process of regulation of estrogens and other sex hormones, the implementation of the immune response at the general and local levels, the inflammatory response, and genetic background. In recent years, the role of the microbiota in different parts of the genital tract of the female organism has been studied not only from the standard approach of inflammatory diseases research of the reproductive organs and pathological vaginal discharge, but its contribution into the development of other gynecological diseases, in particular endometriosis, is presented.The article is devoted to a review of scientific publications about researches devoted to the significance of the genital tract microflora in the pathophysiology of endometriosis. The article presents the concepts of states of eubiosis and dysbiosis, describes the features of the microflora of the lower (vagina, cervix) and upper parts (uterus, fallopian tubes) of the genital tract in healthy women. The data on the importance of Lactobacillus in maintaining an optimal state of acidity in the vaginal environment are presented. The difference in the composition of the microbiota of the vagina, cervical mucus, uterine cavity and peritoneal fluid in women with and without endometriosis is revealed. The pathogenetic mechanisms of the role of the microbiota in the processes of endometriosis pathogenesis, namely, the regulation of the immune response and inflammation processes in this pathology, are described. It has been shown that in women with endometriosis there are differences in the microflora composition of the vagina, cervix, uterine cavity, peritoneal fluid, manifested by a decreased concentration of Lactobacillus and the presence of a variety of other microorganisms in relation to healthy women. The data about the role of gut microflora in patients with this pathology are also presented. The results of research about the diagnosis of various stages of endometriosis by studying the composition of the genital tract microbiota are described.","PeriodicalId":21003,"journal":{"name":"Reproductive health of woman","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75586790","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}