scholarly journals Effekty dlitel'nogo primeneniya estrogen-gestagennoy terapii u zhenshchin reproduktivnogovozrasta s izolirovannym gipogonadotropnymgipogonadizmom

2010 ◽  
Vol 7 (1) ◽  
pp. 52-57
Author(s):  
I A Ilovayskaya ◽  
V Yu Zektser ◽  
A V Il'in ◽  
N P Goncharov ◽  
I I Dedov
Keyword(s):  
Total Cholesterol ◽  
Clinical Symptoms ◽  
Negative Impact ◽  
Mineral Metabolism ◽  
Hypogonadotropic Hypogonadism ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Group 2 ◽  
Group 1

We examined 56 normoprolactinemic women of reproductive age (18-45 y.o.) with isolated hypogonadotropic hypogonadism (group 1) initially and on treatment with 2 mg of 17beta-estradiol and 10 mg of dydrogesterone in sequenced manner (HRT), duration of HRT was from 18 to 42 (median 36) months; 45 healthy women (20-38 y.o.) were included in control group 2. Initially hypercholesterolemia was observed in 50% of cases in group 1 and 6.6% in group 2 (z=12,29, p=0,0005); nevertheless, the difference in lipid levels between groups 1 and 2 was not statistically significant: total cholesterol levels 5,2 (4,3; 6,0) mmol/l and 4,63 (4,15; 5,15) mmol/l respectively (1vs2, р=0,1); triglycerides 0,8 (0,62; 1,3) mmol/l and 0,76 (0,6; 0,85) mmol/l (1vs2, р=0,08); HDL 1,89 (1,24; 2,1) mmol/l and 1,79 (1,44; 2,8) mmol/l (1vs2, p=0,85); LDL 2,7 (2,2; 3,2) mmol/l and 2,75 (2,3; 3,3) mmol/l (1vs2, p=0,64). In group 1 decrease of total cholesterol and triglycerides concentrations was found on HRT: total cholesterol 4,8 (3,95; 5,1) mmol/l (before vs on treatment p=0,041), triglycerides 0,65 (0,6; 0,9) (before vs on treatment p=0,044) respectively, changes in HDL and LDL levels were not revealed. Initial concentrations of Ca++, P, and alkaline phosphatase (AP) were within normal range in all women. However, concentrations of Ca++ and AP were higher in group 1 compared to group 2: Ca++ 1,13 (1,08; 1,19) mmol/l and 1,05 (1,03; 1,09) mmol/l (1vs2, p=0,0016); AP 161,5 (141,8; 183) IU/l and 141,0 (119; 151) IU/l (1vs2, p=0,044). On HRT reduce in Ca++ and AP concentrations was observed: Ca++ concentrations 1,05 (1,03; 1,10) mmol/l (before vs on treatment p=0,004), AP 139 (112; 143) IU/l (before vs on treatment p=0,004). HRT was accompanied by improvement of clinical symptoms, had no influence on thyroid function, and provoked physiological rise of prolactin levels.Thus, despite lacking the expressed biochemical disorders, isolated hypogonadotropic hypogonadism in women of reproductive age have hidden negative impact on lipid and mineral metabolism. Long term HRT is safe and significantly improved parameters of lipid and mineral homeostasis in this cohort of patients.

scholarly journals Indicators of the reproductive function after endoscopic surgical treatment of uterine myomas

2020 ◽  
Vol 13 (4) ◽  
pp. 297-304
Author(s):  
M. M. Vysotskiy ◽  
I. I. Kuranov ◽  
O. B. Nevzorov
Keyword(s):  
Reproductive Function ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Hormone Production ◽  
Degree Of Malignancy ◽  
Main Factors ◽  
Group 2 ◽  
Almost All ◽  
Group 1

Aim: to characterize the function of the reproductive system in women after organ-preserving surgery for uterine myoma: hysteroresectoscopic (HRS) myomectomy and laparoscopic (LS) myomectomy.Materials and methods. Forty one patients were examined and divided into 2 groups: Group 1 – 18 patients after HRS myomectomy and Group 2 – 23 patients after LS myomectomy. The control group included 20 healthy women of reproductive age.Results. The HRS operation led to a significant decrease in the production of anti-Mullerian hormone (AMH), estradiol and progesterone, while the levels of luteinizing (LH) and follicle-stimulating (FSH) hormones increased. After myomectomy performed by the laparoscopic access, the levels of estradiol, progesterone, and AMH decreased but the levels of both LH and FSH increased so that the ratio LH/FSH remained unchanged. Almost all indices of gonadotropic and steroid hormone production became normalized over 6 months of the postoperative period.Conclusion. The main factors of unfavorable prognosis in patients with ovarian tecoma are tumor necrosis, degree of malignancy and mitotic activity.

scholarly journals The frequency and structure of metabolic disorders in obese women in combination with polycystic ovary syndrome

2021 ◽  
Vol 18 (3) ◽  
pp. 254-262
Author(s):  
E. V. Bolotova ◽  
A. V. Dudnikova ◽  
V. A. Krutova ◽  
N. S. Prosolupova
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Metabolic Disorders ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Control Group ◽  
Obese Women ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Group 2 ◽  
Group 1

Background: Obesity is considered a global epidemic and is one of the most significant medical and social problems. Research in recent years shows that in 25-45% of cases of obesity, polycystic ovary syndrome (PCOS) is detected. The influence of obesity on the pathogenesis of metabolic disorders in this category of patients remains controversialAims: to determine the frequency and structure of metabolic disorders in obese women in combination with polycystic ovary syndrome (PCOS).Materials and methods: A single-center cross-sectional sample survey of women of reproductive age was conducted. The study included clinical anthropometry with measurement of body weight, height, waist circumference (OT) and hip circumference (OB), followed by calculation of body mass index (BMI) and OT/OB ratio, and measurement of blood pressure (BP). A biochemical blood test was performed, the hormonal status was examined, and an ultrasound examination of the pelvic organs was performed.Results: A survey of 136 women of reproductive age was conducted. Group 1 included obese women without PCOS (59 patients), group 2 included obese women in combination with PCOS (45 patients), and the control group included 38 healthy women. Group 1 included obese women without PCOS (59 patients), and group 2 included obese women with PCOS (45 patients), in the control group — 38 healthy women. Among group 2 patients, dyslipidemia, visceral obesity, arterial hypertension, insulin resistance, hyperinsulinemia, and hyperuricemia were significantly more common (p<0,05). Correlations between BMI and triglycerides, testosterone and total cholesterol were found (p<0,05). Obese and PCOS patients had significantly higher levels of C-reactive protein(CRP), fibrinogen, anti-Müllerian hormone (AMH), and hepatic transaminases (p<0,05). Vitamin D deficiency was detected in 13,2% of patients, and insufficiency — in 22,7% of patients. There is a statistically significant correlation between the level of 25 (OH)D and indicators of BMI, follicle-stimulating hormone, luteinizing hormone (p<0,05), the level of AMH (p=0,008).Conclusions: A high frequency of metabolic disorders in obese women in combination with PCOS has been identified, which necessitates early screening, diagnosis and treatment of these disorders to strengthen reproductive health and prevent chronic non-communicable diseases.

scholarly journals The application of ultrasonography to select tactics for treatment of women of reproductive age with uterine leiomyoma

2020 ◽  
Vol 24 (4 (96)) ◽  
pp. 32-40
Author(s):  
A. Kornatska ◽  
A. Dubchak ◽  
M. Flaksemberg ◽  
I. Baranetska
Keyword(s):  
Conservative Treatment ◽  
Uterine Leiomyoma ◽  
Ultrasound Examination ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Pelvic Organs ◽  
Group 2 ◽  
Doppler Color ◽  
Group 1

Objective. To study the condition of the pelvic organs in women of reproductive age with uterine leiomyoma UL, depending on the type of treatment based on ultrasonographic monitoring.Materials and methods. 299 women of reproductive age were examined. Patients were divided into 3 groups: 1 group consisted of 159 women with uterine leiomyoma (UL) who underwent surgical treatment, 2 group – 120 women with UL who underwent conservative treatment, 3 control group consisted of 20 healthy women of reproductive age. In order to obtain the most complete information about the size of the uterus, the structure and topography of myomas, the features of their vascularization, patients underwent ultrasound before and 3 months after treatment.Results. Ultrasound examination of the average parameters of the uterine body in the main groups showed an excess of these indicators relative to the control group (3.2 times in group 1 and 1.3 times in group 2). Uterine volume was greater in women of group 1 compared with women of groups 2 and 3 (p <0.05). In most cases, in 139 (49.0%) women of the main groups, the localization of fibroids was intramural with central growth, without changing the configuration of the uterus from the outside and was not deformed cavity. Whereas, intramural nodes with centripetal growth deformed the uterine cavity in 39 (14.0%) cases, and centrifugal - in 100 (36.0%) subjects - its contour. Mixed and central types of angioarchitectonics were characteristic of women with the largest uterine sizes. In dynamic ultrasound examination in women after conservative myomectomy who did not receive hormone therapy, the level of myometrial perfusion was higher than in those who received gonadotropin-releasing hormones before and after treatment, which may be more prognostically favorable for UL recurrence. Women in group 2 after receiving conservative treatment had a positive tendency to reduce the volume of the uterus and fibroids.Conclusions. Ultrasound diagnostics can be considered a highly informative, non-invasive method that helps to identify the presence, location, structure, size of the myoma, the presence of concomitant pathology of the pelvic organs, as well as in addition to Doppler color flow mapping and pulsed Doppler blood allows us to detect the presence of tumor blood circulation. Echographic and Doppler evaluation of uterine leiomyoma with peculiarities of vascularization in the diagnostic algorithm helps to differentiate the choice of the method of treatment (conservative or surgical).

scholarly journals ORAL HOMEOSTASISSTATUSIN MILD CHRONIC GENERALIZED PERIODONTITIS AND MILD DENTAL PERI-IMPLANTITIS

2021 ◽  
Vol 11 (1) ◽  
pp. 100-103
Author(s):  
Vladimir Tlustenko ◽  
Valentina Tlustenko ◽  
Oksana Gusyakova ◽  
Dimitry Trunin ◽  
Vladimir Potapov
Keyword(s):  
Oral Fluid ◽  
Preventive Measures ◽  
Mineral Metabolism ◽  
Control Group ◽  
Periodontal Status ◽  
Group I ◽  
Metabolic Imbalance ◽  
Group 2 ◽  
Destructive Processes ◽  
Group 1

The paper is focused on evaluating the oral cavity homeostasis in patients with mild chronic generalized periodontitis (CGP) (Group 1, 35 persons) and mild peri-implantitis (Group 2, 30 persons). The control group included healthy individuals (20 persons) with neither dental nor somatic issues. The material used for the study was oral fluid. The general metabolic processes in the periodontal and peri-implant area tissues were described based on analysis of the protein and mineral metabolism indicators, as well as on the hygiene and periodontal status indices. The paper presents the results of a comparative assessment involving Groups I and II with the control group and between Groups I and II. Our findings show changes in ion balance in both groups. Significant disturbances in the protein and mineral metabolism have been identified in the main groups, which contributes to the development of inflammation and reduced detoxification in periodontal and peri-implant tissues. A rise in Calcium and Magnesium indicates destructive processes in bone tissues. In case of mild CGP, these changes are more prominent. The oral hygiene and periodontal status indices in Group I proved to be significantly worse. Therefore, while performing implantation on the background of chronic generalized periodontitis, it is important to take into account its metabolic imbalance and implement preventive measures

scholarly journals Restoring Reproductive Function In Overweight And Obese Women Of Childbearing Age

2020 ◽  
Vol 2 (08) ◽  
pp. 77-81
Author(s):  
Hamdamova M. T. ◽  
Jurakulova Z. A
Keyword(s):  
Negative Impact ◽  
Reproductive Function ◽  
Diet Therapy ◽  
Overweight And Obesity ◽  
Reproductive Age ◽  
Obese Women ◽  
Childbearing Age ◽  
Women Of Reproductive Age ◽  
Pregnancy And Childbirth ◽  
Group 2

The prevalence of overweight and obesity among women in Uzbekistan is 31.7 %. There is an annual increase in people with obesity. The facts of the negative impact of fat mass on the hormonal system and, as a result, a decrease in fertility in women are not in doubt. The purpose of this study was to evaluate the results of Metformin use in overweight and obese women of reproductive age. The study included 45 women of reproductive age who could not reduce weight with diet therapy. All patients were divided into three groups: group 1-planning pregnancy (n = 15), group 2 – having abnormal weight gain after childbirth (n = 15), group 3 – having overweight and obesity not related to pregnancy and childbirth (n = 15). Weight loss while taking Metformin increases fertility and should be performed in obese women as pre-gravidar training.

scholarly journals Cervicitis: potentialities of alternative treatment

2021 ◽  
Vol 4 (3) ◽  
pp. 225-228
Author(s):  
L.V. Saprykina ◽  
◽  
D.M. Ibragimova ◽  
M.R. Narimanova ◽  
◽  
...  
Keyword(s):  
Alternative Treatment ◽  
Premenopausal Women ◽  
Antibacterial Treatment ◽  
Reproductive Age ◽  
Herbal Preparation ◽  
Women Of Reproductive Age ◽  
Laboratory Test Results ◽  
Group 2 ◽  
Group 1 ◽  
Systemic Antibacterial

Aim: to assess the efficacy of the alternative treatment for cervicitis in women of reproductive age and premenopausal women. Patients and Methods: this pilot comparative study included 60 women of reproductive age and premenopausal women (25–45 years) with cervicitis who were divided into two groups. Group 1 women (n=30) received multi-component herbal preparation (Tukofitol cream) once daily for 20 days. Group 1 women were subdivided into two subgroups. In women of subgroup 1A (n=14), opportunistic flora in relevant titers was identified, and these women were prescribed systemic antibacterial treatment. In women of subgroup 1B, no opportunistic flora in relevant titers was identified, and these women were prescribed with multi-component herbal preparation only. Group 2 women (controls, n=30) were also subdivided into two subgroups. In subgroup 2A (n=16), women received systemic antibacterial treatment and Povidone Iodine vaginal to manage opportunistic flora. In subgroup 2B (n=14), no opportunistic flora in relevant titers was identified, and a watchand- wait approach was applied. Before treatment and 30 days, subjective symptoms typical for cervicitis were evaluated, laboratory tests and colposcopy were performed. Results: two women from each group have withdrawn from the study. In group 1, more rapid improvement of cervicitis symptoms vs. group 2 (p<0.05) was reported. Moreover, no growth of opportunistic flora was more commonly seen in group 1 (100%) compared to group 2 (92.85%, p>0.05). Conclusion: the improvement of subjective criteria and laboratory test results has demonstrated that treatment was effective in both groups. In the lack of opportunistic flora in relevant titers, multi-component herbal preparation as monotherapy can be prescribed to reduce symptoms of inflammation. KEYWORDS: cervicitis, inflammation of the cervix, Tukofitol, reproductive age, premenopausal age, treatment, diagnostics, colposcopy, opportunistic microbes, sexually transmitted infections, monotherapy. FOR CITATION: Saprykina L.V., Ibragimova D.M., Narimanova M.R. Cervicitis: potentialities of alternative treatment. Russian Journal of Woman and Child Health. 2021;4(3):225–228 (in Russ.). DOI: 10.32364/2618-8430-2021-4-3-225-228.

scholarly journals Endometrial Cytokines in Women with Reproductive Disorders

2021 ◽  
Vol 11 (4) ◽  
pp. 526-531
Author(s):  
Irina Danusevich ◽  
Lyudmila Lazareva ◽  
Uliana Nemchenko ◽  
Lyubov Kolesnikova
Keyword(s):  
Bacterial Flora ◽  
Fold Increase ◽  
Endometrial Tissue ◽  
Reproductive Age ◽  
Control Group ◽  
Reproductive Disorders ◽  
Medical Apparatus ◽  
Tnf Α ◽  
Group 2 ◽  
Group 1

The purpose of this research was to study changes in endometrial cytokine concentrations in women suffering from reproductive disorders with and without chronic endometritis (CE) to justify pathogenetic treatment. Methods and Results: The study included 100 women of reproductive age with reproductive disorders. Group 1 included 50 patients with reproductive disorders and CE; Group 2 included 50 patients with reproductive disorders and without CE. Later on, all patients were divided into the following subgroups: Sub1A (n=31), and Sub2A (n=16) with an isolated bacterial flora, Sub1B (n=19) and Sub2B (n=34) with the absence of bacterial flora. The control group consisted of 31 fertile women. Endometrial aspiration pipe biopsy was performed on days 4-9 of the menstrual cycle (middle proliferative phase) using a disposable intrauterine probe (Taizhou Kechuang Medical Apparatus Co., Ltd, China) followed by histological examination of endometrial tissue. Laboratory diagnostics for sexually transmitted infections (STIs) was performed using the bacterial culture method. For the diagnosis of viral infection (HPV, HSV, CMV), cervical samples were studied using PCR. If STIs were detected, the patients were excluded from further research. Ultrasound examination of the pelvic organs was performed using the Aloka-5500 device with a 7MHz vaginal probe in two-dimensional visualization mode. The concentration of cytokines (IL-1β, INF-γ, TNF-α, ILs-4,6,8,10) in the endometrium was determined using the Protein Contour test systems (Saint Petersburg) and Multiskan EX ELISA Analyzer (Germany). In both groups, reproductive disorders were accompanied by hypoprogesteronemia and relative hyperestrogenemia, significantly apparent in CE. We found a 3-fold increase in the level of tissue pro- and anti-inflammatory cytokines (IL-1β, IL-4,6,10, INF-γ), and a 4-fold increase in the level of TNF-α and IL-8 in Group 1, compared to the CG. In Group 2, we found a 1.4-fold increase in the levels of IL-1β and INF-γ, compared to the CG. In Sub 1a, the levels of IL-6 and IL-8 were significantly higher than in the control group. In Sub1A, the isolated bacterial flora caused a cytokine inflammatory response characterized by a significant increase in the concentration of INF-γ and TNF-α, compared to Sub2A and Sub2B (P<0.05). In Sub1A, we found a tendency towards a decrease in the tissue levels of IL-4 compared to Sub1B and Sub2B; the IL-10 level was significantly lower than in Sub2B (P=0.0009) Conclusion: The results obtained in the present study showed the peculiarities of changes in cytokines at the level of endometrial tissue both in chronic inflammation of the endometrium and in its absence in women with reproductive disorders. The severity of the immune response is significantly higher in patients with CE, with the most significant change in the role of IL-10.

MODERN OUTLOOKS ON PREVALENCE OF ESR1 AND PRG POLYMORPHISM IN WOMEN OF REPRODUCTIVE AGE WITH ENDOMETRIAL HYPERPLASIA

2020 ◽  
pp. 112-120
Author(s):  
I.M. Ordiyants ◽  
A.A. Kuular ◽  
A.A. Yamurzina ◽  
T.A. Bazieva
Keyword(s):  
Endometrial Hyperplasia ◽  
Progesterone Receptors ◽  
Reproductive Age ◽  
Control Group ◽  
Women Of Reproductive Age ◽  
Atypical Endometrial Hyperplasia ◽  
Group 3 ◽  
The Subject ◽  
Polymerase Chain ◽  
Group 2

Prevalence of proliferative processes is very high nowadays. Moreover, such processes easily transform into malignant ones. However, pathogenesis of endometrial hyperplasia (EH) is not fully understood. Imbalance of estrogen and progesterone, as well as estrogen and progesterone receptors is the reason for hyperplastic process onset in hormone-dependent tissues. Currently, there are no markers that could serve as objective predictors for EH development. It is unclear, whether EH transforms into cancer or spontaneously improves. The purpose of the study is to determine prevalence of ESR1 and PRG polymorphism in women of reproductive age with endometrial hyperplasia. Materials and Methods. Trial subjects (n=143) were divided into three groups: Group 1 consisted of 53 patients with glandular and glandular-cystic EH without atypia; Group 2 contained 34 patients with atypical EH; Group 3 was the control group. Polymerase chain reaction of DNA synthesis was used to conduct molecular and genetic loci study. Statistical analysis of the data obtained was performed with SAS JMP 11 and Statistica 10. Results. Mutant CC-allele of PvuII ESR1 polymorphism was found in every fourth woman with glandular endometrial hyperplasia and in every third patient with atypical endometrial hyperplasia. Prevalence of GG genotype of XbaI ESR1 polymorphism did not have any statistically significant differences in comparison with the control group. Mutant TT-allele of Val660Leu PRG polymorphism in glandular endometrial hyperplasia was 1.8 times more common in experimental groups than in the control one. Homozygous AA-genotype of 331G/A PRG polymorphism was not identified in women with endometrial hyperplasia. Conclusion. In endometrial hyperplasia, prevalence of mutant CC-allele of PvuII C/T ESR1 polymorphism leads to a decrease in ERa sensitivity, whereas prevalence of mutant TT-allele of Val660Leu PRG polymorphism leads to impaired sensitivity and a decrease in the biosynthesis rate of progesterone receptors. EH etiology and pathogenesis in women of reproductive age still remains the subject for future scientific research. Keywords: estrogen receptors, progesterone receptors, glandular endometrial hyperplasia, atypical endometrial hyperplasia. Актуальность проблемы пролиферативных процессов связана с высокой частотой распространения и высоким риском их трансформации в злокачественный процесс. В настоящее время до конца не изучен патогенез гиперплазии эндометрия (ГЭ). Причиной формирования гиперпластического процесса в гормонально-зависимых тканях может быть дисбаланс эстрогенов и прогестерона, а также эстрогеновых и прогестероновых рецепторов. В настоящее время отсутствуют маркеры, которые могли бы служить объективными предикторами развития ГЭ в направлении трансформации в рак или, наоборот, спонтанной ее регрессии. Цель исследования. Определить частоту встречаемости полиморфизмов генов ESR1 и PRG у пациенток репродуктивного возраста с различными вариантами гиперплазии эндометрия. Материалы и методы. Все обследованные женщины (143 чел.) были поделены на три группы: I группу составили 53 пациентки с железистой и железисто-кистозной ГЭ без атипии; II группу – 34 пациентки с атипической гиперплазией эндометрия; III группа стала контрольной. Молекулярно-генетическое исследование локусов проведено методом полимеразной цепной реакции синтеза ДНК. Статистический анализ полученных данных выполнен в программах SAS JMP 11 и Statistica 10. Результаты. Мутантный аллель СС полиморфизма PvuII гена ESR1 обнаружен у каждой четвертой женщины с железистой гиперплазией эндометрия и у каждой третей пациентки с атипической гиперплазией эндометрия. Частота встречаемости генотипа GG полиморфизма XbaI гена ESR1 в сравнении с группой контроля не имела статистически значимых различий. Мутантный аллель ТТ полиморфизма Val660Leu гена PRG при железистой гиперплазии эндометрия встречался в 1,8 раза чаще, чем в группе контроля. Гомозиготный генотип АА полиморфизма 331G/A гена PRG у женщин с гиперплазией эндометрия выявлен не был. Выводы. При гиперплазии эндометрия преобладание мутантного аллеля CC полиморфизма PvuII C/T гена ESR1 приводит к снижению чувствительности ERa, а преобладание мутантного аллеля TT полиморфизма Val660Leu гена PRG – к нарушению чувствительности и снижению скорости биосинтеза прогестероновых рецепторов. Предметом исследований по-прежнему остается концепция этиологии и патогенеза ГЭ у женщин репродуктивного возраста, что требует дальнейшего научного поиска. Ключевые слова: эстрогеновые рецепторы, прогестероновые рецепторы, железистая гиперплазия эндометрия, атипическая гиперплазия эндометрия.

Evaluation of the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age

GYNECOLOGY ◽  
2019 ◽  
Vol 21 (4) ◽  
pp. 19-23
Author(s):  
Yanina A Lebedeva ◽  
Inna I Kovalenko ◽  
Oleg L Molchanov ◽  
Dmitrii V Baibuz ◽  
Natalia V Kulikova
Keyword(s):  
Reproductive Potential ◽  
Clinical Manifestations ◽  
Uterine Fibroids ◽  
Pain Syndrome ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Results Of Treatment ◽  
High Prevalence ◽  
Group 2 ◽  
Group 1

Relevance. Due to the high prevalence of uterine fibroids in young women and the possible effect on reproductive potential, the development, implementation and application of the most benign treatment methods are a priority. Aim. To evaluate the effectiveness of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age. Materials and methods. A comparative analysis of the results of treatment of patients of reproductive age with uterine myoma has been carried out. Group 1 (n=38) included patients who underwent conservative myomectomy and/or hysteroresectoscopy without subsequent anti-relapse drug therapy. The average age is 31.5 years (4.6). Group 2 (n=43) included patients after conservative myomectomy who received mifepristone as anti-relapse therapy after surgery. The average age is 31.9 years (4.5). Results. Mifepristone therapy, as an adjuvant treatment after conservative myomectomy, can significantly reduce the risk of recurrence, stabilize the size of the uterus, reduce the severity of clinical manifestations in the form of pain syndrome and heavy menstruation associated with relapse, thereby improving the reproductive health of women. Conclusions. The use of adjuvant anti-progestogen therapy after conservative myomectomy in women of reproductive age is a very effective method for treating uterine fibroids and can be considered as a therapy of choice in such patients.

Vaginal biocenosis state assessment in patients with cervical ectopy relapse in the conditions of human papillomavirus infection

2018 ◽  
pp. 37-41
Author(s):  
Yu.Yu. Mazur ◽  
◽  
V.I. Pyrohova ◽  
N.M. Kuz ◽  
◽  
...  
Keyword(s):  
Hpv Infection ◽  
Test System ◽  
Vaginal Microbiota ◽  
Reproductive Age ◽  
Control Group ◽  
High Recurrence Rate ◽  
Wide Range ◽  
Group 2 ◽  
Significant Polymorphism ◽  
Group 1

Cervical ectopy is one of the most common benign processes, characterized by relatively high recurrence rate, and in the case of vaginal microbiota violations in the conditions of HPV infection combination deserves the aimed attention, particularly in the context of reproductive health care and cancer prevention. The objective: to study the vaginal microbiota features in patients withcervical ectopy relapsein the conditions of HPV infection. Materials and methods. The study included 98 women of reproductive age (18 to 46 years). Three groups were formed: a control group (n=30), in which conditionally healthy women were included, group 1 (n=33) – patients with firstly diagnosed cervical ectopy, group 2 (n=35) – patients with cervical ectopy relapse. All women wereexamined with a bacterioscopic, cytological, microbiological study of the vaginal biocenosis, as well as a determination of the vaginal environmentpH level. Results. In patients with cervical ectopy relapse the pH of the vaginal environmentwas significantly higher than that in women of the control group (p<0.001) and of the group 1 patients (p<0.05). About 9% of patients in both study groups had signs of bacterial vaginosis; in about 70% of group 2 patients the signs of mild and moderate severity aerobic vaginitis were found, significantly (p<0.05) more often than in patients with firstly diagnosed cervical ectopy. In group 2 patients a significant polymorphism of infects was detected in 40.00±8.28% of cases, the associations of 3 or more microorganisms determined simultaneously were significantly (p<0.001) more often foundin group 2 in comparison with patients with firstly diagnosed cervical ectopy. Сonclusion. The use of the short-term test system A.F.GENITAL SYSTEM (Liofilchem®, Italy) has a number of advantages for clinical practice: results being ready in short time, the detection of a wide range of infections, the possibility of quantifying M. hominis and U. urealyticum, and then determining the sensitivity to the most frequently used antibacterial drugs. Recurrent cervical ectopy often occurs in the conditions of colpitis, vaginitis, vaginal microbiota disorders with significant polymorphism of microorganisms and alkalization of the vaginal environment, which complicates the processes of ectopy epithelialization and can predispose to its recurrence. The observed cytological features in this cohort of patients suggest that long-term violations of the vaginal biocenosis in combination with the inflammatory processes of the vagina and cervix create favorable conditions for the realization of dysplastic changes caused by HPV. When determining the tactics of treatment of recurrent cervical ectopy, in particular in the conditions of HPV infection, first of all it is necessary to achieve both the cytological norm and the normalization of the vaginal biocenosis before any intervention, if necessary. Key words: relapse of cervical ectopy, vaginal biocenosis, vaginitis, cervicitis, HPV.

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