The frequency of cesarean section as the instrument of decrease in perinatal mortality, in many countries with the high and average level the income I surpassed reasonable limits. The systematized data of foreign authors concerning the most discussed aspects of the problem are submitted: the reasons of the global increase in the level of operational childbirth, consequences for the health of the mother and the newborn, and also ways and expediency of decrease in their level. Robson classification is widely used in international practice. It gives an opportunity to compare the indications for cesarean section in different countries and regions.

The parameters of the kaolinaktivirovannoy thrombelastographic at physiological gestation, moderate, and severe gestosis. The significant differences between groups for the intensification of intravascular coagulation and fibrinolysis activity. Option and the severity of the changes thrombelastographic determine the need for correction hemocoagulation violations during gestation thrombohemorrhagic to prevent complications in pregnancy.

We performed a prospective study of the course of 97 labor with and without uterotonic use. It was shown that the use of uterotonic during labor has pathological effects on the fetus and has a phase nature. We determined the safe time of uterotonic agents infusion, as well as the time after which fetus loses control over its homeostasis.

Embryo implantation is a multifactorial process. IVF success depends on the quality of the embryo and the receptivity of the endometrium. Ultrasound is non-invasive method to assess the answer of the ovaries and the endometrium in IVF cycles. Color Doppler mapping of the uterine vessels provides information about the degree of vascularization of the uterus and endometrium and ready for implantation. In this article are represented characters uterine blood vessels of 28 infertile women undergoing IVF embryo transfer, followed by 2–3 days of the menstrual cycle, on the day of the trigger and the day of embryo transfer. The comparison of hemodynamic parameters (systolic-diastolic ratio S/D, index of resistance IR, pulsation index PI) of uterine vessels (uterine, arcuate, radial, basal and spiral arteries) was made in 15 pregnant and 13 non-pregnant women after IVF treatment. It was found, that the hemodynamic parameter of uterine vessels on 2–3 days of menstrual cycle does not reflect the ability of endometrium to implantation in IVF cycles. The most effective in the forecast of pregnancy was to determine the mentioned hemodynamic parameters in the basal, spiral arteries of the uterus on the day of the trigger and basal IR and spiral PI arteries on the day of embryo transfer.

Threatened abortion is one of the most common complications of early pregnancy. In the presence of a live embryo, the most frequently encountered sonographic finding is a subchorionic hematoma. Resent studies suggest that the presence of intrauterine hematoma during the first trimester may identify a population of patients at increased risk for adverse pregnancy outcome. In the review the etiology, pathogenesis of subchorionic hematoma and diagnostic and treatment management of patients with such pregnancy complication are described.

Study devoted to HIV viral load assessment (blood versus cervical and vaginal specimen) among HIV infected women using effective hormonal, intrauterine and barrier contraceptive methods in short-term prospective. Based on lab data and contraceptive methods authors formulate assumptions of HIV sexual transmission.

The article represents results of monotherapy with metformin, as well as combined treatment with metformin and combined oral contraceptive (COC), containing drospirenone, in patients with polycystic ovary syndrome (PCOS). In general, treatment was given to 42 patients with PCOS. Combined treatment was prescribed to 18 of them. Equally high efficiency of both schemes of treatment in correction of disorders of carbohydrate metabolism was demonstrated. But efficacy of metformin alone in restoration of ovulatory menstrual cycle was low – ovulation occurred in 3 patients (13 %) and only two women (8.7 %)became pregnant. These results do not allow recommendation of monotherapy with this medication for restoration of fertility. Implication of combined therapy has shown benefits in normalization of menstrual cycle, ultrasound structure and volume of ovaries. COC with drospirenone also has antiandrogenic properties. So combination of metformin with COC, containing drospirenone, can be recommended as a first-line therapeutic option for patients with PCOS and impaired carbohydrate metabolism.

The article includes the results of comparative study of uterine scar after cesarean section depending on the time of surgery – at term pregnancy or during the term labor. There was more intense neoangiogenesis in the uterine wound at early postoperative period and the number of patients with morphologically “sufficient” uterine scar increased in 2 times when cesarean section was performed at term labor.

The fetal blood flow state studies of pregnant women undergoing psycho-emotional stress, with the help of self-report scale of Spielberger and Doppler examination found an increase in state and trait anxiety, increase in resistance of the umbilical artery and descending aorta, as well as raised heart rate and blood pressure values. At the same time there is a decrease in the pulsatility index of the middle cerebral artery and increase in umbilical-cerebral ratios, indicating the compensatory centralization of fetal blood flow and improving blood supply to the brain. Possible mechanisms of the detected changes have been discussed.

The review of literature devoted to sources and ways of use of energy in a placenta during the different periods of physiological pregnancy and at a diabetes mellitus is submitted. The importance of various ways of utilization of a glucose and glycogen depending on term and character of a course of pregnancy is considered. The materials about features of carbohydrate and energy exchanges in the placenta during the different types of diabetes and influence of insulin on the placental metabolism of glucose are generalized.

In this article these literatures are presented about the studied genetic aspects and immune mechanisms in pathogenesis of bacterial vaginosis, about polyetiology in development and features of clinical flow of this disease, about nocifensors, providing colonization resistance of vagina.

The implantation is the foundation is basic event of the successful pregnancy, which requires the participation of various endocrine, paracrine and autocrine mechanisms on the hormonal, cellular and molecular levels. The result is an adequate growth and differentiation of endometrium, adhesion and invasion of the blastocyst and formation of a normal placenta. The success of implantation depends on embryo quality, presence of receptive endometrium and normally functioning immune system to provide an active dialogue between the blastocyst and endometrium. The cytokines and growth factors play an important role in the process of implantation. Imbalance synthesis of these molecules leads to partial or complete failure of the implantation process. LIF cytokine and GM-CSF, TGF -b, VEGF growth factors are the most important factors involved in the process of implantation . This review reflects the role of these molecules in the process of implantation and modern methods of their determination to predict pregnancy rate in IVF.

Controversial issues of preterm labour are discussed in the article. Data on the frequency of preterm labour worldwide, perinatal mortality, morbidity and long-term sequelae of preterm infants is presented. Questions of pathogenesis, conduction and preterm labour anaesthesia as well as ethical issues of reanimation and nursing of very premature infants are reviewed.

The delivery of 128 women with uterine fibroid of various locations and sizes in case of Caesarean operation was analyzed. The analysis of indications for the Caesarean operation in patients with hysteromyoma was made. The technique of performing myomectomy in case of surgical delivery was lightened. The issues of advisability for the use of myomectomy, pre-surgical preparation and length of the operation, the blood loss and the course of the post-surgical period were discussed. The procedure for the organizational arrangements in the delivery of pregnant women with uterine fibroid was developed.

Diagnostic and therapy monitoring prospectives and challenges with pregnant women of different gestational age have been analysed and reviewed. The advanced laboratory techniques for the prediction of preeclampsia and fetal growth restriction, as well as such biomarkers as placental growth factor, neutrophil gelatinase-associated lipocalin, holotranscobalamin, 25-hydroxyvitamin D, B-type natriuretic peptide and cardiac troponin I are discussed.).