This lecture presents the management of pregnancy and labor in cardiovascular patients. Classification of congenital cardiovascular diseases is presented, the changes in cardiovascular system developing in pregnancy and labor are described. The authors emphasize that hospitalization is recommended for this patient population before 12 weeks, in order to diagnose the heart disease, rule out the rheumatic process, and decide whether pregnancy can be prolonged. Repeated hospitalization is recommended at weeks 28-32, for further examinations and treatment, and then 2-3 weeks before planned delivery, in order to prepare the patient to labor, determine the labor management plan and mode of delivery in an inpatient setting. Complex clinical and laboratory studies should be carried out in all pregnant patients with heart diseases. Women with congenital heart disease and their babies should be examined with the use of genetic methods. The management of pregnancy and labor in patients with mitral and aortic valvular diseases, with a history of cardiosurgery, with rheumatic heart disease is described. Differences in drug therapy of patients with various diseases are emphasized. The authors emphasize that the outcome of labor largely depends on proper preparation to labor, correct choice of the mode of delivery, timely therapy and anesthesiological care in labor, and qualification of the physician.

This review of literature discusses modern data on the diagnosis and treatment of the urinary tract infections (UTI), the epidemiology, classification, etiology, and pathogenesis thereof. The basic and alternative treatment protocols for the most incident UTI are presented from the documented medicine viewpoint. Fundamentals of rational antibiotic therapy in practical obstetrics are formulated. The author emphasizes the need in screening pregnant patients for UTI.

Theories of emergence and the pathogenesis of Stein-Loewenthal’s syndrome, or the polycystic ovaries syndrome (PCOS), are discussed, its diagnosis and clinical morphological manifestations are presented. Methods for conservative and surgical treatment are presented, with special emphasis on surgical treatment of infertility caused by the syndrome (laparoscopic laser drilling of the ovaries with subsequent extracorporeal fertilization).

Low level expression of matrix protein Elastin generators (FBLN-5, LOXL-1) in the structures of the connective tissue of the vaginal wall with destructive high protease activity (MMP-2, ММР-9) and low concentrations of their tissue inhibitors (TIMP-2) in patients with pelvic organ prolapse (POP) may indicate violation of the synthesis of elastic fibers.

For full implantation is important not only morphological condition of endometrium, proliferative activity, the readiness of the receptor apparatus, but also immunological features of the mucosa. To evaluate the endometrium in women with infertility and endometrial hyperplasia uses a variety of immunohistochemical markers.

Pre-eclampsia (PE) - one of the most serious complications ofpregnancy. Frequency of occurrence in recent years increase. In this work we show the effectiveness of identify PE using assessment of the level of endothelial dysfunction on pre-clinical stage on women in the third trimester ofpregnancy. The result’s analysis is focused on forecasting PE which indicates that most perspective belongs to EndoPAT.

In the course of the work we have seen that it is the combined use of clinical data, morphological studies and molecular techniques are the most justified to identify the earliest prognostic markers of endometrial cancer pathology and thus implement an effective treatment of patients with endometrial hyperplasia in premenopausal women.

In order to determine the endocrine status of the fetus in uncomplicated pregnancy and placental insufficiency of varying severity were comprehensively studied (clinical, echographic, Doppler, hormonal) 320 pregnant women. Studied ultrasound morphology (size of shares, circumference, echostructure, echogenicity) and peculiarities of organ blood flow offetal thyroid and adrenal glands of the fetus during pregnancy and uncomplicated placental insufficiency of the varying severity.

While examination of 26 patients of reproductive age who are receiving glucocorticoid therapy due to the systemic diseases noticable changes of vaginal biocenosis have been diagnosed. The patients of this cohort require local probiotics therapy.

The determination of the long-term changes of ovarian reserve state after organ-sparing pelvic surgery in women of reproductive age is one of the most challenging issues of modern gynaecology.

Investigation of the outcomes of in vitro fertilization cycles after controlled ovarian hyperstimulation in severe-to-moderate endometriosis with and without suppressive hormonal therapy. Administration of 2 mg dienogest daily 3-6 month before IVF cycle significantly improve IVF outcome. Clinical pregnancy rate was 50% versus 23.3% (p<0.05) in patients undergoing medical treatment with dienogest and without medical treatment before IVF cycles respectively.

The progression of obesity increases the production of lipid peroxidation products in patients who developed MS. Antioxidant system has its adaptive capacity.

Radical operation on the uterus and appendages activate lipid peroxidation, and slow down the processes of antioxidant protection.

This article represents the results of perinatal outcomes of postterm pregnancies delayed delivaries depending on the method of delivery. Antenatal and postnatal features and fetus and newborn indicators are reviewed and analyzed. Various historical views of doctors on the problem of postterm pregnancy and the results of international studies are presented.

The level of CD56 +-lymphocytes in the peripheral blood may become a new diagnostic criterion of recurrent miscarriage (RM). Women with RM have proportion of NK-lymphocytes (CD3 -CD56 +) in the blood more than 12-18% (according to different authors), the proportion of CD56 + dim is 95.6-96.6%. The count of CD56 +-lymphocytes is diagnostically significant when measured in peripheral blood as well as in the analysis of endometrial biopsy. CD56 highlights women with potential to be more effectively immunotherapy treated.

Over the past decade approaches to the treatment of breast cancer have changed significantly. So, new directions targeted therapy, adjuvant endocrine therapy. According to statistics, 61% of patients with primary tumors contain estrogen receptors, which makes it necessary to conduct hormone, as a component of combination therapy.

The minimally invasive diagnostic method of ovarian aromatase activity with the test with aromatase inhibitor letrosol is developed in the study. Aromatase activity is not considerably effect on combined treatment of endometriosis with gonadotrophin-releasing hormone agonist, but its increase can serve as pathogenetic ground for administration of aromatase inhibitors in this disease.

The decreased relative area of expression of estrogen receptor-alpha and progesterone receptors in endometrioid lesions and eutopic endometrium of patients with endometriosis compared to healthy women is revealed by immunohistochemical assay in this study. These data will allow to optimize preparation of such patients for pregnancy.

A prospective survey of 816pregnant women, pregnancy and childbirth was performed in order to develop modern approaches to screening and management of pregnant women with critical fetal distress. We have used the new technologies for assessment of mother and fetus, and rational choice of timing and method of delivery. Differentiated approach to obstetric care and choice of tactics depending on the severity of placental insufficiency allowed 2.6 times lower frequency of children born with malnutrition, 1.5 times - in a state of moderate and severe asphyxia, 1.75 times - the need for resuscitation, 1.8 times - the frequency of hypoxic-ischemic lesion of the central nervous system, 2.6 times - perinatal losses during this pregnancy complications.

The present investigation represents comparison of efficiency of oxytocin and its synthetic analogue carbetocin in prophylaxis of postpartum hemorrhage. Totally 192 patients were enrolled in the study. They were divided into 2 groups according to injected uterotonic. The both groups were comparable with age and duration of labor. Administration of carbetocin was shown to lead to significantly less blood loss in comparison with oxytocin according to gravimetric method.

Conducted a randomized, double-blind, controlled clinical trial of gynecological patients of reproductive age with chronic endometritis, with an estimation of informative comprehensive screening diagnostics of functional state of the reproductive system. Identify highly informative technique, which allowed her to recommend screening assessment offunctional abnormalities in chronic salpingoophoritis.

Conducted a randomized controlled clinical study of 60 healthy women aged 25 to 45 years. The experimental group of women in a period of not less than 3 years, took low-dose COCs. In the experimental and control groups were evaluated vascular endothelial FMD of the brachial artery and measuring the thickness of the intima-media thickness of the carotid artery. The result of this study revealed the negative impact of long-term intake of low-dose COCs on the vascular endothelium.

When applying system Elevate anatomical and functional efficiency within 4 years of the study - 95.9%. Complications: intraoperative - 5.4%, early postoperative - 18.9%, late postoperative complications were not identified. Relapse within 4 years of follow-up identified in 4.1% of women. Analysis of remote results of the basic methods of surgical treatment of various defects of the pelvic floor shows rationality and long-term efficacy of modern synthetic systems of the last generation - Elevate anterior/posterior and apical AMS Ink.

The results of the use of proteolytic enzyme longidaza in the combined treatment of pelvic endometriosis are presented in this study. The use of this drug leads to reduction of pain syndrome and adhesions, suppresses neoangiogenesis, decreases inflammatory reaction and development of fibroid tissue.

Subgroup retrospective analysis on overweight, obese patients and patients with normal weight was performed. Obesity and overweight have negative impact on IVF treatment outcomes.