Here we review the recent literature on pelvic floor dysfunction, which is increasingly common in women of reproductive age and represents a significant medical problem occurring as a result of injured pelvic floor ligaments. Pelvic floor dysfunction is largely associated with vaginal delivery and might lead to urinary and fecal incontinence as well as pelvic organ prolapse. Intraabdominal hypertension, nerve damage, obesity, and genetic predisposition are among the major contributors to pelvic floor dysfunction. Being asymptomatic at the early stage, pelvic floor dysfunction gradually leads to the irreversible alterations in pelvic floor anatomy, ultimately deteriorating quality of life. Surgery remains a gold standard in the treatment of pelvic organ prolapse, yet POP-Q stage I-II prolapse should be treated conservatively. Currently, there are no specific treatment regimens and no evidence-based opinion regarding Kegel exercises and laser therapy. Biofeedback pelvic floor muscle training is the treatment of choice for urinary incontinence. Use of pessaries represents another efficient approach to conservative treatment.
You study the influence of alternative therapies drug «Klimadynon®» in menopausal’nym patients with metabolic syndrome in the climacteric syndrome, weight, blood pressure, carbohydrate and lipid metabolism. Surveyed 38 patients aged 45 to 61 years (mean age 53,6±0,6 years) who were in natural menopause and had a series of violations within the framework of the metabolic syndrome (excess weight or obesity on abdominal’nomu type 2, type IMD dislipidemiu, arterial hypertension). Correction for climacteric disorders has been appointed an alternate method of treatment – «Klimadynon®» to 1 tablet 2 times daily. Estimated climacteric syndrome using modified menopausal index (E.V. Uvarova, 1983), carbohydrate, lipid Exchange, anthropometric parameters, level of HELL originally, after 3 and 6 months of initiating treatment. Against the backdrop of the reception of an alternative method of treatment with «Klimadynon®» we got the better of menopausal syndrome: in 13,3 % of heavy gravity menopausal syndrome has moved to middle level, in 52,6 % of the average degree of menopausal syndrome has moved into easy. Accurately noted improvements in the level of blood sugar on an empty stomach, reducing insulinorezisten- tnosti in women with menopausal’nym metabolic syndrome with therapy. «Klimadynon®» anticonvulsant therapy has statistically significant antiaterogennomu shift indicator of lipid Exchange in women. A tendency towards lower body mass index, waist, blood pressure. Thus, the application of the «Klimadynon®» in women with abnormal klimaksom and menopausal’nym metabolic syndrome could be a good option alternative therapies and significantly improve their quality of life.
Aim. To identify measures for the improvement of obstetric techniques and telemedicine technologies in women with major obstetric haemorrhage.Materials and Methods. We analyzed medical documentation of 54 women in Altai Krai who experienced major obstetric haemorrhage within 28- 36 weeks of gestation before (2008-2012) and after (2013-2017) implementation of risk management using the telemedicine “Registry of pregnancies” technology.Results. Implementation of risk management principles led to the admission of women with major obstetric haemorrhage exclusively to specialised hospitals in contrast to the preceding period. Further, it was associated with a higher prevalence of caesarean sections (from 55.6% to 96.3%) in women with major obstetric haemorrhage due to an increase in cases of complete placenta previa or placenta increta. In 73.0% of cases, such patients delivered in specialised hospitals where autologous blood transfusion or intrauterine balloon tamponade could be applied. In spite of increase in frequency of major obstetric haemorrhages, risk management reduced their severity by decreasing blood loss and, hence, the risk of posthaemorrhagic complications and blood transfusion side effects.Conclusions. Risk management-based strategy for optimising obstetric care by telemedicine technologies leads to the admission of high-risk, even “near miss” patients in specialised hospitals that is particularly efficient in regions with low population density and a large network of primary healthcare facilities.
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