Introduction. One of the leading problems of modern reproductive surgery is treatment of adhesive disease, and in turn, prevention of intrauterine adhesions after intrauterine interventions is of particular interest. Purpose: to evaluate the effectiveness and safety of anti-adhesive gel “Antiadgesin” for intrauterine use in patients with a combination of pathology of the uterine cavity and severe forms of endometriosis. Materials and methods. The study included 24 patients aged 23 to 39 years with a combination of pathology of the uterine cavity and severe forms of genital endometriosis. The main group consisted of 12 patients to whom the anti-adhesive gel “Antiadhesin” was applied at the end of the laparoscopic and hysteroscopic stages on the region of the ovaries, pelvic peritoneum in the areas of separation of the adhesions, and also inside the uterine cavity. The comparison group included 12 patients who received 0.9% sodium chloride solution (5 ml) on the surgical area. Patients of both groups underwent treatment with gonadotropin-releasing hormone agonists (GnRH-a) 3.75 mg for 4 months after the operation. We performed gynecological ultrasound 4 weeks after operation, 4 weeks after the last injection of GnRH-a, and after the first menstrual bleeding. Assessment of the state of the uterine cavity, diagnosis of intrauterine synechia was performed by hydrosonography. Results. The duration of the operation, the amount of intraoperative blood loss did not differ significantly between the groups. In all patients, no complications of the postoperative period, no allergic or inflammatory reactions associated with the use of “Antiadhesin” were detected. The duration the uterine bleeding after the operation did not differ significantly between the groups. In 2 patients of the comparison group hydrosonography confirmed the adhesive pathology of the uterine cavity. In the main group there were not identified any signs of intrauterine adhesions by ultrasound. Within 12 months after the treatment, pregnancy occurred in 50% of the patients in the main group and in 33.3% of the patients in the comparison group. Conclusion. The results of the study showed that the introduction of the anti-adhesive gel “Antiadgesin” in the uterine cavity after hysteroresectoscopy is a safe and effective method for preventing the formation of intrauterine synechia.
The study involved 89 postpartum women and 97 nonpregnant women aged 20 to 35 years. The results of a genetic test compared with the BMD. In parturients in the lumbar spine the highest IPC and the value of the Z-scores were in patients with genotype FF, and the lowest with the genotype ff. Patients with the heterozygous genotype were charac terized by intermediate values of the BMD and Z-scores in the lumbar spine. A similar results was observed in the proximal femur and the distal forearm. The results of the correlation analysis showed a moderate negative correlation between the ff genotype and the level of BMD in lumbar spine (r = –0,44; p < 0.05) and proximal femur (r = –0.37; p < 0.05).
This literature review is devoted to the use of focused ultrasound in gynecological practice as an alternative to the traditional surgical treatment of uterine fibroids and deep infiltrating endometriosis. According to available data, the effectiveness of the treatment of uterine fibroids with focused ultrasound varies widely, ranging from 16.4% to 93.0%. Due to the lack of prospective studies, it is not possible to draw reliable conclusions about the effect of ablation of uterine fibroid with focused ultrasound on fertility. However, unplanned pregnancies after such treatment occurred up to 19.5%, and in 66.3% of cases, pregnancies ended with the childbirth. Research results demonstrate that in 87% of cases, treatment of retrocervical infiltrative endometriosis using focused ultrasound is feasible. Further data accumulation is required to determine the range of patients with uterine fibroids and deep infiltrating endometriosis, to whom the treating technique could be most effective and safe.
Background. Prevalence of asthma (BA) among pregnant women reaches 12%. Obstetric complications (preeclampsia, placental insufficiency, IUGR, etc.) mainly occur in the absence of control of asthma. Aspects of the placenta status in women with chronic allergic respiratory disease are not well understood. Purpuses and tasks — studying the expression of markers of immature dendritic cells (CD35) and natural killer (CD57) cells in the placenta of patients with asthma, depending on the of severity, control and the type of therapy. Materials and methods. The study involved 200 pregnant women, including 170 with asthma (44 patients with mild intermittent, 52 with mild persistent, 61 with moderate and 13 with severe asthma), and 30 patients without pulmonary and allergic diseases. We analized complications and pregnancy outcomes, conducted the immunohistochemical study of placental samples of 134 patients for the expression of CD35 (marker of immature dendritic cells) and CD57 (marker of NK cells) on cryostat sections, immunomorphological study of the placenta with determination of the fixation of pathogenic immune complexes (PIC), IL-6, IL- 4, IL-10 in the placenta. Results. CD35 expression in the placenta of women with asthma is increased, while in patients undergoing preeclampsia CD35 expression is lower, especially in cases of uncontrolled asthma in the 3rd trimester. In all cases with persistent and incompletely controlled asthma, the expression of the natural killer marker (CD57) in the placenta correlates with the presence of PIC, IL-6, IL-4, IL-10 and inflammatory changes in the placenta. Conclusions. The results of the study suggest that a decrease in CD35 expression in cases with the combination of uncontrolled persistent asthma and preeclampsia seems to deplete the mechanisms of the immune response. Increased NK cell marker expression (CD57) in the placenta of women with uncontrolled and persistent asthma indicates on the cytotoxic role of this subpopulation of cells, leading to morphological and immune changes in the placenta that adversely affect the fetus and newborn.
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