The outcomes of pregnancy and childbirth, which ended with a cesarean section, were studied in accordance with Robson's classification in order to find ways to reduce the frequency of surgical delivery in a level 3 hospital. The mechanisms to reduce the frequency of cesarean section in an obstetric hospital are defined: pregravid preparation in risk groups for preterm delivery and assessment of perinatal risk factors, a personalized approach to methods of pre-induction of parturition in high-risk patients, especially in full-term pregnancy, rational management of parturition, prevention of the first cesarean section, an increase in delivery through the natural birth canal in pregnant women with a scar on the uterus.
Aim. Evaluate the effectiveness of management tactics for patients with mild cervical intraepithelial neoplasia.
Materials and methods. A comprehensive clinical and laboratory examination of 72 patients aged 18 to 35 years with morphologically verified CIN I was performed. The main group consisted of 36 patients who, along with active observation, were prescribed vaginal suppositories diindolylmethane at a dose of 200 mg per day for 3 months. The comparison group included 36 patients who, according to clinical recommendations, had chosen the tactics of active observation.
Results. An analysis of the outcomes of mild squamous intraepithelial lesions after 12 months showed that in the main group CIN I regression was observed in 91.7% of patients, persistence in 8.3% of cases, while in the comparison group CIN I regression was noted in 69. 4% of cases, persistence in 25% of patients, and progression to CIN II in 5.6% of cases.
Conclusion. The results of the study suggest that the inclusion of diindolylmethane, which has multi-target antitumor activity, in the treatment of pre-invasive diseases of the cervix in young women.
The article presents data from a retrospective analysis of 8,706 childbirth histories of the Volgograd Clinical Perinatal Center No. 2 for 2018–2019 years. To analyze the frequency and indications for caesarean section, the 10-group classification by M. Robson was used. The results obtained allowed us to determine the groups with the highest frequency of cesarean section and outline ways to reduce the frequency of abdominal birth in these groups.
Cervical insufficiency is the main cause of miscarriage in the second trimester of pregnancy (up to 40 %), and in the third trimester occurs in a one third of women with preterm birth. Diagnosis of this pathology is based on the identification of structural changes in the cervix, which determines the impossibility of predicting this pathology before pregnancy. Current morphological studies have shown that connective tissue predominates in the cervix, represented mainly by collagen, which provides up to 85 % of the weight of the cervical tissue, elastin and proteoglycans. A key factor in the development of CI is currently considered a defect in collagen synthesis and the development of cervical incompetence is considered as a manifestation of undifferentiated connective tissue dysplasia. The results of recent studies show that cervical insufficiency is a genetically determined condition and polymorphisms in genes related to the metabolism of connective tissue can play a role in the development of CI.
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