Diagnosis and treatment of acute surgical diseases in gynecology, despite the modern achievements of medical science, has been and remains a difficult and responsible task. In urgent situations, there is always a danger of operating the patient when it was not necessary, or viewing the acute surgical process with prolonged observation, which contributes to the development of complications and even death of the patient. Often, not only health, but also the woman’s life depends on how quickly and correctly the doctor will orient in the situation and apply the right organizational and medical measures. The development of endoscopic technology has allowed us to go from a simple visual examination of the abdominal cavity and pelvic organs to complex surgical interventions without an abdominal incision, and in emergency conditions, in case of acute abdominal pathology, in most cases, resolve diagnostic doubts. The article describes the advantages and disadvantages of endoscopic treatment of the most common urgent gynecological pathologies, especially the postoperative management of patients, rehabilitation and preventive measures to restore their reproductive health. Key words: urgent gynecological conditions, ectopic pregnancy, laparotomy, laparoscopy, semi-operative management, rehabilitation, prevention.
The objective: depression of frequency of not incubation at women with congenital anomalies of development of uterus on the basis of scientific justification and introduction of advanced algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. Retrospective inspection of 100 women with congenital anomalies of development of uterus, prospective inspection of 30 women with congenital anomalies of development of uterus who received the algorithm improved by us. Results. Not incubation frequency in 1 trimester of pregnancy at women with anomalies of development of uterus made 8.0%, and the main reasons were: the stood pregnancy (3.0%); premature amotio of chorion (3.0%) and intraamniale becoming infected (2.0%). At women with congenital anomalies of development of uterus level of premature births reaches 24.0%, and the main are two reasons – premature rupture of fetal covers (10.0%) and noneffective treatment of threat of an abortion (10.0%), and at 4.0% the antenatale death of fetus takes place. Conclusion. Use of the algorithm improved by us allows to reduce not incubation frequency from 8.0% to 3.3%; premature births – from 24.0% to 13.3%, and also the cooperative frequency of perinatal pathology – for 10.0%. Key words: not incubation, congenital anomalies of development of a uterus, prophylaxis.
<p>Вступ. В останні роки проблема остеопорозу (ОП) набула особливого звучання внаслідок двох тісно пов’язаних демографічних процесів: різкого<br />збільшення в популяції старих людей і, відповідно, кількості жінок у постменопаузі. Приблизно в кожної третьої жінки після 65 років трапляється<br />один остеопоротичний перелом. Переломи стегнової кістки приводять до зменшення тривалості життя на 12−15 років. Хронічні запальні захворювання гастродуоденопанкреатичної зони і печінки супроводжуються зниженням абсорбції мінералів і вітаміну D в кишечнику, внаслідок чого знижується мінеральна щільність кісткової тканини (МЩКТ), що часто призводить до інвалідизації хворих.</p>
In most European countries in recent years, the frequency of multiple births ranges from 11 to 14 per 1000. These pregnancies have a high number of complications. Perinatal mortality in multiple births is more than 6 times higher than in singleton pregnancies. Severe neurological abnormalities under the age of 1 year have from 10% to 25% of twins. According to most researchers, the main cause of perinatal losses in multiple births is deep prematurity and severe fetal growth delay. It has now been proven that placental insufficiency is the main reason of developmental delay, discordant fetal growth, antenatal death of one of the fetuses. A fetus that develops and is born in conditions of chronic placental insufficiency is more vulnerable and at high risk of developing perinatal pathology. The purpose of the research was to study the frequency and structure of complications of the pregnancy and labor of women with multiple pregnancies, complicated uteroplacental insufficiency and fetal discordance. The study was carried out at the city clinical maternity house during 2013–2019. The information was gathered from literature and by interviewing pregnant women with twins. 20 pregnant women (group I) with dichorionic, diamnionic twins with the presence of placental insufficiency and fetal discordance of more than 20%. Group II consisted of 20 pregnant women with twins but fetal discordance did not exceed 20%. However, the control group ІІІ consisted of 30 women without complications and ended in physiological labor. The general, somatic, obstetric and gynecological anamnesis, especially the course of pregnancy, childbirth, the state of the cervix by vaginal and ultrasound examination were studied. The results of the study show that in the anamnesis of pregnant women with fetal discordance, take place in vitro fertilization and infections of the respiratory and urinary tract. Multiple pregnancies which were accompanied by fetal discordance exceeding 20% is accompanied by impaired uteroplacental circulation. Labor with twins complicated by impaired uteroplacental circulation occurs in a large number of complications. The results can be applied to the using various medications for the correction of disorders of the uteroplacental circulation.
The objective: optimization of diagnostics and tactics of conducting pregnancy at women with benign tumors and tumorous formations of ovaries by improvement of diagnostic and treatment-and-prophylactic actions. Patients and methods. 129 patients in various durations of gestation from which 104 were with benign tumors and tumorous formations of ovaries were surveyed. Results. The clinical course of pregnancy at course of pregnancy at women with benign tumors and tumorous formations of ovaries is characterized by the high frequency of threat of discontinuing in І (49.7%) that ІІ trimesters (50.8%). Level of other complications depends on maintaining tactics, and it considerably vichy at refusal of women of expeditious treatment and their conservative maintaining: placental dysfunction – 44.0% and 16.2%; fetus distress – 30.0% and 6.7%; delivery by operation of cesarean section – 33.3% and 10.8%; disturbances of post-natal adaptation of newborns – 9.5% and 6.8% respectively. Conclusion. The improved and introduced algorithm of maintaining women with benign tumors and tumorous formations of ovaries allows to improve obstetric and perinatal outcomes of delivery of women of group of high risk. Key words: benign tumors and tumorous formations of ovaries, pregnancy, maintaining tactics.
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