Introduction. The novel coronavirus pandemic makes the issue of iron deficiency in pregnancy even more urgent and forces multidisciplinary clinicians to search for modern ways to correct disorders caused by this infection.Objective. To assess the features of the course of post-covid anemia associated with combination therapy, as well as the effect of therapy on the dental health status in pregnant women.Materials and methods. 30 pregnant women (treatment group 1) in the third trimester who had coronavirus infection with mild IDA during gestation were enrolled in the prospective study. Comparison group 2: included 15 patients with mild IDA who did not have coronavirus infection during gestation. Control group 3: included 15 conditionally healthy pregnant women without IDA who did not have a novel coronavirus infection during gestation.Results. Pregnant women who had COVID-19 during gestation were significantly more likely to suffer from gum bleeding, angular cheilitis, oral erosive and ulcerative lesions. Gum bleeding was significantly more common in pregnant women with IDA against the background of coronavirus infection, than in the women in the comparison and control groups (SBI index, p < 0.05). The decrease in the normal microflora suggests the presence of dysbiotic changes in all pregnant women against the background of IDA, however, the patients after the COVID-19 infection had the most significant changes in it.Conclusions. The novel coronavirus infection, which the women had during gestation, aggravates the course of IDA, reduces the quality of life of patients with characteristic complaints (gum bleeding, angular cheilitis, oral erosive and ulcerative lesions), leads to dysbiotic oral microbiome changes. The management of this group of patients requires a systemic correction of the microflora balance, the introduction of individual oral hygiene regimens and adequate treatment of IDA using high-technology medicinal products
Review article is devoted to one of the most common polygenic endocrinopathies in women of reproductive age, polycystic ovarian syndrome (PCOS). We review the current criteria used to make a correct diagnosis based on four phenotypes of PCOS: Frank (phenotype A) – biochemical and/or clinical hyperandrogenism, oligo-/anovulation, polycystic ovarian morphology according to ultrasound; anovulatory (phenotype B) – oligo-/anovulation, biochemical and/or clinical hyperandrogenism; ovulatory (phenotype C) – biochemical and/or clinical hyperandrogenism, polycystic ovarian morphology according to ultrasound; non-androgenic (phenotype D) – oligo-/anovulation, polycystic ovarian morphology according to ultrasound. This article presents the main theories of PCOS pathogenesis: peripheral, central, insulin, genetic, and also considers epigenetic factors. PCOS is a multifactorial disease in which genes are responsible for the mechanisms of the process, and environmental factors through epigenetics affect the genetic material. PCOS phenotypes play an important role in clinical practice, as they allow an individualised approach to the selection of therapy in each case, taking into account the pathogenesis of the disease and predicting its course in the future. The main therapeutic options for treating patients with PCOS, taking into account the multifactorial nature of the disease and the patient's interest in pregnancy, are reviewed. The article presents modern methods for the correction of hyperandrogenism and anovulation, with special emphasis on the need for progesterone therapy.
Introduction. The vaginal microflora has a direct impact on the health of a newborn child, as well as during the postpartum period in new mothers. The composition of the vaginal microflora of a new mother determines the microflora of her conjunctiva, gastrointestinal tract, and the skin of the newborn, which are identical to the microflora of the mother’s birth canal, and the risk of infection in newborns is directly related to the degree of amniotic fluid insemination. At least half of women have some kind of vaginal microcenosis disorder during pregnancy. In the course of the study, the peculiarities of vaginal microbiota in a full-term pregnancy were studied and the effectiveness of correction of vaginal microcenosis abnormalities when applying the preparation Gaynomax was assessed.Aim of the study. To study the peculiarities of the vaginal microbiota in case of full-term pregnancy and to evaluate the effectiveness of correction of its abnormalities when applying the preparation Gaynomax.Materials and methods. On the basis of City Clinical Hospital No. 40, separate subdivision “Maternity hospital“, clinical and diagnostic department 72 pregnant women in the gestation period of 37-39 weeks the analysis of microscopic examination of vaginal swabs culture and sensitivity test was performed. The analysis included the results of a microscopic study of vaginal and cervical swabs stained using the Gram method. Bacteriological analysis of the vaginal content by cultivating aerobic and anaerobic microorganisms on special nutrient media. PCR method with real-time detection of results (Femoflor 16), including the determination of a wide range of microorganisms. To obtain adequate results, only samples with a sufficient number of cells caught in the test tube with the analyzed sample and sufficient total bacterial mass were used. Samples in which the number of DNA of human cells was more than 104 genome equivalents (GE) in the sample were taken into account, this is a swab quality indicator (SQI).The results: In pregnant women with high frequency infectious risk group, vaginal dysbitoic conditions were revealed with development of bacterial vaginosis, vaginal candidiasis and nonspecific vaginitis. Vaginal sanitation was carried out in patients. Excellent effect was obtained in 33/72 (49,2%) women, good effect in 21/72 (31,4%) patients, satisfactory in 13/72 (19,4%), which indicates fully justified expectations from the chosen treatment method. Conclusion: The use of Gaynomax vaginal suppositories is a reasonable and quick method of vaginal sanitation before delivery.
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