Aim. To review the current publication highlighting the features of pregnancy and childbirth outcomes in patients with endometriosis. Materials and methods. The analysis of 45 foreign and domestic publications on this topic has been carried out. Results. Patients with endometriosis have fertility problems, and when pregnancy occurs, it was characterized by a higher risk of preeclampsia, placenta previa, gestational diabetes, miscarriage and preterm labor, as well as delivery by caesarean section. Newborns in women with endometriosis have an increased risk of prematurity and small for gestational age. Probably, in addition to the presence of endometriosis, the risk of obstetric and neonatal complications is influenced by the localization and severity of the disease, as well as the use of assisted reproductive technologies. Conclusion. The results obtained indicate that patients with endometriosis have a high risk of perinatal complications and require additional antenatal monitoring and care.
Aim. To conduct an analytical review of modern publications highlighting modern approaches to improving the quality and increasing life expectancy in postmenopausal women. Materials and methods. The analysis of 47 foreign and domestic literature sources on this topic is carried out. Results. Menopause is a time of significant change for women and a good time to assess and promote health. Patient counseling should include information on lifestyle, contraception, individual and family risks of cancer and osteoporosis. Hormonal, non-hormonal and complementary methods can be used to correct the symptoms of menopause. MHT is the most effective treatment for symptom relief and can be offered to most women. Topical vaginal oestrogen treatment is effective in relieving urogenital symptoms. Women should be able to make informed choices regarding the use of MHT, based on balanced and accurate information about its benefits and risks. Conclusion. Menopause is a time of change for women and provides an opportunity for health assessment and promotion. The decision to treat menopausal symptoms using hormonal, non-hormonal and complementary methods should be made on an individual basis depending on the presence of risk factors and the patients preferences.
A prospective, randomized, open, comparative study. There were 105 women of reproductive age with obesity and simple endometrial hyperplasia without atypia (EH) included into the study. 13 patients had left the study.31 patients took an agonist of gonadotropin-releasing hormone (aGnRH) Buserelin at the dose of 3.75 mg intramuscularly every 28 days. 33 patients took 10 mg of norethisteron per day. 28 patients took combined estrogen-gestagen drugs (30 mkg of ethinylestradiol + 150 mkg of desogestrel). The base therapy of obesity (a balanced diet and a physical activity)had been administered to all of the patients. Treatment in all groups lasted 6 months. The results of this study showed that usage of aGnRH in management of endometrial hyperplasia in patients of reproductive age with obesity is most effective and safe.
Aim. To determine the frequency of the polymorphisms within the genes encoding estrogen metabolism enzymes: CYP1A1 (rs4646903), CYP1A2 (rs762551), CYP19 (rs700519) and SULT1A1 (rs9282861) in women with early miscarriage.Materials and Methods. We recruited 103 consecutive women who experienced early miscarriage (< 12 weeks of pregnancy, n = 103) and 257 women without past medical history of adverse pregnancy outcomes. Following DNA extraction, we genotyped all samples by means of restriction fragment length polymorphism analysis. We analyzed the polymorphisms within the CYP1A1 gene (T264 → C, rs4646903), CYP1A2 gene (C734 → A, rs762551), CYP19 gene (C → T, rs700519), and SULT1A1 gene (G638 → A, rs9282861).Results. We found a significantly increased prevalence of the mutant allele C as well as T/C and C/C genotypes of the rs4646903 polymorphism within the CYP1A1 gene and mutant T allele along with the T/C genotype of the rs700519 polymorphism within the CYP19 gene in women with early miscarriage as compared with those having a normal pregnancy course. Concurrently, we detected a reduced frequency of the C/A genotype of the rs762551 polymorphism within the CYP1A2 gene in patients who suffered from early miscarriage. The risk of miscarriage was significantly increased in carriers of CYP1A2 (rs762551 C/C) + CYP1A1 (rs4646903 T/C + C/C) + CYP19 (rs700519 C/T), CYP1A2 (rs762551 C/C) + CYP1A1 (rs4646903 T/C + C/C) + SULT1A1 (rs9282861 G/G) + CYP19 (rs700519 C/T), CYP19 (rs700519 C/T) + SULT1A1 (rs9282861 G/G), (CYP1A2 (rs762551 C/C) + CYP1A1 (rs4646903 T/C + C/C); CYP1A2 (rs762551 C/C) + CYP19 (rs700519 C/T), CYP19 (rs700519 C/T) + CYP1A1 (rs4646903 T/C + C/C), and SULT1A1 (rs9282861 G/G) + CYP1A1 (rs4646903 T/C + C/C) haplotypes. Investigation of the possible gene-environment interactions found a considerable increase in CYP1A1 (rs4646903 T/C) + CYP1A2 (rs762551 A/A) and CYP1A1 (rs4646903 T/C) + SULT1A1 (rs9282861 A/A) haplotypes in conjunction with a CYP1A2 (rs762551 A/A) + SULT1A1 (rs9282861 G/A) haplotype.Conclusion. Patients with early miscarriage more frequently have the mutant allele C as well as C/T or C/C genotypes of the rs4646903 polymorphism within the CYP1A1 gene and mutant allele T (in particular within the C/T genotype) of the rs700519 polymorphism within the CYP19 gene; in contrast, C/A genotype of the rs762551 polymorphism within the CYP1A2 gene was less common in these patients. Specific risk haplotypes revealed in our study may indicate a combination of estrogen-dependent and chemically induced process caused by the bioactivation of exogenous xenobiotics in patients with early miscarriage.
Aim. To compare effects of the drug containing ethinylestradiol (EE) 0.03 mg and drospirenone (DRSP) 3 mg and the drug containing EE 0.02 mg and DRSP 3 mg on the skin and anthropometric parameters. Materials and methods. A prospective comparative randomized study included 40 women of reproductive age who didn’t have contraindications to use of combined oral contraceptive (COCs). The first group consisted of 20 women who were administrated EE 0.03 mg and DRSP 3 mg in the 21/7 regimen according to a prescribing information; the 2nd group included 20 patients who were administrated EE 0.02 mg and DRSP 3 mg in the 24/4 regimen according to a prescribing information. The study protocol included 8 visits: at the 0th visit, the inclusion and exclusion criteria were evaluated, at the 1st visit patient were randomized (envelope method) to receive one or another drug, at the 2nd - 7th visits (once a month) blood pressure was measured, anthropometric parameters were determined including body weight, height, waist, hips as well as body mass index, a degree of hirsutism (with Ferriman-Gallwey scale), skin and hair skin oiliness, acne (with a 10-point visual scale) were evaluated. Results. The use of EE 0.03 mg and DRSP 3 mg for 6 months did not significantly affect the body weight and body mass index, waist and hips. In the 6th month, the use of EE 0.03 mg and DRSP 3 mg lead to a statistically significant decrease in skin oiliness, severity of acne and hirsutism, which was comparable to a clinical effectiveness of EE 0.02 mg and DRSP 3 mg. Conclusions. EE 0.03 mg and DRSP 3 mg has a similar effect on skin oiliness, severity of acne and hirsutism with EE 0.02 mg and DRSP 3 mg, without significantly affecting the main anthropometric parameters. It is likely that the effect of DRSP-containing COCs on androgen levels and adipose tissue is due precisely to the effect of DRSP, and not to the dose of EE.
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