Uterine myoma is the most common benign tumor among women which affects mainly those of reproductive age. Moreover, the frequency of emergence of this pathology in population is growing while the age of patients is steadily decreasing. Despite the enormous prevalence of this disease, its pathogenesis has not been studied properly. This article is concerned with an analysis of publications devoted to the study of the mechanisms of growth and development of uterine fibroids, it provides some data on the role of various factors in its extension. The article concerns the most popular concepts of the pathogenesis of this disease according to which the illness may be caused by increased levels of sex hormones (estrogens and progestins), enhanced expression of their receptors, impaired apoptosis, the effect of growth factors (e. g. epidermal growth factor, heparin-binding epidermal growth factor, acid and basic fibroblast growth factors, vascular endothelial growth factor, insulin-like growth factor, platelet-derived growth factor, transforming growth factor-β, activin, myostatin), abnormal deposition extracellular matrix, genetic (chromosomal aberration and various MED12 gene defect) and epigenetic mechanisms (such as action microRNA), circulatory disorders and impairment of cell differentiation from a population of accessory stem cells. However, it is noted that the pathogenesis of this pathology requires further detailed study, as the understanding of the processes leading to its development could greatly contribute to the improvement of the tactics of treatment and possibly allow to elaborate some preventive measures to avert the development of fibroids.
At the moment, the problem of preterm birth is one of the most urgent in the modern world. Preterm birth is of the greatest interest in obstetrics, as they can lead to various conditions that interfere with the further development and vital activity of the baby, which can lead to various disorders in the babys body systems, and in the worst case, can also lead to its death. Nowadays, there is no complete understanding of the mechanisms of development of preterm labor. The pathogenesis and pathophysiology of preterm birth are extremely complex, however, of course, many factors affect the development of this process, including the state of the microflora of the female genital tract. This article provides a review of current literature on the effects of bacterial vaginosis and significant infectious microorganisms (Prevotella sp., Mobiluncus sp., Gardnerella vaginalis, Mycoplasma hominis, etc.) on the development of preterm labor. This work presents a review of the current literature on the available data on the effect of various microorganisms of the female genital tract, as well as the significant cytokines, defensins, prostaglandins, and other biologically active substances secreted by them that are most likely involved in the process of preterm delivery. A probable mechanism for the development of preterm labor is presented under the influence of changes in the vaginal microflora and the predominance of pathogenic and conditionally pathogenic flora with the participation of matrix metalloproteinases, phospholipases and ligands of Toll-like receptors.
The article presents the experience of drug treatment of inertial tubal pregnancy. Currently, ectopic pregnancy is one of the most serious pathologies of pregnancy, leading to a decrease in the woman's reproductive health and directly threatening her life. In this clinical case, the possibility of treatment of ectopic pregnancy with mifepristone and misoprostol in a hospital of the 3rd level, with a patient's refusal of surgical treatment, has been demonstrated. At the moment, according to clinical recommendations adopted in the Russian Federation, interstitial tubal pregnancy is an indication for surgical treatment. Instructions for the use of mifepristone and misoprostol do not provide indications and treatment regimens for ectopic pregnancy. Medicamentous treatment of ectopic pregnancy is possible only with early diagnosis, in hospital settings and with the patient's voluntary consent. We have demonstrated the possibility to consider drug treatment not only as a therapy for despair, but also as an alternative to surgery leading to operative trauma of the reproductive organs, which is more extensive with the rare localization of interstitial tubal pregnancy, namely not only removal of the fallopian tube, but excision of the uterine tube trunk angle. Operative treatment of ectopic pregnancy leads to various complications that reduce the reproductive function of patients. Conservative treatment, perhaps, will help in the subsequent to avoid complications associated with surgical treatment and preserve the ability to procreate, in women with a burdened obstetric-gynecological anamnesis.
Infertility is one of the most acute problems in modern reproductive studies. The theme of research is poorly conceptualized in modern medical literature, and this fact is an additional confirmation of the relevance and scientific significance of this research. With the use of assisted reproductive technology (ART), pregnancy in an infertile marriage became possible. In this article, the authors pay significant attention to the role of the endometrium in the implantation process. To better assess the status of the endometrium, they performed hysteroscopy and endometrial biopsy and conducted morphological study of biopsy material and immunohistochemistry analysis. The features, competitive advantages, or disadvantages of every method of research and treatment have also been included in the discussion. Analysis of the results of the immunohistochemical studies revealed the presence of autoimmune chronic endometritis and chronic endometritis without an autoimmune component. Comprehensive examination and treatment resulted in successful pregnancy in 90% of women with failed IVF attempts in anamnesis. At the same time, in 60% of cases the pregnancy resulted in childbirth between 36 and 40 weeks of gestation. During such pregnancies, there are only a few specific features: high risk of miscarriage, fetal defects, and extragenital pathology. Thus, reproductology is in constant search for new methods that are able to further improve the positive results of IVF.
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