Our observations demonstrate the coexistence of two endogenous cardiotonic steroids in preeclamptic plasma, a more polar OLC and a less polar MBG-like compound. Substantial increases in plasma OLC and MBG immunoreactivity in preeclampsia, along with the vasoconstrictor properties of authentic MBG and Na+,K+ ATPase inhibitory activity of human MBG immunoreactive factor, suggest, that in preeclampsia, plasma concentrations of MBG are enough to substantially inhibit the sodium pump in cardiovascular tissues, and are in accordance with the views attributing endogenous digitalis-like factors a pathogenic role in the preeclamptic hypertension.

Research objective: to identify a role of kisspeptine in the regulation of reproduction function.Materials: literature data by foreign authors for the period from 1985 till 2016.Methods: systematic analysis and compilation of information in the literature.Results. The article provides a review of literature data on research of kisspeptine gene and its receptor; it includes description of their role in regulation of reproduction function and mutation in the genes responsible for realization of kisspeptine and neurokinin signaling pathways. Features of kisspeptine secretion in patients with hypogonadotropic hypogonadism, premature sexual development, hyperprolactinemic deficiency of ovaries, polycystic ovarian syndrome, genital endometriosis and opportunity of kisspeptine use in clinical practice as an ovulation trigger are described.Conclusion. It is necessary to carry out further studies for clarification of kisspeptine role in patients with various diseases and the opportunity of its use as a therapeutic target.

A local inflammatoMicrobial invasion of amniotic cavity and subsequent infection process are the leading cause of adverse pregnancy outcomes. Intra-amniotic infection can be caused by both pathogenic and opportunistic microorga­nisms and viruses, but in the vast majority of cases intra-amniotic infection is associated with the normal microflora of different body sites – the vagina, intestines, mouth and respiratory tract. In the paper, current views about the role of infection factor in the adverse pregnancy outcomes, sources and mechanisms of intra-amniotic infection are summarized.

In the present review modern data about change of morfo-functional properties of a trophoblast during pregnancy, and also about influence of the cytokines produced by cells of a microenvironment, including leucocytes of mother, on a functional state of trophoblast is cited. Features of interaction between trophoblast and immune cells of mother are described within physiological pregnancy and within pregnancy complicated by preeclampsia.

1 ФГБНУ «НИИ акушерства, гинекологии и репродуктологии им. Д.О. Отта», Санкт-Петербург; 2 СПб ГБУЗ «Родильный дом № 9», Россия, Санкт-Петербург Поступила в редакцию: 10.06.2016 Принята к печати: 04.08.2016 ■ В статье представлен материал о критических состояниях в акушерской и гинекологической практике (near miss), полученный на основании собственных исследований, а также данных отечественных и зарубежных авторов. Показано, что основным фактором, определяющим исход беременности и родов, является качество медицинской помощи, предоставляемой женщине. Дана характеристика состоянию near miss, указаны факторы риска его возникновения. Предложен показатель, характеризующий медицинскую помощь до получения тяжелых осложнений беременности и родов, а также возможные пути снижения частоты их развития. ■ Ключевые слова: качество медицинской помощи; материнская смертность; критические состояния в акушерстве; факторы риска; дефекты медицинской помощи.■ The article presents material about critical states in obstetric and gynecologic practice ("near miss"), obtained on the basis of their own research, as well as the data of domestic and foreign authors. It is shown that the main factor determining the outcome of the pregnancy and birth, is the quality of medical care provided to the woman. The characteristics of "near miss", indicated the risk factors for its occurrence. A measure of the health care until serious complications of pregnancy and childbirth, as well as possible ways to reduce the frequency of their development.

There were summarized the results of discussion concerning problems of bioethics, deontology, patients rights and juridical resonsibility of obstetrician and gynecologists.

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Summary: Diurnal rhythms of the activity of a number of monoaminergic systems of the hypothalamus (norepinephrine and serotonin in PA and ME-ArN, as well as dopamine in ME-ArN) have been shown to depend on the functioning of an endogenous circadian oscillator in SCN of the hypothalamus. Light modifies the diurnal rhythms of the neurotransmitters. Enhancement of the activity of the noradrenergic systems with sex steroids in proestrus is an important mechanism of the forming of the preovulatory surge of GnRH and gonadotropines secretion, which initiates ovulation. Consideration of our own experimental data and literature allow the supposition that the change of diurnal rhythms of norepinephrine in PA and ME-ArN could result in profound disturbances of hypothalamic regulation of reproductive cycles and be one of key reasons for negative effect of xenobiotics on reproduction. Supported by RFBR grant 04-04-49204.