Vol 18, No 6 (2016)

In this systematic review of scientific literature on stress-related menstrual disorders we summarize the results presented in papers, published in course of last 15 years and indexed in Pubmed. We describe contemporary theories considering the mechanism of psychogenic menstrual disorders development and review their specific features. We identify certain characteristics of sensitivity to stress and personality traits in women, reacting on stress with menstrual disorder. We also describe certain non-pharmacologic psychotherapeutic approaches to the management of these disorders.

The aim of this study was to evaluate bone mineral density (BMD) changes depending on the performance of follicle stimulating hormone and identification thresholds of the hormone, the formation of osteoporotic changes in women during the menopausal transition. The results showed a negative correlation between the levels of follicle stimulating hormone and lumbar spine BMD in women during the menopausal transition (r=-0.44; p=0.001). In assessing BMD fluctuations depending on the level of follicle stimulating hormone was determined classification threshold of this hormone, amounting to 34.7 mIU/ml in which the increased risk of osteoporotic changes. The odds ratio for the formation of these disorders in menopausal transition period amounted to 3.063 (1.558-6.022).

Heartburn is one of the most common complaints during pregnancy. In a number of heartburn pregnant studies it is isolated as a separate symptom that appears on the background of pregnancy and due to it. The urgency of the problem of heartburn among pregnant women is due to its high prevalence, the close relationship with the subsequent development of gastroesophageal reflux disease and with reduced quality of life. Due to the proven efficacy, safety and lack of side effects alginate-containing drugs such as Gaviscon Forte are the drugs of choice for the treatment of heartburn during pregnancy. Indicators of efficiency and safety of the drug Gaviscon Forte are confirmed by numerous clinical and toxicological studies that can be recommended for use in pregnant and lactating women.

Literary data on a problem of the influence of tuberculosis on pregnancy and its development, the course of childbirth and the early postnatal period, and also on development of the fetus and the newborn are presented in the article. Most of authors indicate negative influence of a specific infection, however this opinion isn't unambiguous. Absolute indications and contraindications for interruption of pregnancy at women with lung tuberculosis are listed, however the final decision on incubation of pregnancy depends on the mother. Therefore, phthisiatricians, obstetricians - gynecologists and pediatricians, recently, are even more often anxious about the problem of preservation of life of both the fetus and the mother with lung tuberculosis.

June 27, 2016 the IX regional forum «Mother and Child», began its work in Sochi. In its framework, a symposium devoted to one of actual problems of obstetrics and gynecology - hormonal contraception and its role in the preservation of women's reproductive health took place.

The changes in the consist of immune cells which are adaptive in the reproductive system during pregnancy are discussed. An insolvency of modulation of immune responses on the part of the mother's body if accompanied by bacterial or viral infection leads to a significant imbalance in the immune system of women, which is reflected in gestation and the postnatal development of the child. Studies concerning the prevention of respiratory infections with the help of inactivated influenza vaccines have proved their efficacy and safety but still it is has been discussing the possibility of the existence of different mechanisms of post-vaccination immune response after immunization with unadjuvanted and adjuvanted influenza vaccines depending on the trimester. However, the possibility of the existence of different mechanisms of post-vaccination immune response when administered adjuvanted and unadjuvanted influenza vaccines is still examining. An answer on this question will help to make the proper selection of vaccines according to the trimester of pregnancy.

Relevance. Saving women's reproductive health and safe motherhood is a priority task of modern medicine throughout the world. Goal. The study of individual parameters, such as biochemical profile, characterized by the presence of adaptive changes in patients using hormonal contraceptives. Materials and methods. The article presents surveillance data for 220 female patients who used hormonal contraception. All patients were examined using clinical and laboratory diagnostic methods: the anamnestic, clinical, ultrasound (pelvic organs, mammary glands), biochemical blood tests. Results. The findings suggest that when taking combined oral contraceptives in the first 3 months in the body of patients adaptive changes occur, the reflection of which - statistically significant deviations of individual parameters biochemical profile (total blood protein, bilirubin, alanineaminotransferase, asparaginaminotransferaza, alkaline phosphatase). Using vaginal hormonal contraceptive does not lead to statistically significant changes in a number of biochemical parameters, which change the first 3 months of oral hormonal contraceptives. Conclusion. Hormonal contraceptive vaginal use is preferred in patients with gastrointestinal disease.

Mastodynia is a condition characterized by painful sensations in the breasts. It is diagnosed in middle-aged women in the reproductive 50%, while in the older age group it is significant; y lower - 5%. Pain in the breast may be cyclic and non-cyclic in nature. Cyclical is associated with the hormonal changes of the menstrual cycle, bilateral, more pronounced in the upper outer quadrant of the breast. Non-cyclic is permanent or intermittent in nature, one-way. Their cause is stretching in the Cooper ligaments, smoking, ductal ectasia, mastitis, an inflammatory cancer, pregnancy, thrombosis, trauma, cysts, previous breast surgery and the use of drugs. Diagnosis mastalgia includes patient survey, physical examination, ultrasound scan, and mammography. Treatment consists in the normalization of diet, and symptomatic medication.

The article presents the epidemiology and classification of pelvic pain in women, etiological factors, current concept of pathogenesis of chronic pelvic pain syndrome. To-date integrated approach to management of patients with pelvic pain, including extensive examination and multidisciplinary approach to treatment and rehabilitation is elucidated. The principles of surgical treatment, drug therapy, physiotherapy and psychological rehabilitation are covered.

In modern urogynecological practice around the world in addition to traditional surgical methods of treatment of genital prolapse and stress urinary incontinence, new, high-performance methods associated with the use of erbium lasers are used. These technologies make it possible to safely carry out the correction of this disease and its associated states without the rehabilitation period. Now the intimate problems of patients in the perimenopausal period can be solved, and post-natal rehabilitation carried out without mucosal damage to the vaginal canal in an outpatient setting.

The authors conducted a study on the outcomes of assisted reproductive technology (ART) in patients with infectious - inflammatory and dysplastic cervical disease. The results indicate that the pathology of the cervix can be a co-factor for unfavorable outcome of ART protocols. In this connection, the authors put the task of improving the efficiency of ART programs, through in-depth examination and optimization methods and timing of the treatment of cervical pathology before the ART protocols.