Objective: to study the microbiota of the vagina, myomatous nodes, their bed in patients with fibroids. Materials and methods: a comprehensive examination of 83 patients aged 26 to 50 years with diagnosed interstitial, interstitial-subserous uterine myoma was carried out. By age, all women are divided into 3 groups. Standard clinical and clinical laboratory studies, colposcopy, microbiological examination of the detachable posterior vaginal fornix, biopsy specimens of myomatous nodes and their bed, as well as morphological examination of biopsy specimens of myomatous nodes and their bed were performed.Results: in the structure of clinical manifestations of uterine fibroids, pain syndrome was the leading one (p<0.05). The number of myoma nodes in patients varied from 1 to 22. The duration of the operation and the amount of blood loss did not differ significantly (p>0.05). According to the results of a bacteriological study of the detachable posterior vaginal fornix in patients in the 2nd group, a decrease in the frequency of detection and the number of lactobacilli was revealed compared to the 1st group, and in women in the 3rd group, these microorganisms were absent. Among the anaerobic microorganisms in the 1st and 2nd groups, Eubacterium spp. dominated, in the 3rd — Peptostreptococcus spp. In patients of group 3, the frequency of detection of Bacteroides spp. was significantly increased (p<0.05). Among the aerobic spectrum of microorganisms in all groups, coagulasenegative staphylococci predominated. In a bacteriological study of biopsy specimens, the absence of growth of microorganisms in myomatous nodes was observed in 7.2% of cases, in the tissue of the bed of myomatous nodes in 17.7%. The microbiota of myomatous nodes and their bed in most cases was represented by anaerobic taxa. According to the results of a morphological study of biopsy specimens, no inflammatory reaction of tissues was detected. Conclusions: In women with uterine myoma of different age groups, multidirectional changes in the vaginal microbiota were revealed. In most cases, the myomatous node (92.8%) and its bed (82.3%) are not sterile with the dominance of anaerobic microbiota taxa. Identified significant correlations in the loci «vagina – myomatous node – myomatous node bed» indicate their relationship. The detection of various taxa of microorganisms in the myomatous node and its bed, according to morphological studies, is not associated with the presence of infectious and inflammatory processes in the tissues.

Objective: to evaluate the results of treatment of patients after undergoing surgical hemostasis in obstetric hypotonic bleeding. Materials and methods: the 31 patients were examined, whose delivery was complicated by hypotonic uterine bleeding, and as a result, surgical hemostasis was performed in the amount of ligation of the ovarian and internal iliac artery. Anthropometric data were analyzed, as well as the dynamics of the results of laboratory and instrumental research methods before and after surgery. In the late postoperative period, the results of helical computed tomography (CT) under angiography conditions were evaluated in the period from 6 months to 5 years. Statistical processing was carried out using the IBM SPSS Statistics 25 program. Results: the age, anamnestic data, anatomical and physiological parameters of patients, terms of delivery and their outcome did not become predictors of developed hypotonic bleeding. Early postpartum bleeding was determined in 93,5% of cases. Extirpation of the uterus was performed in 9,7% of cases. The median blood loss was 1200,0 ml, blood loss of 45-50% of the BCC was determined in 19,4%, 35–45% of the BCC was also in 19,4%. The reduced level of erythrocytes persisted until the moment of discharge, and the reduced hemoglobin after the operation tended to increase. In the course of CT, in 100% of cases, defects in the contrasting of the internal iliac artery on both sides were determined. Collateral circulation was also developed in 100,0% of cases, despite the type of defect in the internal iliac artery. Conclusions: ligation of the ovarian and internal iliac artery is a reliable method of surgical hemostasis, which allows saving the uterus in 90,3% of cases. In the late postoperative period, all patients developed various degrees of arterial patency in the ligation zone, and collateral circulation developed on both sides.

Th e aim of the research. To evaluate the eff ectiveness of our proprietary developed compression suture on the uterus for stopping obstetric hypotonic bleeding. Material and methods. A retro- and prospective case-control study was carried out. The cohort of the examined patients (n=100) was divided into two groups: I – the patients with the original proprietary compression suturing (Patent No.2752549) (n=21); II – women with compression suturing applied according to A. Pereira et al. (n=79). Statistical data processing was performed using IBM SPSS Statistics 25 soft ware. Laboratory parameters, blood loss volume, the necessity of uterine extirpation, ligation of the ovarian and internal iliac arteries were compared. An echographic assessment of the uterus, uterine and ovarian vessels in the postoperative period was carried out. Results. The analysis has revealed the comparability of both groups in terms of the main indicators (age, height, weight, delivery time, results of clinical and laboratory examination). Th e necessity of ligation of the ovarian and internal iliac arteries was 4.8 % in group I and 11.4 % in group II. There were no cases of uterus removal in group I was while the percentage of extirpation in group II equalled 1.26 %. In group I, no blood loss amounting to 45-50 % of the CBV was found, while 6.3 % of group II patients had a blood loss equal to 45-50 % of the CBV. Echography in the postoperative period (from the 1st to the 7th day) showed adequate dynamics of uterus involution in all patients of both groups. Conclusion. Th erefore, the application of the proposed proprietary compression suture to the uterus during hypotonic bleeding is highly eff ective and is sufficient to stop bleeding in 95.2 % of the cases. There were no intraoperative or delayed complications in the postpartum period, which makes it possible to recommend the method for clinical use.

The article presents a case of diagnostics of arteriovenous thrombosis of the umbilical cord. At the gestational age of 36+4, ovoid echogenic parietal inclusions in the umbilical vein lumen and fragmented increase in the venous wall echogenicity were detected. One day later, a healthy preterm male child was born through natural delivery with the Apgar score of 6-7 and weight of 2280g. Histological analysis of placenta identified arteriovenous thrombosis combined with cavernous haemangioma of the umbilical cord.

No abstract