Annotation. As of today, there is no effective method for treating the fetoplacental dysfunction (FPD) in pregnant women with preeclampsia. The aim of research was the study of the method proposed by the authors for restoring the functional activity of the fetoplacental complex in pregnant women with FPD on the background of treatment of preeclampsia. А randomized controlled study of the effect proposed treatment (intravenous solution of pentoxifylline; solution containing arginine hydrochloride and levocarnitine; rheosorbilact) of 37 pregnant women at 35-40 weeks of gestation with FPD on the background of moderate preeclampsia, was performed. Such ultrasound doppler measurements have been studied: systolic-diastolic ratio, resistance index, pulsation index in the umbilical arteries, right and left uterine arteries, fetal middle cerebral artery, fetal internal carotid artery and fetal aorta before and after the performed treatment. Statistics were processed using LibreOffice Calc (Mozilla Public License v 2.0), adapted for medical and biological research. We used nonparametric Wilcoxon criteria, Mann-Whitney criteria at a significance level of p <0.05. After the performed treatment, stabilization of the fetoplacental blood circulation in women of the main group was observed, which manifested by decrease in S/D in umbilical artery in 1.3 times, in the left uterine artery in 1.4 times and in the fetal aorta in 1,1 times, and decrease in RI indices in the umbilical artery in 1.1 times, in the right uterine artery in 1.3 times, and increase in the middle cerebral artery in 1.4 times. So, in the course of the proposed treatment, the restoration of the blood flow velocity and the stabilization of vascular resistance in uterine arteries and the umbilical artery were observed in the women of the main group. The research of the possibility of using the above methodology in earlier gestational age and in the risk group for the prevention of preeclampsia is prospective and requires further attention.
According to WHO, now on the planet 46% of women are over the age of 45 years, among women in Ukraine – this is almost half (13.2 million). Of these, 46-68% suffer from climacteric syndrome. An increase in the duration of a healthy life and prolongation of the age of working capacity acquire not only medical, but also socio-economic significance, both in Ukraine and in other European countries. Therefore, the aim of the study was a comprehensive (involving pituitary, ovarian, adrenal and thyroid hormones) hormonal examination of women of peri- and postmenopausal age with menopause syndrome to identify the most likely hormonal predictors of this pathology. For this purpose, 64 women of perimenopausal and postmenopausal age with menopause and 42 healthy women of the same age categories had a study of the concentration of pituitary (LH, FSH, prolactin), ovarian hormones (estradiol, progesterone, testosterone), thyroid hormones (TSH, triiodothyronine (T3), thyroxine (T4)) and adrenal glands (DHEA-s, cortisol) in blood plasma. Hormones were determined using a set of test systems from “Immunotech” (Czech Republic-France) using the radio-immune method. Comparisons of the quantitative data of the two related groups (before and after treatment) were made using Wilcoxon signed rank test. When differences were detected, pairwise group comparisons were performed using the Mann-Whitney test. In women of perimenopausal and postmenopausal age with menopause syndrome, compared with healthy women of the same age groups, a significant increase in gonadotropin levels (LH by 3.7 and 3.0 times, respectively; FSH by 1.6 and 1.9 times) and a decrease indicator of prolactin in 1.5 and 1.2 times; estradiol 1.2 and 2.2 times and testosterone 2.9 and 2.4 times. A significant decrease in progesterone by 1.9 times occurred only in the group of postmenopausal women with menopause syndrome. In women of perimenopausal and postmenopausal age of the main group, a significant decrease was found in comparison with the control of DHEA-s levels by 1.3 times and 2.2 times, respectively; cortisol 1.2 and 2.0 times; TSH is 2.6 times and 2.0 times, respectively, however, thyroxine tended to increase (the probability p<0.05 was valid only for women of perimenopausal age). Thus, in postmenopausal women with menopausal syndrome, hormonal imbalance is more pronounced, indicating a deep atrophy of hormone-dependent tissue receptors and, as a result, a deepening of involutive processes.
The number of appeals of migrant women and servicewomen for specialized gynecological care has increased during the years of the armed conflict in Eastern Ukraine. The aim of the work was a comprehensive study of the hormonal function of pituitary gland, ovaries, thyroid gland and adrenal glands in women of reproductive age with various types of menstrual cycle disorders caused by a prolonged stressful situation. Materials and methods. With the help of immune-enzyme analysis the authors have conducted a study of pituitary hormones (FSH, LH, prolactin), ovarian hormones (estradiol, progesterone, free T), thyroid hormones (TSH, FТ 4) and thyroid peroxidase antibodies, as well as adrenal glands hormones (ACTH, cortisol (urine), DHEA-s) of 74 migrant women and servicewomen with menstrual disorders caused by a stressful situation. According to complaints, women were divided into 2 subgroups: with amenorrhea 34 (45.9 %) and abnormal uterine bleeding-40 (54.1 %). Results. Women with stressed amenorrhea had a significant 2 times (P < 0.05) increase in FSH; 1.9 times-LH; 1.6 timesprolactin (which is not typical for classical hyperprolactinemia) and 3.2 times decrease in estradiol, 3.9 times-progesterone in comparison to the control group. Dysfunction of the thyroid gland was recorded, in particular 2 times decrease in FT 4 and 1.7 times increase in thyroperoxidase antibodies relative to the control. A significant 1.6 times increase in ACTH, 1.8 times increase in cortisol (urine) and 1.6 times increase in DHEA-s were detected compared with the control. Women with abnormal uterine bleeding had a significant 1.5 times (P < 0.05) increase in prolactin, 1.3 times increase in estradiol, and a 2.5 times decrease in progesterone compared to the control women group. 90.5 % of women of reproductive age with menstrual cycle disorders caused by the influence of prolonged stress factor had hormonal disorders of the ovaries, adrenal glands and thyroid gland. Conclusions. In women with stress-related amenorrhea there is a violation of the relationship in the hypothalamic-pituitary system while maintaining the negative feedback loops of the pituitary-ovarian axis or ovarian depletion; post-traumatic stress disorders have a significant pathological effect on the reproductive system of women who have experienced such suffering.
Annotation. We used PubMed, Cochrane Library, Google Scholar databases, mostly referring to publications from the last five years (2016–2020). The long-term persistence of oncogenic types of human papilloma virus is the main etiological factor for cervical intraepithelial neoplasia (CIN). Prolonged persistence of herpes infection can also have a transformative effect on cervical epithelium. Since this pathology is most often diagnosed in women of reproductive age, the maximum preservation of reproductive function, prevention of perinatal complications requires the search for new conservative CIN treatments aimed at the complete elimination of viruses and neoplastic cells. The effectiveness of conservative antiviral therapy of CIN I, II without the use of surgical methods has been proved, especially in women who have not fulfilled their reproductive plans. In addition, antiviral therapy during pre- and postoperative periods contributes to the reduction of complications and relapses in women with severe cervical neoplasia.
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