Anemia is a common condition in women of childbearing age which is associated with wide spread hyperplastic processes in the uterus (leiomyomas, etc.) and abnormal and/ or abundant uterine bleeding (AUB). Our study has considered the main causes of bleeding and the therapy aimed on limiting the amount of blood loss, as well as preoperative treatment of iron deficiency in women with uterine leiomyomas, planning for pregnancy.The combination of anemia with other abnormalities in the woman's health status is associated with complications during pregnancy such as premature births, the birth of small children and failure of the formation of neural tube in iron deficiency and hypoxia. During the treatment of iron deficiency anemia (IDA) with saline iron, we noted severity and pain in the stomach in 11.9% of patients, nausea in 13.1%, constipation in 21.4%, and diarrhea in 7.1% of women. Such complications did not occur while treating with ferric iron. The use of drugs Iron III hydroxide polymaltozate in women after the end of lactation resulted in normalization of the blood hemoglobin within 30 days and the number of erythrocytes and of serum ferritin by the 90th day.

Constipation is one of the most common problems. About half of pregnant women experience stool retention, which occurs due to maternal physiological changes in pregnancy: the action of progesterone, uterine growth and other causes, can cause complications of pregnancy, childbirth and the postpartum period and requires treatment. However, this condition is not discussed enough among obstetrician-gynecologists. In the authors’ opinion, the importance of the problem is underestimated. The clinical data provided in the text of the article show that intestinal biocenosis disorder due to chronic colostasis in pregnant women can become a predisposing factor for bacterial vaginosis. In addition, constipation in pregnancy is one of the risk factors that may increase the rate of preterm birth, premature rupture of membranes, birth of small-for-date babies and other complications. For these reasons, the problem demands close attention of the medical community. The article provides basic information about the causes, endocrine, metabolic and other prerequisites for constipation, the features of their manifestations during pregnancy, possible complications, modern pharmacological and non-pharmacological treatments and lifestyle correction capabilities. The authors provided a list of essential drugs to treat constipation, described indications and contraindications for use of such drugs during pregnancy and listed side effects. Sodium picosulfate may be used in the second and third trimesters, which restores the passage of stools in the intestine in a short time and is not contraindicated in a pregnancy. Consideration has been given to the usage of the drug in the practice of obstetrician-gynecologists.

Data on the health status of the population of the indigenous small-numbered peoples of the North of Khanty and Mansi, who migrated to the city and changed the traditional nomadic way of life, are few and not systematized.The aim of the study was to study the course of pregnancy and childbirth among the indigenous peoples of the north who migrated and live in the city of Khanty-Mansiysk, Khanty-Mansiysk Autonomous Okrug-Yugra. An increase in the frequency of gynecological diseases was revealed: menstrual irregularities (in 38.5%), inflammatory diseases of the cervix (in 42.3%) and inflammatory diseases of the uterus (in 19.2%). Half of the observed women had gastritis (50%), cholecystitis (51.9%), every fourth cystitis (23.1%), anemia was diagnosed in every third in 30.8%. Pregnancy in women of the study cohort was often complicated by early toxicosis, anemia, gestational diabetes mellitus, threatening premature birth. Childbirth in pregnant women from among the indigenous small peoples of the north living in the city was complicated by anomalies in labor, indications for emergency operative delivery. This requires further study of the health status of the indigenous peoples of the north and the development of a health improvement program.Materials and methods. The course of pregnancy, childbirth and the postpartum period was retrospectively analyzed in 168 women selected by the continuous sampling method. Women from the Khanty and Mansi KMNS living in the village of Berezovo, in the camps and in Khanty-Mansiysk were examined. Statistical processing was performed in the software package SPSS, Statistica 8.0, as well as using the Microsoft Excel analysis package.Results. The results of the study showed that the least number of deviations in the state of health were among women from the number of KMNS living in the village and in the camps and leading a traditional nomadic lifestyle. The course of pregnancy rarely had complications and 100% of women ended in spontaneous labor on time.Conclusion. The urbanization of women from among the indigenous small-numbered peoples of the north has an adverse effect on the state of somatic and reproductive health, characterized by a high frequency of gynecological diseases, pregnancy complications, labor anomalies and operative delivery.

Цель обзора: анализ современных научных публикаций, посвященных прогнозированию и предупреждению основных осложнений беременности, в том числе врожденных пороков развития плода. Основные положения. Применение фолиевой кислоты в периконцепционном периоде снижает риск первичных и вторичных дефектов нервной трубки плода. Рационально дополнение рациона питания женщины в период подготовки и во время беременности витаминно-минеральными комплексами, имеющими в составе фолиевую кислоту. В настоящее время с целью профилактики дефицита фолиевой кислоты и других витаминов и минералов активно применяют препараты линейки Элевит. Заключение. Использование витаминно-минеральных комплексов обеспечивает улучшение здоровья женщин, что способствует нормальному течению беременности и рождению здоровых детей. Ключевые слова: прегравидарная подготовка, беременность, фолаты, эссенциальные микронутриенты, поливитаминный комплекс.

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