According to the modern classification system, chronic disorders of consciousness are defined as an altered state of consciousness that develops after coma and is accompanied by the restoration of wakefulness without the complete recovery of conscious activity for more than 28 days after traumatic brain injury. Clinical cases of chronic chronic disorders of consciousness development in women after surgical interventions related to various obstetrical and gynecological pathologies, as well as after routine surgical interventions for comorbid somatic pathology, are of particular interest to obstetricians and gynecologists. In the presented chronic chronic disorders of consciousness related clinical cases of operations for ectopic pregnancy, as well as consequences of elective surgery for gallstone disease, the development of hypo- and normogonadotropic ovarian insufficiency associated with chronic disorders of consciousness is described. The characteristics of the thyroid status, adrenocorticotropic function, and vitamin D levels are given. Further in-depth examination and accumulation of data on patients with chronic disorders of consciousness may provide an opportunity to determine informative markers for prognostication of outcomes, as well as to develop new effective approaches to consciousness rehabilitation in this category of patients.

Hypothesis/aims of study. Gestational diabetes mellitus (GDM) is one of the leading causes of perinatal morbidity and mortality. The use of assisted reproductive technologies (ART) is an independent risk factor for the development of GDM. Among other risk factors are overweight, diabetes burdened heredity, previous GDM, previous birth weight more than 4 kgs, stillbirth, miscarriage in history, glucosuria, polyhydramnios in this pregnancy, age over 30 years, polycystic ovary syndrome. The most significant risk factor for GDM is excess weight before pregnancy. The aim of this study was to investigate the risks of GDM in patients after ART. Study design, materials, and methods. 342 case histories of women with single pregnancy for the period 2014–2017 were studied on archival material. The main group consisted of 234 women with single pregnancy after ART. The comparison group comprised 108 medical records of fertile women with a history of single pregnancy that occurred spontaneously. The exclusion criteria in the comparison group were pregestational diabetes mellitus and severe extragenital pathology. Results. The incidence of GDM was significantly higher in the group of women in whom pregnancy occurred after ART compared to the comparison group (15.4 ± 0.4% and 5.5 ± 0.4% respectively). In the main group, patients were more likely to have overweight, extragenital pathology and pregnancy complications. Conclusion. The increase in the frequency of GDM among patients after ART is probably associated with late reproductive age, initially negative somatic background at the time of entry into the IVF protocols, as well as long-term hormone therapy during pregnancies after ART, starting from early terms.

Hypothesis/aims of study. Recently, due to empowering the improvement of care for patients with traumatic brain injury and creating effective methods of intensive therapy for severe brain lesions of various genesis, there has been a tendency towards an increased number of patients who have gone out of a coma into an unconscious state a vegetative state or an unresponsive wakefulness syndrome (BS / UWS). The functions of the brain stem and hypothalamus in patients in a BS / UWS are preserved. The aim of this study was to evaluate the significance of the relationship between the regulation of sex steroid hormones and the secretion of neurotransmitters. Study design, materials and methods. The study was performed using systematic analysis and compilation of literature data obtained by foreign and domestic authors over the period from 1931 to 2018. Results. This article reviews publications covering the relationship between the regulation of sex steroid hormones and the secretion of neurotransmitters, as well as their effect on the reproductive system. The theory of neurosecretion depicting the mechanisms of positive and negative feedback of the synthesis of neurotransmitters and sex steroid hormones, and the characteristics of the secretion machineries for sex hormones with normogonadotropic and hypogonadotropic pituitary insufficiency, and nonendocrine manifestations of the pathology of the hypothalamus is highlighted in this review. Conclusion. The hormonal profile of patients with chronic disorders of consciousness remains almost unstudied. A further study of the hormonal profile in this patient category will create the prerequisites for the development of pathogenetically substantiated hormone-modifying replacement therapy, which may have a positive effect on the dynamics of recovery of consciousness and improve treatment outcomes.

BACKGROUND: Chronic disorders of consciousness are rare clinical conditions that develop after coma and are accompanied by the restoration of wakefulness without the full restoration of consciousness 28 days or longer after brain damage. All women with chronic disorders of consciousness have menstrual irregularities such as oligomenorrhea or secondary amenorrhea. Clinical experience shows that recovery of the menstrual response in a number of patients with chronic disorders of consciousness precedes or is combined with recovery of clear consciousness. The results of a comprehensive examination of patients with different types of ovarian failure, depending on the type of chronic disorders of consciousness, have not been presented in the literature. Therefore, an analysis of the results of such an examination can become the basis for the selection of pathogenetically substantiated hormone-modulating therapy and the development of predictive models for assessing recovery of consciousness from chronic disorders of consciousness. AIM: The aim of this study was to assess the variants of ovarian failure in patients with different types of chronic disorders of consciousness and to develop prognostic models that evaluate the possibility of restoring consciousness. MATERIALS AND METHODS: This study enrolled 30 patients aged 18 to 44 years divided into three groups depending on the level of consciousness: vegetative state / unresponsive wakefulness syndrome (n = 12), minimally conscious state minus (n = 6), and minimally conscious state plus (n = 12). Here we examined lipid profile changes (total cholesterol, low-density lipoprotein, high-density lipoprotein) and levels of follicle-stimulating hormone, luteinizing hormone, prolactin, total testosterone, estradiol, free triiodothyronine, thyroxine, thyroid-stimulating hormone, adrenocorticotropic hormone, cortisol, and vitamin 25(OH)D in the blood, as well as levels of melatonin in the blood serum and 6-sulfatoxymelatonin in the urine. In addition, in the blood serum and cerebrospinal fluid, we evaluated levels of brain-derived neurotrophic factor, apoptosis antigen 1, Fas-ligand, glutamate, and S100 protein. We also performed ultrasound of the pelvic organs and mammary glands, magnetic resonance imaging of the chiasmal-sellar region, cervical screening, and genetic study (the prothrombin gene mutation and the Leiden factor). RESULTS: Hypogonadotropic and normogonadotropic ovarian failures were detected in 36.7% and 63.3% of patients, respectively. No differences in neurotrophin levels between the study groups were found. Three mathematical models were formulated for predicting the recovery of patients into a clear consciousness using the levels of thyroid-stimulating hormone, prolactin, follicle-stimulating hormone, anti-Mllerian hormone, total testosterone, and the age of patients. CONCLUSIONS: The presented prognostic models by determining hormone levels in the blood plasma allow for calculating the output of patients in clear consciousness. Further research and accumulation of data on patients with chronic disorders of consciousness are promising for the development of new effective approaches to the rehabilitation of this group of patients.

Endometriosis is a widespread gynecological disease, which affects reproductive-aged women. An accurate diagnosis is critical to develop a more comprehensive treatment strategy for endometriosis than is currently available. This article provides an overview of current data on the value of radiation techniques for the diagnosis of external genital and extragenital endometriosis, deep infiltrating endometriosis, and adenomyosis. The necessity of using a systematic approach to examine the pelvis in women with suspected endometriosis is shown, modern terms and methods of measurement being given to describe ultrasound picture of endometriosis.