BACKGROUND: According to WHO (2015), abortion complications account for 8% of maternal deaths. These statistics have prompted the search for new ways to safely terminate early pregnancy. In 2010, at the World Congress of Obstetricians and Gynecologists in Lisbon, medical abortion was called a world revolution. Due to the introduction of medical abortion, maternal mortality after abortion decreased by 20,000 persons in 2012. Medical abortion using prostaglandin preparations, which can be used to solve this problem, is safer than surgical abortion, since curettage of the uterine cavity can cause inflammation, mechanical trauma, and infertility. In the Russian Federation, a prostaglandin preparation (misoprostol 200 mcg) has been certified for medical termination of pregnancy. However, this drug is expensive, as it is manufactured through complex chemical synthesis. At the Ufa Institute of Chemistry, Russian Academy of Sciences (UIC, RAS), due to a directed search for uterotonics among 11-deoxyprostaglandins of the E- and F-groups, a promising analog of prostaglandin E1 with a higher uterotonic activity than misoprostol was revealed. The agent is 11-deoxymisoprostol (11-DMP), which is several times cheaper and more accessible for synthesis. AIM: This study aimed to compare the pharmacological properties of misoprostol and 11-deoxymisoprostol. MATERIALS AND METHODS: The experiments were performed on non-linear white rats weighing 190210 g. The animals were fed with a standard diet for the entire experimental period. Animals were monitored and assessed on a daily basis. Animals were divided into six experimental groups, using their body weight as the main criterion for randomization (deviation of body weight values within the group was no more than 10%), with 20 animals in each experimental group. The drug was administered intragastrically at a dose of 10 mg/kg. To assess the immunotoxic properties, we studied the indicators of nonspecific and specific humoral immunity and cellular immunity in rats and assessed its effect on the mass of lymphoid organs and their cellularity. The allergenic properties of 11-DMP were evaluated using the methods of anaphylactic shock, indirect reaction of mast cell degranulation, reaction of immune complexes, and conjunctival test. RESULTS: After administration of 11-DMP, a decrease in the rate of weight gain, changes in behavior, and death of animals were not observed in any of the studied groups of males or females. The fertility index did not differ significantly in all experimental groups. The average number of fetuses per female, the sex ratio of rat pups, and the death rate of newborn rat pups did not change in the broods of all experimental groups. The study of the allergenic effect of the drug revealed that 11-DMP does not have allergenic properties, as shown by the reactions of mast cell degranulation, immune complexes, and the conjunctival test. CONCLUSIONS: When studying the pharmacological properties, it was revealed that 11-DMP compared with misoprostol has higher uterotonic properties; the therapeutic margin is 2 times greater, the toxicity is 2 times lower, and it is more stable and has a more accessible route of chemical synthesis.

Isthmic-cervical insufficiency (ICI) is one of the main causes of recurrent miscarriage, leading to an increase in perinatal mortality rates and a deterioration of womens reproductive health. There are currently several methods for diagnosing ICI during pregnancy. In the non-pregnant state, its diagnosis is mainly made retrospectively based on a history of preterm birth due to shortening of the cervix. The main treatment for ICI during pregnancy is cervical cerclage. Despite the well-established technique, this surgical intervention is not always effective for prolonging pregnancy and is associated certain pregnancy risks, including uterine contractions, bleeding, and infection. Cases of cervical rupture after suturing have also been reported, which can ultimately lead to miscarriage or preterm delivery. There have been repeated cases of pregnancy loss in women even after the timely detection of ICI and surgical treatment, suggesting that these women are at risk of miscarriage in the future. For such patients, it is necessary to develop an examination algorithm to identify the various aspects of their cervical insufficiency and treatment at the pregravid stage.

Uterine leiomyoma occurs in women over 35 years of age in 25–30% and in pregnant women in about 3–12%. However, in 10% of pregnant women, it turns out to be an accidental finding and is detected by ultrasound examination in the first trimester of pregnancy Approximately 10–30% of pregnant women with uterine leiomyoma have complications during pregnancy, childbirth and the postpartum period. The article demonstrates a case of successful delivery in a patient with uterine myoma at full-term pregnancy with preservation of reproductive function in a maternity hospital of the 3rd level. In the period of 38–39 weeks, the patient was hospitalized in the maternity hospital. By the decision of the council, the pregnant woman was prepared for a planned operative delivery. A lower median laparotomy was performed for adequate access. Performed caesarean section in the lower segment according to Defler. During the operation, a live, full-term girl weighing 3600 g and height 53 cm, 7/8 points on the Apgar scale was extracted. On the left, along the anterior surface of the uterus in the bottom area, a subserous myomatous node on a pedicle is determined, measuring 300*220*150 mm. Blunt and sharp dissection of adhesions was performed, followed by removal of a myomatous node weighing more than 1 kg. The postoperative period was uneventful. The patient was discharged on the 5th day. In our clinical case, a successful myomectomy was performed during a planned caesarean section. This type of surgery can be considered a safe option in carefully selected cases and a cost-effective method. However, this method should be performed by experienced surgeons who are skilled in the technique and take into account the size and location of the myomatous node.

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Placental in-growth is a severe obstetric pathology characterized by invasive placentation and associated with a high-risk of life-threatening hemorrhage. Despite the widespread use of instrumental methods of examination, timely diagnosis of placental in-growth is a challenging issue. Here, we reviewed the existing biochemical markers used for early detection and confirmation of placental in-growth, their specificity and sensitivity, and correlation with gestational age. Significant results were found for the following substances: pregnancy-associated plasma protein A (PAPP-A) in the first trimester, alpha-fetoprotein (AFP) and human beta-chorionic gonadotropin (Beta-hCG) in the second trimester, brain natriuretic peptide, antithrombin III, plasminogen activator inhibitor type I, soluble Tie-2 receptor (endothelial cell-specific tyrosine kinase receptor), and soluble vascular endothelial growth factor receptor-2. Our findings support the use of the aforementioned biomarkers as screening method for placental in-growth in medical practice.