The formation of adolescent reproductive health is the main trigger of demographic growth. This process is based on knowledge about the need to preserve reproductive health, its relationship with somatic and mental health, risk factors and the basics of prevention of disorders. The Russian system of reproductive health protection of children and adolescents is much more effective than similar systems in foreign countries. It includes a more advanced mechanism of preventive examinations, built on respect for the traditional values of the family as a union of men and women, care for the younger generation, sexual integrity of minors. The paper shows the specific achievements of the pediatric and adolescent gynecology service of the Tyumen region: solving the personnel problem, reducing the gynecological morbidity of minors, reducing the frequency of pregnancies and its termination in girls under the age of 18. These achievements are based on consistent work on teaching the basics of hygiene, on the formation of health-preserving reproductive behavior and safe reproductive behavior in minors: schoolchildren, students of secondary specialized educational institutions. At the same time, reproductive losses, which compete with childbirth in their frequency, are a serious obstacle to solving urgent demographic problems. The authors see the solution to the problem in the formation of a cult of a healthy lifestyle among adolescents, creation of effective conditions for the timely detection and treatment of gynecological diseases in minors.

Introduction. The reproductive experience of women 18–44 years of age is quantitatively superior to adolescent girls. The structure of reproductive losses of adolescents, its identity or difference in comparison with women of reproductive age is extremely unexplored.Aim. To compare the structure of reproductive losses of adolescents and women of reproductive age on the example of the Tyumen region.Materials and methods. A retro-prospective analytical study carried out. Study period – 2016–2021. Adolescent girls and women of reproductive age with completed pregnancies included.Results and discussion. In the Tyumen region, the frequency of reproductive losses approaches childbirth (42.83% and 57.17%), mainly represented by medical abortion (59.98%). The proportion of completed pregnancies among adolescent girls (1.14%) is  inferior to women of reproductive age (98.86%). Adolescent girls are characterized by the completion of pregnancy by childbirth (OR = 1.68), a high frequency of medical abortion (OR = 1.71). Reproductive losses up to 12 weeks distinguish completed pregnancies in women of reproductive age (OR = 1.68); unsuccessful abortion attempt, criminal and unspecified types of abortion before 12 weeks and other abnormal products of conception after 12 weeks are their exclusive markers. The pregnancy outcome is associated with age: with adolescents – medical abortion before (OR = 1.71) and after 12 weeks (OR = 2.01); with reproductive age – other abnormal products of conception (OR = 1.64) and ectopic pregnancy (OR = 6.15). Reproductive losses are associated with gestational age before/after 12 weeks: with adolescents – spontaneous abortion after 12 weeks (OR = 2.55); with reproductive age – other types of abortion (OR = 20.37), medical abortion (OR = 1.93), other abnormal products of conception (OR = 1.89) before 12 weeks and spontaneous abortion (OR = 5.42) after 12 weeks.Conclusion. In the Tyumen region, reproductive losses in frequency compete with childbirth. Augmented the concept of the abortion-contraceptive behavior of modern society based on the association of medical abortion with adolescent girls that we have identified. The structure of reproductive losses is associated with a woman’s age period and gestational age.

Introduction. Studies show that up to 8 % of pregnant women suffer from eating disorders. Such problems are found everywhere, most often women do not even realize that this may be related to problems. And for pregnant women, this issue is most relevant, since there is a risk of complications of the gestation period, after which it is necessary to prevent unfavorable variants of the course of pregnancy and childbirth.   Aim. To study the variants of eating disorders in pregnant women to assess the prognosis of pregnancy.   Materials and methods. We conducted a retrospective analysis of clinical case histories of pregnant women (n = 267), followed by a survey of women on the basis of the State Medical Institution “Maternity Hospital No. 2” in Tyumen. The study period is from 2019–2022. Two groups were identified for the analysis: 1st  – BMI of 18.5–24.9 kg/m2 : 2nd  – BMI of 25 kg/m2  or more. In order to determine the type of eating disorder, we used various versions of questionnaires.   Results. Of the total number of women surveyed, overweight (BMI) was determined in 149/267 (55.9 %, 2 group), in 118/267 (44.1 %, 1 group), BMI was within normal values. Risk factors were identified for the groups that could affect the course of the gestational process in the case of an identified eating disorder. When assessing comorbidity, gynecological diseases were detected, pathologies were significantly more common for group 2 62/149 (41.6 %). The dependence of the presence of a violation of any type of eating behavior and the risk of possible complications of pregnancy is not statistically significant.   Conclusions. To maximize the favorable course of pregnancy and reduce the risk of possible complications, it is necessary to prepare a plan of preventive measures, which will include nutrition planning with a detailed description of solutions for a certain type of eating disorder.

Introduction. Subclinical hypothyroidism occurs in 2–3% of pregnant women and is often associated with pregnancy complications, including preterm birth.Aim – to study correlations between thyroid dysfunction and pregnancy outcomes.Materials and methods. 64 clinical cases of managing pregnant women in the Perinatal Center (Tyumen) were analyzed for 2017– 2021: 28 women with thyroid-stimulating hormone (TSH) > 2.5 mU/l, 36 women with TSH ≤ 2.5 mU/l) during the entire period of pregnancy. Quantitative features are described by absolute and relative (percentage) indicators. The probability of outcome depending on the presence of a clinical-amnestic factor was assessed by determining the relative risk (RR) and 95% confidence interval (CI). The level of statistical significance in testing the null hypothesis is p < 0.05.Results. There were no differences in pregnant women with and without subclinical hypothyroidism when considering such medical and social factors as age, marital status, work, education, nicotine addiction, obesity, kidney disease. An increased risk of preterm delivery was found in patients with a TSH level > 2.5 mU/l: RR 1.41 (0.59–3.37), especially against the background of a positive test for antibodies to thyroperoxidase: RR 1.63 (0.62–4.28). In the absence of treatment, the risk of early delivery, preterm birth, preeclampsia was revealed.Conclusions. A universal approach to determining the threshold values of TSH for the diagnosis of subclinical hypothyroidism in pregnant women, to the need and tactics of its treatment has not been developed. Diseases of the thyroid gland are endemic for Western Siberia, often associated with iron deficiency anemia, their high frequency in the anamnesis of pregnant women is  noted. Establishing a  correlation between subclinical hypothyroidism, hormonal correction and pregnancy complications requires further research. An obstacle is the lack of proper diagnosis of the TSH level in women who give birth on an emergency basis in early gestational periods.

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